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YA9-29309-08358

3 vaccinations 7 coded responses 18 check-ins 7 free-text entries 1 call case
Sex
Male
Age at first dose
56-60
ZIP prefix
113 / NY
Registered
2021-03-08
Relationship
Self
Race
White
Ethnicity
Hispanic or Latino
Registered dependents
QTC-13455-85231 Child or adolescent in my care · Female · 2022-06-24

Timeline

  1. 2021-03-08
    Registered in v-safe
  2. 2021-03-08
    Dose 1 — Janssen/Johnson & Johnson
  3. 2021-03-08
    Survey response — day 0, dose 1
    MedDRA: Nasal pruritus — Feeling: Good
    Free text: Itching inside the nose and chasper in the throat. Thats it.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-09
    Survey response — days 1–6 daily, dose 1
    MedDRA: Flank pain — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Diarrhea
    Free text: Pain in my waist
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-10
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-03-11
    Survey response — days 1–6 daily, dose 1
    MedDRA: Ear pain, Headache, Pain — Feeling: Fair · Site: Pain · Headache
    Free text: I have never had pain in my left ear, I have now it is not constant but it is like a nail pinch, the same thing with headache, my left side is never in pain now it is also with pinch like pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-13
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-03-14
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Nausea, Diarrhea · Be unable to do your normal daily activities
    Adult check-in
  10. 2021-03-15
    Health check-in — day 7, dose 1
    Feeling: Fair · Diarrhea
    Adult check-in
  11. 2021-03-22
    Survey response — day 14, dose 1
    MedDRA: Diarrhoea — Feeling: Fair
    Free text: Diarrhea
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-29
    Survey response — day 21, single dose
    MedDRA: Pruritus, Rash — Feeling: Fair
    Free text: Rash itching in the arm where I had the vaccine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-04-05
    Health check-in — day 28, single dose
    Feeling: Fair
    Adult check-in
  14. 2021-04-12
    Health check-in — day 35, single dose
    Feeling: Fair
    Adult check-in
  15. 2021-04-19
    Survey response — day 42, single dose
    MedDRA: Diarrhoea — Feeling: Poor · Be unable to do your normal daily activities
    Free text: This is my 5th week with diarrhea, no medicine is helping even prescribed medicine. I dont know what to do. I have no insurance.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-06-07
    Health check-in — 3 months, dose 1
    Feeling: Good
    Adult check-in
  17. 2021-09-06
    Health check-in — 6 months, dose 1
    Feeling: Good
    Adult check-in
  18. 2022-01-07
    Dose 2 — Pfizer-BioNTech
  19. 2022-06-06
    Dose 3 — Pfizer-BioNTech
  20. 2022-06-24
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  21. 2022-06-27
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  22. 2022-09-07
    Survey response — 3 months, dose 3
    MedDRA: Back pain, Cough, Malaise, Nasopharyngitis, Pre-existing disease, 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: I had cold like symptoms , I tested negative for covid-19 twice? I have been sick already for more than a month, coughing, back pain and allergies, still not over.
    MedDRA releases: 2024-11 · check-in free text available
  23. 2022-09-07
    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)
  24. 2022-09-08
  25. 2022-09-08

Vaccinations

DoseDateManufacturerCo-administered
12021-03-08Janssen/Johnson & Johnson
22022-01-07Pfizer-BioNTech No
32022-06-06Pfizer-BioNTech No

Call center

ReportedOutcomeVAERS-related outcome
2022-09-07 Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-08

Systemic reaction (other): Itching inside the nose and chasper in the throat. Thats it.

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): Pain in my waist

2021-03-11

Systemic reaction (other): I have never had pain in my left ear, I have now it is not constant but it is like a nail pinch, the same thing with headache, my left side is never in pain now it is also with pinch like pain

Release 6 — day 14, dose 1

2021-03-22

Symptoms: Diarrhea

Release 6 — day 21, single dose

2021-03-29

Symptoms: Rash itching in the arm where I had the vaccine

Release 7 — day 42, single dose

2021-04-19

Symptoms: This is my 5th week with diarrhea, no medicine is helping even prescribed medicine. I dont know what to do. I have no insurance.

Release 12 — 3 months, dose 3

2022-09-07

Symptoms: I had cold like symptoms , I tested negative for covid-19 twice? I have been sick already for more than a month, coughing, back pain and allergies, still not over.

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

FieldPreferred term2021-092023-042024-11
SDBack pain · · ✓
SDCough · · ✓
SDDiarrhoea ✓ ✓ ✓
SDMalaise · · ✓
SDNasopharyngitis · · ✓
SDPre-existing disease · · ✓
SDPruritus ✓ ✓ ✓
SDRash ✓ ✓ ✓
SDSARS-CoV-2 test negative · · ✓
SROEar pain ✓ ✓ ✓
SROFlank pain ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SRONasal pruritus ✓ ✓ ✓
SROPain ✓ ✓ ✓

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