YC3-16100-47819

3 vaccinations 7 coded responses 27 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 452 / OH
Registered: 2021-04-03

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Registered dependents

DAP-22967-96680 Child or adolescent in my care · Male · 2021-11-16

Timeline

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

2021-04-03
Registered in v-safe
2021-04-03
Dose 1 — Janssen/Johnson & Johnson
2021-04-03
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

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

Adult check-in
2021-04-12
Health check-in — day 7, dose 1
Feeling: Good · Chills, Abdominal pain

Adult check-in
2021-04-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 28, single dose
Feeling: Fair

Adult check-in
2021-05-08
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-15
Survey response — day 42, single dose
MedDRA: Cough, Headache, Muscle spasms, Oropharyngeal pain — Feeling: Fair

Free text: Never experienced headaches before and now mild ones. Leg cramps and off and on coughing with mild sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-03
Survey response — 3 months, dose 1
MedDRA: Abdominal pain upper, Asthenia, Fatigue — Feeling: Fair

Free text: Tiredness, weakness, stomach pains.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-04
Survey response — 6 months, dose 1
MedDRA: Abdominal pain upper, Chills, Cough, Decreased appetite, Diarrhoea, Dizziness, Dry throat, Headache, Pain, Pyrexia, Unevaluable event — 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

Free text: Symptoms: Chills, fever, severe headaches, loss of appitite, dizzyness, dry throat, very bad cough, severe bodyaches, stomacheache, diareha. The worst i have ever felt in my life · Healthcare visit (other): Still on 14 day isolation. Per health dept

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Report sent to call center — 6 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)
2021-10-06
Call 1 — Left Voicemail
2021-10-31
Dose 2 — Moderna
Co-administered: Flu
2021-11-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-11-05
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: Very swollen lymph nods under right armpit with pain since Sunday when i got the injection.

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-11-07
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-14
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-12-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-01-30
Survey response — 3 months, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Extremely tired

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Survey response — 6 months, dose 2
MedDRA: Cough, Fatigue, Muscle spasms — Feeling: Fair

Free text: Fatigue, caughing, leg cramps

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Dose 3 — Moderna
2022-06-05
Survey response — day 21, dose 3
MedDRA: Cough, Fatigue — Feeling: Fair

Free text: Coughing and tiredness

MedDRA releases: 2024-11 · check-in free text available
2022-06-07
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-06-14
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-06-23
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-08-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-11-10
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-03	Janssen/Johnson & Johnson
2	2021-10-31	Moderna	Flu
3	2022-05-10	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-04	Unsuccessful

Free text

Release 8 — day 42, single dose

2021-05-15

Symptoms: Never experienced headaches before and now mild ones. Leg cramps and off and on coughing with mild sore throat

Release 9 — 3 months, dose 1

2021-07-03

Symptoms: Tiredness, weakness, stomach pains.

Release 10 — 6 months, dose 1

2021-10-04

Symptoms: Chills, fever, severe headaches, loss of appitite, dizzyness, dry throat, very bad cough, severe bodyaches, stomacheache, diareha. The worst i have ever felt in my life

Healthcare visit (other): Still on 14 day isolation. Per health dept

Release 10 — days 1–6 daily, dose 2

2021-11-05

Systemic reaction (other): Very swollen lymph nods under right armpit with pain since Sunday when i got the injection.

Release 11 — 3 months, dose 2

2022-01-30

Symptoms: Extremely tired

Release 11 — 6 months, dose 2

2022-05-01

Symptoms: Fatigue, caughing, leg cramps

Release 11 — day 21, dose 3

2022-06-05

Symptoms: Coughing and tiredness

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
HCVO	Unevaluable event	·	·	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Chills	·	·	✓
SD	Cough	✓	✓	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Dry throat	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓

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