XX2-18031-34359

3 vaccinations 6 coded responses 28 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 183 / PA
Registered: 2021-04-01

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-04-01
Registered in v-safe
2021-04-01
Dose 1 — Janssen/Johnson & Johnson
2021-04-01
Health check-in — 0 day, dose 1
Feeling: Good · Site: Pain · Nausea

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Post-traumatic pain, Pre-existing disease, Procedural pain, Thirst — Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-08
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — 14 day, dose 1
Feeling: Fair

Adult check-in
2021-04-22
Survey response — 21 day, single dose
MedDRA: Arthralgia, Fatigue, Headache, Myalgia, Spinal pain, Vision blurred — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-29
Health check-in — 28 day, single dose
Feeling: Fair

Adult check-in
2021-05-06
Health check-in — 35 day, single dose
Feeling: Fair

Adult check-in
2021-05-13
Health check-in — 42 day, single dose
Feeling: Fair

Adult check-in
2021-07-01
Health check-in — 3 month, dose 1
Feeling: Fair

Adult check-in
2021-09-30
Survey response — 6 month, dose 1
MedDRA: Abdominal pain, Abdominal rigidity, Eye discharge, Feeding disorder, Granuloma annulare, Headache, Hepatomegaly, Lymphadenopathy, Lymphocyte count increased, Office visit, Pre-existing disease, Splenomegaly, Weight decreased — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2021-09-30
Report sent to call center — 6 month, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-01
Dose 2 — Pfizer-BioNTech
2021-11-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness

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

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-10
Health check-in — 7 day, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-15
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-11-22
Health check-in — 21 day, dose 2
Feeling: Fair

Adult check-in
2021-12-01
Survey response — 28 day, dose 2
MedDRA: Arthralgia, Fatigue, Haematochezia, Pre-existing disease, Spinal pain, Vaccine positive rechallenge, White blood cell count increased — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-12-06
Survey response — 35 day, dose 2
MedDRA: Gastrointestinal pain, Reaction to previous exposure to any vaccine, Rectal haemorrhage — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2021-12-10
Call successful
Participant prefers to complete VAERS report online
2021-12-13
Health check-in — 42 day, dose 2
Feeling: Fair

Adult check-in
2022-01-31
Health check-in — 3 month, dose 2
Feeling: Fair

Adult check-in
2022-05-05
Survey response — 6 month, dose 2
MedDRA: Anxiety, Dizziness, Feeling abnormal, Palpitations, Panic reaction, Respiratory disorder — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-08-11
Dose 3 — Pfizer-BioNTech
2022-11-10
Health check-in — 3 month, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Janssen/Johnson & Johnson
2	2021-11-01	Pfizer-BioNTech	No
3	2022-08-11	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-30	Successful 2021-12-10	Participant prefers to complete VAERS report online

Free text

Release 7

Systemic reaction (other): Surgical sites - oddly - spine (fusion at neck & lumbar) spinal hematomas & other trauma, R knee/ankle, left wrist - areas of nerve damage numbness got intense in a very painful odd way. Lower bowl (divertic, IBS, post spinal surgery difficulty with bowel movements - spasmodic in a way Ive not had in years. Thirsty excessively thirsty.

Symptoms: Spinal and joint/muscle pain, exhaustion, brain fog ...keeps ebbing and flowing. Low grade headache often.

Release 9

Symptoms: Elevated Lymph count 5130. Loss of weight, inability to eat, flare of Granuloma Annular. Headaches, ongoing goopyeyes etc. enlarged liver and spleen, lymph nodes neck. Abd pain & spasms.

Healthcare visit (other): Bloodwork, GI appt, Immuno doc appt being set up

Release 10

Symptoms: Blood with bowel movement like what happened after J&J vaccine. Odd fatigue has roared back to life as has joint and spinal pain (every surgical site). Unclear if my White count has blown up again as per 1st vaccine.

Symptoms: Still having bleeding with bowel movements (not all) now with spasms like with J&J.

Release 11

Symptoms: A general feeling of being off. Heart palpable/heightened anxiety/panic like feeling. Digestion difficulties (start to finish). Light headed often - woozy weird.

Free-text releases are not linked to a specific 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
HCVO	Office visit	·	·	✓
SD	Abdominal pain	·	·	✓
SD	Abdominal rigidity	·	·	✓
SD	Anxiety	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Eye discharge	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeding disorder	·	·	✓
SD	Feeling abnormal	·	·	✓
SD	Gastrointestinal pain	·	·	✓
SD	Granuloma annulare	·	·	✓
SD	Haematochezia	·	·	✓
SD	Headache	✓	✓	✓
SD	Hepatomegaly	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Lymphocyte count increased	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Palpitations	·	·	✓
SD	Panic reaction	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	Rectal haemorrhage	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Spinal pain	✓	✓	✓
SD	Splenomegaly	·	·	✓
SD	Vaccine positive rechallenge	·	·	✓
SD	Vision blurred	✓	✓	✓
SD	Weight decreased	·	·	✓
SD	White blood cell count increased	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Post-traumatic pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Procedural pain	✓	✓	✓
SRO	Thirst	✓	✓	✓

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