Y8J-23698-46252

3 vaccinations 11 coded responses 31 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 223 / VA
Registered: 2021-04-11

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

2021-04-10
Dose 1 — Janssen/Johnson & Johnson
2021-04-11
Registered in v-safe
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Arthritis, Back pain, Headache, Neck pain, Self-medication — Feeling: Good · Headache, Muscle or body aches

Free text: Headache is actually pain at temples. Back neck aches is arthritis that is annoyed. Tylenol arthritis relieves some ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Good · Headache, Muscle or body aches

Free text: Headache lessened

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Neck pain — Feeling: Good · Muscle or body aches

Free text: Still have achy back and neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain upper — Feeling: Good · Muscle or body aches, Abdominal pain

Free text: New stomach ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — day 7, dose 1
MedDRA: Abdominal pain upper — Feeling: Good · Muscle or body aches, Abdominal pain

Free text: Mild upper abdominal ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-07-10
Survey response — 3 months, dose 1
MedDRA: Food poisoning, Gastric disorder — 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 · Telehealth, virtual health, or email health consultation

Free text: Food poisoning over holiday with slow recovery pertaining to stomach

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Report sent to call center — 3 months, 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)
2021-07-14
Call 1 — Left Voicemail
2021-07-14
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-09
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-11-24
Dose 2 — Janssen/Johnson & Johnson
2021-12-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-29
Survey response — day 35, dose 2
MedDRA: Fatigue, Rhinorrhoea, Throat irritation — Feeling: Fair

Free text: Runny nose, slight scratchy throat, exhausted starting around 12/26

MedDRA releases: 2024-11 · check-in free text available
2022-01-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-02-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-05-04
Dose 3 — Pfizer-BioNTech
2022-05-04
Health check-in — day 0, dose 3
Feeling: Good · Headache

Adult check-in
2022-05-05
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site pain — Feeling: Good · Site: Swelling · Headache, Fatigue or tiredness

Free text: Mostly arm ache at injection

MedDRA releases: 2024-11 · check-in free text available
2022-05-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2022-05-08
Survey response — days 1–6 daily, dose 3
MedDRA: Urinary tract infection — Feeling: Good · Headache

Free text: Found out i have a UTI, on antibiotic

MedDRA releases: 2024-11 · check-in free text available
2022-05-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-05-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-05-11
Survey response — day 7, dose 3
MedDRA: Headache, Neck pain — Feeling: Good · Headache

Free text: Not sure if headaches are telated to weather or shot. Neck achy

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-06-03
Survey response — day 28, dose 3
MedDRA: Cardiac flutter, Respiration abnormal — Feeling: Good

Free text: Every day, day/night, laying down primarily, sitting, Ithave a stuttered breath w/heart flutter. I havent changed any foods in my daily routine. Short, brief episode. Dont feel bad, no dizziness. Dont experience when stexperienceor walking.

MedDRA releases: 2024-11 · check-in free text available
2022-06-08
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-06-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-08-03
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-11-02
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-10	Janssen/Johnson & Johnson
2	2021-11-24	Janssen/Johnson & Johnson	No
3	2022-05-04	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-10	Successful 2021-07-14	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-12

Systemic reaction (other): Headache is actually pain at temples. Back neck aches is arthritis that is annoyed. Tylenol arthritis relieves some ache

2021-04-14

Systemic reaction (other): Headache lessened

2021-04-15

Systemic reaction (other): Still have achy back and neck

2021-04-16

Systemic reaction (other): New stomach ache

Release 7 — day 7, dose 1

2021-04-17

Systemic reaction (other): Mild upper abdominal ache

Release 9 — 3 months, dose 1

2021-07-10

Symptoms: Food poisoning over holiday with slow recovery pertaining to stomach

Release 10 — day 35, dose 2

2021-12-29

Symptoms: Runny nose, slight scratchy throat, exhausted starting around 12/26

Release 11 — days 1–6 daily, dose 3

2022-05-05

Systemic reaction (other): Mostly arm ache at injection

2022-05-08

Systemic reaction (other): Found out i have a UTI, on antibiotic

Release 11 — day 7, dose 3

2022-05-11

Systemic reaction (other): Not sure if headaches are telated to weather or shot. Neck achy

Release 11 — day 28, dose 3

2022-06-03

Symptoms: Every day, day/night, laying down primarily, sitting, Ithave a stuttered breath w/heart flutter. I havent changed any foods in my daily routine. Short, brief episode. Dont feel bad, no dizziness. Dont experience when stexperienceor walking.

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	Cardiac flutter	·	·	✓
SD	Fatigue	·	·	✓
SD	Food poisoning	✓	✓	✓
SD	Gastric disorder	✓	✓	✓
SD	Respiration abnormal	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Throat irritation	·	·	✓
SRO	Abdominal pain upper	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Neck pain	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Urinary tract infection	·	·	✓

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