YJY-27644-19428

4 vaccinations 6 coded responses 16 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 773 / TX
Registered: 2021-03-16

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

2021-03-16
Registered in v-safe
2021-03-16
Dose 1 — Janssen/Johnson & Johnson
2021-03-16
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Paraesthesia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Body feels tingly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Oropharyngeal pain — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Sore throat, lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Headache, Fatigue or tiredness, Abdominal pain

Free text: These could be lingering symptoms from COVID19 I had in August 2020??

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 7, dose 1
MedDRA: Chest pain — Feeling: Fair · Nausea

Free text: Chest burns. Has since had COVID in 8/2020, but has been worse since receiving vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-07
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-04-13
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-06-15
Survey response — 3 months, dose 1
MedDRA: Asthma — 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 · Outpatient clinic or urgent care clinic visit

Free text: Lungs worse. Diagnosed w/asthma. Dr says activated by COVID virus (that had in July 2020).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
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)
2021-06-24
Call 1 — Left Voicemail
2021-09-16
Health check-in — 6 months, dose 1
Feeling: Fair

Adult check-in
2021-11-10
Dose 2 — Moderna
2022-03-16
Health check-in — 12 months, dose 1
Feeling: Poor

Adult check-in
2022-05-13
Dose 3 — Moderna
2022-10-21
Dose 4 — Moderna
2022-11-11
Survey response — 6 months, dose 3
MedDRA: Chest discomfort, Chest pain, Dyspnoea, Fatigue, Lung disorder, Office visit, Rheumatoid arthritis — 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: Have Rheumatoid arthritis from immune system attacking joints and healthy tissue. Lungs continue to be an issueshort of breath, feeling heavy, burning. Fatigue continues to be a problem. · Healthcare visit (other): In-office visits with pulmonologist, asthma specialist, and rheumatologist.

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Report sent to call center — 6 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

1 call case(s)
2022-11-14
Call 2 — Left Voicemail
2022-11-14
Call 1 — Left Voicemail
2022-12-02
Call 3 — Left Voicemail
2022-12-02
Call 2 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Janssen/Johnson & Johnson
2	2021-11-10	Moderna	No
3	2022-05-13	Moderna	No
4	2022-10-21	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-15	Unsuccessful
2022-11-11	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Body feels tingly

2021-03-18

Systemic reaction (other): Sore throat, lightheaded

Release 6 — days 1–6 daily, dose 1

2021-03-22

Systemic reaction (other): These could be lingering symptoms from COVID19 I had in August 2020??

Release 6 — day 7, dose 1

2021-03-23

Systemic reaction (other): Chest burns. Has since had COVID in 8/2020, but has been worse since receiving vaccine.

Release 9 — 3 months, dose 1

2021-06-15

Symptoms: Lungs worse. Diagnosed w/asthma. Dr says activated by COVID virus (that had in July 2020).

Release 12 — 6 months, dose 3

2022-11-11

Symptoms: Have Rheumatoid arthritis from immune system attacking joints and healthy tissue. Lungs continue to be an issueshort of breath, feeling heavy, burning. Fatigue continues to be a problem.

Healthcare visit (other): In-office visits with pulmonologist, asthma specialist, and rheumatologist.

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	Office visit	·	·	✓
SD	Asthma	✓	✓	✓
SD	Chest discomfort	·	·	✓
SD	Chest pain	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Lung disorder	·	·	✓
SD	Rheumatoid arthritis	·	·	✓
SRO	Chest pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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