XY6-59662-79059

2 vaccinations 8 coded responses 27 check-ins 8 free-text entries 5 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 605 / IL
Registered: 2021-03-21

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

2021-03-21
Registered in v-safe
2021-03-21
Dose 1 — Janssen/Johnson & Johnson
2021-03-21
Health check-in — 0 day, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — 7 day, dose 1
Feeling: Good · None

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

Adult check-in
2021-04-11
Health check-in — 21 day, single dose
Feeling: Good

Adult check-in
2021-04-19
Survey response — 28 day, single dose
MedDRA: Fatigue, Pain — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-25
Health check-in — 35 day, single dose
Feeling: Good

Adult check-in
2021-05-02
Health check-in — 42 day, single dose
Feeling: Good

Adult check-in
2021-06-20
Survey response — 3 month, dose 1
MedDRA: Blood thyroid stimulating hormone decreased, Lethargy, Office visit, Tinnitus, Weight increased, White blood cell count decreased — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-20
Report sent to call center — 3 month, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-23
Call 1 — Left Voicemail
2021-09-20
Survey response — 6 month, dose 1
MedDRA: Cough, Ear congestion, Fatigue, Nasal congestion, Pyrexia, Rhinorrhoea — Feeling: Poor · 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

MedDRA releases: 2024-11 · check-in answers available
2021-09-20
Report sent to call center — 6 month, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-21
Call 1 — Left Voicemail
2021-11-05
Dose 2 — Moderna
2021-11-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-11-08
Survey response — days 1–6 daily, dose 2
MedDRA: Ear swelling, Sudden hearing loss, Tinnitus — Feeling: Fair · Site: Swelling · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2021-11-08
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-09
Survey response — days 1–6 daily, dose 2
MedDRA: Ear discomfort, Ear pain, Sudden hearing loss, Tinnitus — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2021-11-09
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-09
Call 1 — Left Voicemail
2021-11-10
Call 1 — Left Voicemail
2021-11-11
Survey response — days 1–6 daily, dose 2
MedDRA: Ear swelling, Hypoacusis, Office visit, Tinnitus — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-11-12
Survey response — 7 day, dose 2
MedDRA: Ear swelling, Joint swelling, Sudden hearing loss — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available
2021-11-19
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-11-26
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-12-03
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-12-10
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-12-17
Survey response — 42 day, dose 2
MedDRA: Arthralgia, Chest pain, Joint swelling, Painful respiration — Feeling: Fair · 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
2021-12-17
Report sent to call center — 42 day, dose 2
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)
2021-12-21
Call 1 — Left Voicemail
2022-02-04
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-21	Janssen/Johnson & Johnson
2	2021-11-05	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-20	Unsuccessful
2021-09-20	Unsuccessful
2021-11-08	Unsuccessful
2021-11-09	Unsuccessful
2021-12-17	Unsuccessful

Free text

Release 7

Symptoms: Sudden, extreme, entire body fatigue and aching. Lasted for 2 days. Occurred on days 16 and 17 after vaccination.

Release 9

Symptoms: Severely loud bilateral tinnitus, lethargy, weight gain, low WBC, low TSH.

Healthcare visit (other): Outpatient OCP visit, blood work, and referrals to specialists.

Symptoms: Low grade fever, fatigue, runny nose, stuffed up nose and ears, slight cough.

Release 10

Systemic reaction (other): Sudden hearing loss to ear , tinnitus, inner ear swelling

Systemic reaction (other): Ringing, fullness, pain and sudden hearing loss to ear

Systemic reaction (other): Tinnitus to left ear. Feeling of swelling in ear. The decreased hearing is now increasing. I had to go to the doctor and be put on high dose prednisone

Systemic reaction (other): Ear swelling, sudden hearing loss resolving. Knee swelling decreasing. On 5th day of 60 mg of Prednisone.

Symptoms: Left sided chest pain. Pain during deep breaths. Extreme pain and swelling to right kneeno fall or blunt injury to knee occurredpain happened suddenly.

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	Arthralgia	·	·	✓
SD	Blood thyroid stimulating hormone decreased	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Cough	·	·	✓
SD	Ear congestion	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Joint swelling	·	·	✓
SD	Lethargy	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Pain	✓	✓	✓
SD	Painful respiration	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Tinnitus	✓	✓	✓
SD	Weight increased	✓	✓	✓
SD	White blood cell count decreased	✓	✓	✓
SRO	Ear discomfort	·	·	✓
SRO	Ear pain	·	·	✓
SRO	Ear swelling	·	·	✓
SRO	Hypoacusis	·	·	✓
SRO	Joint swelling	·	·	✓
SRO	Office visit	·	·	✓
SRO	Sudden hearing loss	·	·	✓
SRO	Tinnitus	·	·	✓

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