XX4-25545-48136

2 vaccinations 12 coded responses 26 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 087 / NJ
Registered: 2021-04-05

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

2021-04-05
Registered in v-safe
2021-04-05
Dose 1 — Janssen/Johnson & Johnson
2021-04-05
Health check-in — 0 day, dose 1
Feeling: Good · Vomiting

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Vomiting

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 1
MedDRA: Pyrexia, Rash, Rash erythematous — Feeling: Good · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Fair · Fever · Chills, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · None

Adult check-in
2021-04-12
Health check-in — 7 day, dose 1
Feeling: Good · Fever · Chills

Adult check-in
2021-04-20
Health check-in — 14 day, dose 1
Feeling: Fair

Adult check-in
2021-04-26
Survey response — 21 day, single dose
MedDRA: Office visit, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-26
Report sent to call center — 21 day, single dose
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-03
Survey response — 28 day, single dose
MedDRA: Office visit, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-10
Health check-in — 35 day, single dose
Feeling: Fair

Adult check-in
2021-05-17
Health check-in — 42 day, single dose
Feeling: Fair

Adult check-in
2021-05-27
Call 1 — Left Voicemail
2021-07-07
Survey response — 3 month, dose 1
MedDRA: Dandruff, Pruritus — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-10-06
Survey response — 6 month, dose 1
MedDRA: Dandruff, Dry skin — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2022-02-11
Dose 2 — Moderna
2022-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2022-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Joint pains, Fatigue or tiredness

Adult check-in
2022-02-18
Health check-in — 7 day, dose 2
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-02-27
Survey response — 14 day, dose 2
MedDRA: Headache, Myalgia — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2022-03-04
Health check-in — 21 day, dose 2
Feeling: Fair

Adult check-in
2022-03-11
Survey response — 28 day, dose 2
MedDRA: Headache, Vomiting — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-03-19
Survey response — 35 day, dose 2
MedDRA: Headache, Impaired work ability, Malaise, Pyrexia — Feeling: Fair · Be unable to work or attend school

MedDRA releases: 2024-11 · check-in answers available
2022-03-25
Survey response — 42 day, dose 2
MedDRA: Headache, Impaired work ability, Malaise, Mobility decreased, Myalgia, Vomiting — Feeling: Fair · Be unable to work or attend school

MedDRA releases: 2024-11 · check-in answers available
2022-05-17
Survey response — 3 month, dose 2
MedDRA: Flushing, Headache, Malaise, Pyrexia, Swelling face, Vomiting — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-08-13
Health check-in — 6 month, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-05	Janssen/Johnson & Johnson
2	2022-02-11	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-26	Unsuccessful

Free text

Release 7

Systemic reaction (other): I just wanted to let you know that yesterday one day after the shot I did have a rash that was on my thighs in my legs they were red they were just bothersome and I was running a fever that day.

Systemic reaction (other): I just feel extremely tired like worn out.

Release 8

Symptoms: I don't know if this has anything to do with the vaccine however on my left hand my middle finger swelled up to twice the three times the size last week on Wednesday and Thursday however I went to my doctor today and he thinks there might be some inf cut off by CDC

Healthcare visit (other): I saw on my regular doctor and his office today

Symptoms: I'm not sure if I checked in with this but my middle finger on my left hand has swollen up I seen my Healthcare doctor and he put me on antibiotics and had an X-ray done on my finger. I get the results tomorrow at my doctor

Release 9

Symptoms: My scalp is very itchy and it seems to me since I've gotten of Johnson & Johnson shut that I developed dandruff is that possible I don't really know it could be it could just be that I'm wearing a hat at work I don't know but that's the only new prob cut off by CDC

Release 10

Symptoms: These odds that I seem to develop dandruff my scalp is very flaky for dry skin I don't know if it had anything to do with the shot or not I am going to see a dermatologist cuz it's really embarrassing.

Release 11

Systemic reaction (other): I have a headache but only in my left side that is the side that I got the shot in Xbox One sharp pain in my head in my temple.

Symptoms: I am having a lot of muscle aches and headaches

Symptoms: I had extreme headaches headaches headaches headaches to the point where they made me throw up.

Symptoms: I was not feeling well and massive headaches running a fever so much that I missed one day of work.

Symptoms: I have had a lot of headaches and throwing up and my muscles are really achy. I even missed one day's work about 2 weeks ago because I couldn't get out of bed I was sick for actually 3 days but I only lost one day at work

Symptoms: I have not feeling well. Throwing up.. it just comes on.. feverish., headaches.. flushing in the face...face slightly swollen.

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	Dandruff	✓	✓	✓
SD	Dry skin	·	·	✓
SD	Flushing	·	·	✓
SD	Headache	·	·	✓
SD	Impaired work ability	·	·	✓
SD	Malaise	·	·	✓
SD	Mobility decreased	·	·	✓
SD	Myalgia	·	·	✓
SD	Office visit	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Swelling face	·	·	✓
SD	Vomiting	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓

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