J3C-80627-64608

3 vaccinations 10 coded responses 32 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 430 / OH
Registered: 2021-03-07

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

Timeline

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

2021-03-04
Dose 1 — Janssen/Johnson & Johnson
2021-03-07
Registered in v-safe
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-06-03
Health check-in — 3 months, dose 1
Feeling: Fair

Adult check-in
2021-09-02
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-10-28
Dose 2 — Pfizer-BioNTech
2021-10-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-11-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-11-11
Survey response — day 14, dose 2
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe arthritis pain, full body

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Survey response — day 21, dose 2
MedDRA: Blepharospasm — Feeling: Good

Free text: Eye twitching

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-02
Survey response — day 35, dose 2
MedDRA: Oropharyngeal pain, Pruritus — Feeling: Fair

Free text: Sore throat, itchy

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-01-27
Survey response — 3 months, dose 2
MedDRA: COVID-19 — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Covid

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-31
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-02
Survey response — 6 months, dose 2
MedDRA: Hyperthyroidism — Feeling: Good

Free text: Hyperthyroidism

MedDRA releases: 2024-11 · check-in free text available
2022-10-21
Dose 3 — Moderna
2022-10-22
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-10-23
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-10-25
Survey response — days 1–6 daily, dose 3
MedDRA: Cold sweat — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Clammy skin

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Oropharyngeal pain, Pharyngeal erythema, Throat irritation — Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore red throat, itchy and cough

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Survey response — day 7, dose 3
MedDRA: Cough — Feeling: Fair

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2022-11-04
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-11-11
Survey response — day 21, dose 3
MedDRA: Chills, Cough, Oropharyngeal pain — Feeling: Fair

Free text: Sore throat and cough,chills

MedDRA releases: 2024-11 · check-in free text available
2022-11-20
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-12-02
Survey response — day 42, dose 3
MedDRA: Cough, Rhinorrhoea — Feeling: Poor · Be unable to do your normal daily activities

Free text: Dry persistent cough, runny nose

MedDRA releases: 2024-11 · check-in free text available
2023-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Janssen/Johnson & Johnson
2	2021-10-28	Pfizer-BioNTech	No
3	2022-10-21	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 10 — day 14, dose 2

2021-11-11

Symptoms: Severe arthritis pain, full body

Release 10 — day 21, dose 2

2021-11-18

Symptoms: Eye twitching

Release 10 — day 35, dose 2

2021-12-02

Symptoms: Sore throat, itchy

Release 11 — 3 months, dose 2

2022-01-27

Symptoms: Covid

Release 11 — 6 months, dose 2

2022-05-02

Symptoms: Hyperthyroidism

Release 12 — days 1–6 daily, dose 3

2022-10-25

Systemic reaction (other): Clammy skin

2022-10-26

Systemic reaction (other): Sore red throat, itchy and cough

Release 12 — day 7, dose 3

2022-10-28

Systemic reaction (other): Cough

Release 12 — day 21, dose 3

2022-11-11

Symptoms: Sore throat and cough,chills

Release 12 — day 42, dose 3

2022-12-02

Symptoms: Dry persistent cough, runny nose

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	Arthralgia	·	·	✓
SD	Blepharospasm	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Hyperthyroidism	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pruritus	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Cold sweat	·	·	✓
SRO	Cough	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pharyngeal erythema	·	·	✓
SRO	Throat irritation	·	·	✓

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