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VPU-78484-72565

4 vaccinations 12 coded responses 33 check-ins 12 free-text entries 3 call cases
Sex
Female
Age at first dose
46-50
ZIP prefix
573 / SD
Registered
2021-04-08
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-04-08
    Registered in v-safe
  2. 2021-04-08
    Dose 1 — Janssen/Johnson & Johnson
  3. 2021-04-08
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-04-09
    Survey response — days 1–6 daily, dose 1
    MedDRA: Swelling — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, 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: Lump on left collarbone by neck.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-09
    Report sent to call center — days 1–6 daily, dose 1
    Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  6. 2021-04-10
    Survey response — days 1–6 daily, dose 1
    MedDRA: Bone swelling — Feeling: Fair · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Bump on collarbone
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-04-11
    Survey response — days 1–6 daily, dose 1
    MedDRA: Lymphadenopathy — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities
    Free text: Bump on collarbone
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-04-12
    Survey response — days 1–6 daily, dose 1
    MedDRA: Swelling — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Bump on collarbone
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-04-13
    Survey response — days 1–6 daily, dose 1
    MedDRA: Swelling — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities
    Free text: Bump on collarbone
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-04-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Swelling — Feeling: Fair
    Free text: Bump on collarbone
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-04-15
    Survey response — day 7, dose 1
    MedDRA: Swelling — Feeling: Good
    Free text: Bump on collarbone
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-22
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-04-29
    Health check-in — day 21, single dose
    Feeling: Good
    Adult check-in
  14. 2021-05-06
    Survey response — day 28, single dose
    MedDRA: Diarrhoea, Nausea, Vomiting — Feeling: Good · Be unable to work, Be unable to do your normal daily activities
    Free text: Nausea, vomiting, diarrhea
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-05-13
    Health check-in — day 35, single dose
    Feeling: Good
    Adult check-in
  16. 2021-05-20
    Health check-in — day 42, single dose
    Feeling: Good
    Adult check-in
  17. 2021-05-27
    Call successful
    Reported to VAERS voluntarily prior to GDIT contact
  18. 2021-07-08
    Health check-in — 3 months, dose 1
    Feeling: Good
    Adult check-in
  19. 2021-10-07
    Health check-in — 6 months, dose 1
    Feeling: Good
    Adult check-in
  20. 2021-10-25
    Dose 2 — Moderna
  21. 2021-10-31
    Survey response — days 1–6 daily, dose 2
    MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Lymph node on collarbone swollen & painful
    MedDRA releases: 2024-11 · check-in free text available
  22. 2021-11-01
    Survey response — day 7, dose 2
    MedDRA: Neck mass — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Lump on collarbone.
    MedDRA releases: 2024-11 · check-in free text available
  23. 2021-11-08
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-11-15
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-11-22
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-11-29
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-12-06
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  28. 2022-01-26
    Survey response — 3 months, dose 2
    MedDRA: COVID-19 — Feeling: Good · 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
  29. 2022-01-26
    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)
  30. 2022-02-07
    Call successful
    Participant prefers to complete VAERS report online
  31. 2022-04-03
    Dose 3 — Pfizer-BioNTech
  32. 2022-04-25
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  33. 2022-05-01
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  34. 2022-05-08
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  35. 2022-05-15
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  36. 2022-07-03
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  37. 2022-09-12
    Dose 4 — Moderna
  38. 2022-10-03
    Survey response — 6 months, dose 3
    MedDRA: Unevaluable event, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Hives · Healthcare visit (other): Check
    MedDRA releases: 2024-11 · check-in free text available
  39. 2022-10-03
    Report sent to call center — 6 months, dose 3
    Get care from a doctor or other healthcare professional
    1 call case(s)
  40. 2022-10-05
  41. 2022-10-05
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  42. 2022-10-07
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  43. 2022-10-10
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  44. 2022-10-17
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  45. 2022-10-24
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-04-08Janssen/Johnson & Johnson
22021-10-25Moderna No
32022-04-03Pfizer-BioNTech No
42022-09-12Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-04-09 Successful
2021-05-27
 Reported to VAERS voluntarily prior to GDIT contact
2022-01-26 Successful
2022-02-07
 Participant prefers to complete VAERS report online
2022-10-03 Successful
2022-10-05
 Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-09

Systemic reaction (other): Lump on left collarbone by neck.

2021-04-10

Systemic reaction (other): Bump on collarbone

2021-04-11

Systemic reaction (other): Bump on collarbone

2021-04-12

Systemic reaction (other): Bump on collarbone

2021-04-13

Systemic reaction (other): Bump on collarbone

2021-04-14

Systemic reaction (other): Bump on collarbone

Release 7 — day 7, dose 1

2021-04-15

Systemic reaction (other): Bump on collarbone

Release 8 — day 28, single dose

2021-05-06

Symptoms: Nausea, vomiting, diarrhea

Release 10 — days 1–6 daily, dose 2

2021-10-31

Systemic reaction (other): Lymph node on collarbone swollen & painful

Release 10 — day 7, dose 2

2021-11-01

Systemic reaction (other): Lump on collarbone.

Release 11 — 3 months, dose 2

2022-01-26

Symptoms: Covid

Release 12 — 6 months, dose 3

2022-10-03

Symptoms: Hives
Healthcare visit (other): Check

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

FieldPreferred term2021-092023-042024-11
HCVOUnevaluable event · · ✓
SDCOVID-19 · · ✓
SDDiarrhoea ✓ ✓ ✓
SDNausea ✓ ✓ ✓
SDUrticaria · · ✓
SDVomiting ✓ ✓ ✓
SROBone swelling ✓ ✓ ✓
SROLymph node pain · · ✓
SROLymphadenopathy ✓ ✓ ✓
SRONeck mass · · ✓
SROSwelling ✓ ✓ ✓

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

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