YQH-14813-28375

3 vaccinations 6 coded responses 21 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 971 / OR
Registered: 2021-04-10

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
Registered in v-safe
2021-04-10
Dose 1 — Janssen/Johnson & Johnson
2021-04-10
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Free text: I have lupus ra and MCTD so this is common

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Free text: These are everyday symptoms for me with young kids and my disease

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 · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-04-17
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-02
Health check-in — day 21, single dose
Feeling: Fair

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

Adult check-in
2021-05-17
Health check-in — day 35, single dose
Feeling: Fair

Adult check-in
2021-05-24
Health check-in — day 42, single dose
Feeling: Fair

Adult check-in
2021-07-10
Survey response — 3 months, dose 1
MedDRA: Diarrhoea, Medical counselling, Muscle spasms — 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: Loose bms for the last week and horrible cramps · Healthcare visit (other): Called my on call rheumatologist to see if medication brand change could be problem.

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)
2021-07-13
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-11
Health check-in — 6 months, dose 1
Feeling: Fair

Adult check-in
2021-12-12
Dose 2 — Moderna
2022-04-11
Dose 3 — Moderna
2022-04-12
Survey response — 12 months, dose 1
MedDRA: Chills, Headache, Pain, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I got my second booster yesterday and today I have a fever, headache, body aches, and chills

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I have lupus and have to stop my medication for 1week after getting vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Health check-in — day 7, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-25
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-05-09
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-05-16
Survey response — day 35, dose 3
MedDRA: Norovirus infection — 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: Noro virus

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Report sent to call center — day 35, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-10	Janssen/Johnson & Johnson
2	2021-12-12	Moderna	No
3	2022-04-11	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-10	Successful 2021-07-13	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-16	Successful 2022-05-17	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-11

Systemic reaction (other): I have lupus ra and MCTD so this is common

2021-04-12

Systemic reaction (other): These are everyday symptoms for me with young kids and my disease

Release 9 — 3 months, dose 1

2021-07-10

Symptoms: Loose bms for the last week and horrible cramps

Healthcare visit (other): Called my on call rheumatologist to see if medication brand change could be problem.

Release 11 — 12 months, dose 1

2022-04-12

Symptoms: I got my second booster yesterday and today I have a fever, headache, body aches, and chills

Release 11 — days 1–6 daily, dose 3

2022-04-13

Systemic reaction (other): I have lupus and have to stop my medication for 1week after getting vaccine

Release 11 — day 35, dose 3

2022-05-16

Symptoms: Noro virus

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	Medical counselling	✓	✓	✓
SD	Chills	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Headache	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Norovirus infection	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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