FKR-31866-22263

4 vaccinations 4 coded responses 56 check-ins 3 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 232 / VA
Registered: 2021-03-14

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Registered dependents

FYA-22754-16501 Child or adolescent in my care · Female · 2022-04-22

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-13
Dose 1 — Janssen/Johnson & Johnson
2021-03-14
Registered in v-safe
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness, lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-20
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-06-12
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-09-11
Survey response — 6 months, dose 1
MedDRA: Pneumonia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Pneumonia

MedDRA releases: 2024-11 · check-in free text available
2021-09-11
Report sent to call center — 6 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-15
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-26
Dose 2 — Moderna
2021-10-26
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-11-02
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-01-25
Survey response — 3 months, dose 2
MedDRA: Cough, Dyspnoea, Fatigue, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cough, congestion, shortness of breathe, running nose, and fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Dose 3 — Moderna
2022-04-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2022-04-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-04-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2022-04-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-04-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-04-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-04-28
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-05-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-05-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-06-02
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-07-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-09-23
Dose 4 — Moderna
2022-09-23
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-09-24
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling, Itching · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-09-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-26
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Itching · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-30
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-07
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-14
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-21
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-28
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-04
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-23
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-26
Survey response — 6 months, dose 4
MedDRA: No adverse event — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Janssen/Johnson & Johnson
2	2021-10-26	Moderna	No
3	2022-04-21	Moderna	No
4	2022-09-23	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Dizziness, lightheaded

Release 9 — 6 months, dose 1

2021-09-11

Symptoms: Pneumonia

Release 11 — 3 months, dose 2

2022-01-25

Symptoms: Cough, congestion, shortness of breathe, running nose, and fatigue

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	No adverse event	·	·	✓
SD	Pneumonia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Dizziness	✓	✓	✓

✓ active code · ○ coded but marked inactive · blank = not in that release