XZE-24310-42253

2 vaccinations 7 coded responses 21 check-ins 7 free-text entries 5 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 481 / MI
Registered: 2021-04-09

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

Timeline

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

2021-04-09
Registered in v-safe
2021-04-09
Dose 1 — Janssen/Johnson & Johnson
2021-04-09
Health check-in — 0 day, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-04-23
Survey response — 14 day, dose 1
MedDRA: Cough, Rhinorrhoea — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-02
Health check-in — 21 day, single dose
Feeling: Good

Adult check-in
2021-05-07
Health check-in — 28 day, single dose
Feeling: Fair

Adult check-in
2021-05-14
Health check-in — 35 day, single dose
Feeling: Good

Adult check-in
2021-05-21
Survey response — 42 day, single dose
MedDRA: Cough, Decreased appetite, Office visit, Paranasal sinus discomfort, Pneumonia, Respiratory tract congestion, Weight decreased — Feeling: Poor · 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

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-21
Report sent to call center — 42 day, single dose
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)
2021-05-31
Call 1 — Could Not Reach Participant
2021-06-07
Call 2 — Could Not Reach Participant
2021-07-09
Health check-in — 3 month, dose 1
Feeling: Good

Adult check-in
2021-10-10
Survey response — 6 month, dose 1
MedDRA: Office visit, Pneumonia — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2021-10-10
Report sent to call center — 6 month, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-13
Call 1 — Left Voicemail
2021-11-24
Dose 2 — Moderna
2021-11-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-12-22
Survey response — 28 day, dose 2
MedDRA: Bronchitis, Cough, Office visit, Oropharyngeal pain — 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

MedDRA releases: 2024-11 · check-in answers available
2021-12-22
Report sent to call center — 28 day, 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

1 call case(s)
2021-12-23
Call 1 — Left Voicemail
2021-12-31
Survey response — 35 day, dose 2
MedDRA: Office visit, Pneumonia — 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

MedDRA releases: 2024-11 · check-in answers available
2021-12-31
Report sent to call center — 35 day, 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

1 call case(s)
2022-01-04
Call 1 — Left Voicemail
2022-05-30
Survey response — 6 month, dose 2
MedDRA: Emergency care, Hypertension, Seizure — 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 · Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11 · check-in answers available
2022-05-30
Report sent to call center — 6 month, 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-05-31
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-09	Janssen/Johnson & Johnson
2	2021-11-24	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-21	Unsuccessful
2021-10-10	Unsuccessful
2021-12-22	Unsuccessful
2021-12-31	Unsuccessful
2022-05-30	Unsuccessful

Free text

Release 7

Systemic reaction (other): Shakiness in hands and arms

Symptoms: Cough runny nose

Release 8

Symptoms: Diagnosed with pneumonia 3 days ago. Horrible cough, sinus pressure and congestion. Lost 10 pounds this week. No appetite.

Healthcare visit (other): Primary care physician

Release 10

Symptoms: Pneumonia

Healthcare visit (other): Primary care doctor in person

Symptoms: Cough bronchitis sore throat

Healthcare visit (other): Primary care physician in office viait

Symptoms: Pneumonia

Healthcare visit (other): Primary care on office

Release 11

Symptoms: High blood pressure (much higher than normal) and had a seizure after going to the hospital for high blood presaure

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	Bronchitis	·	·	✓
SD	Cough	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Emergency care	·	·	✓
SD	Hypertension	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Paranasal sinus discomfort	✓	✓	✓
SD	Pneumonia	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Seizure	·	·	✓
SD	Weight decreased	✓	✓	✓
SRO	Tremor	✓	✓	✓

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