Y37-11913-87109

3 vaccinations 12 coded responses 44 check-ins 12 free-text entries 2 call cases

Sex: Male
Age at first dose: 36-40
ZIP prefix: 927 / CA
Registered: 2021-04-06

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-04-06
Registered in v-safe
2021-04-06
Dose 1 — Janssen/Johnson & Johnson
2021-04-06
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease, Rhinorrhoea, Self-medication, Throat irritation — Feeling: Good

Free text: Slight runny nose and itchy throat but probably allergies because it went away with Zyrtec

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Survey response — day 7, dose 1
MedDRA: Pre-existing disease, Sneezing — Feeling: Good

Free text: Allergies with sneezing from a cat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — day 14, dose 1
MedDRA: Headache, Injection site pain, Pain in extremity, Toothache — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Had bad headache one day along with pain at injection site which I didnt have before also felt weird pain in arm and my teeth hurt but it all cleared up by the next day. This was 12 days after being vaccinated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-27
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-17
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-05-18
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-07-06
Survey response — 3 months, dose 1
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-05
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-10-28
Dose 2 — Janssen/Johnson & Johnson
2021-10-28
Survey response — day 0, dose 2
MedDRA: Immediate post-injection reaction, Presyncope — Feeling: Fair · Site: Pain · Chills, Joint pains, Nausea · Be unable to do your normal daily activities

Free text: Almost fainted 18 minutes after vaccine was administered

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Survey response — days 1–6 daily, dose 2
MedDRA: Peripheral swelling — Feeling: Fair · Site: Pain · Joint pains, Diarrhea

Free text: Fingers feel swollen

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — days 1–6 daily, dose 2
MedDRA: Peripheral swelling — Feeling: Fair · Site: Pain · Joint pains, Diarrhea

Free text: Hands feel swollen

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-11-01
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms, Pain in extremity — Feeling: Fair · Joint pains, Muscle or body aches

Free text: Left leg felt cramping and sore in the calf and upper leg

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms, Pain in extremity — Feeling: Fair · Joint pains, Muscle or body aches, Diarrhea

Free text: Left leg hurts. Left foot is cramping

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-11-04
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-11-11
Survey response — day 14, dose 2
MedDRA: Malaise, Toothache — Feeling: Fair

Free text: Teeth hurt. Feel a little under the weather in the head/nasal area

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-12-09
Health check-in — day 42, dose 2
Feeling: Fair

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

Adult check-in
2022-04-30
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-08-03
Dose 3 — Pfizer-BioNTech
2022-08-03
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · 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
2022-08-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Diarrhea, Abdominal pain

Adult check-in
2022-08-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness, Diarrhea

Adult check-in
2022-08-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2022-08-07
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-08-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-08-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-08-10
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-08-17
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-08-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-08-31
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-09-09
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-09-14
Survey response — day 42, dose 3
MedDRA: Headache — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headache

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Survey response — 3 months, dose 3
MedDRA: Enlarged uvula, Office visit, SARS-CoV-2 test negative — Feeling: Fair · 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: Uvula swelling. Went to urgent care tested negative for Covid and strep

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Report sent to call center — 3 months, dose 3
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)
2022-11-03
Call 1 — Left Voicemail
2023-02-01
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Janssen/Johnson & Johnson
2	2021-10-28	Janssen/Johnson & Johnson	No
3	2022-08-03	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-20	Successful 2021-05-17	Reported to VAERS voluntarily prior to GDIT contact
2022-11-02	Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): Slight runny nose and itchy throat but probably allergies because it went away with Zyrtec

Release 7 — day 7, dose 1

2021-04-13

Systemic reaction (other): Allergies with sneezing from a cat

Release 7 — day 14, dose 1

2021-04-20

Symptoms: Had bad headache one day along with pain at injection site which I didnt have before also felt weird pain in arm and my teeth hurt but it all cleared up by the next day. This was 12 days after being vaccinated.

Release 9 — 3 months, dose 1

2021-07-06

Symptoms: Fatigue

Release 10 — day 0, dose 2

2021-10-28

Systemic reaction (other): Almost fainted 18 minutes after vaccine was administered

Release 10 — days 1–6 daily, dose 2

2021-10-29

Systemic reaction (other): Fingers feel swollen

2021-10-30

Systemic reaction (other): Hands feel swollen

2021-11-01

Systemic reaction (other): Left leg felt cramping and sore in the calf and upper leg

2021-11-02

Systemic reaction (other): Left leg hurts. Left foot is cramping

Release 10 — day 14, dose 2

2021-11-11

Symptoms: Teeth hurt. Feel a little under the weather in the head/nasal area

Release 12 — day 42, dose 3

2022-09-14

Symptoms: Headache

Release 12 — 3 months, dose 3

2022-11-02

Symptoms: Uvula swelling. Went to urgent care tested negative for Covid and strep

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

Field	Preferred term	2021-09	2023-04	2024-11
SD	Enlarged uvula	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Malaise	·	·	✓
SD	Office visit	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Toothache	✓	✓	✓
SRO	Immediate post-injection reaction	·	·	✓
SRO	Muscle spasms	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Peripheral swelling	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Presyncope	·	·	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Throat irritation	✓	✓	✓

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