YR7-13912-90981
4 vaccinations
15 coded responses
58 check-ins
15 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 56-60
- ZIP prefix
- 531 / WI
- Registered
- 2021-03-16
- Relationship
- Self
- Race
- White
- Ethnicity
- Hispanic or Latino
Timeline
-
2021-03-16
Registered in v-safe
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2021-03-16
Dose 1 — Janssen/Johnson & Johnson
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2021-03-16
Survey response — day 0, dose 1MedDRA: No adverse event — Feeling: Good · Site: Pain · HeadacheFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-17
Survey response — days 1–6 daily, dose 1MedDRA: Disturbance in attention — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tirednessFree text: Lack of mental acuityMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-18
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Good · Site: Pain · Fever · Headache, Fatigue or tirednessFree text: NoneMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-03-19
Survey response — days 1–6 daily, dose 1MedDRA: Dyspnoea — Feeling: Good · Site: Pain · Fatigue or tirednessFree text: Feeling a bit short of breath, which I forgot to report yesterday too.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-20
- 2021-03-21
- 2021-03-22
- 2021-03-23
- 2021-03-30
- 2021-04-06
- 2021-04-13
- 2021-04-20
- 2021-04-27
- 2021-06-15
- 2021-09-14
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2021-10-25
Dose 2 — Pfizer-BioNTech
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2021-10-25
Survey response — day 0, dose 2MedDRA: Asthenia, Brain fog — Feeling: Good · Site: PainFree text: A slightly vague, increasing lack of energy that isn't really tiredness but more like brain fogMedDRA releases: 2024-11 · check-in free text available
- 2021-10-26
- 2021-10-27
- 2021-10-28
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-01
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
- 2022-01-24
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2022-04-09
Dose 3 — Moderna
- 2022-04-09
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2022-04-10
Survey response — days 1–6 daily, dose 3MedDRA: Chills, Fatigue, Injection site pain, Nausea — Feeling: Good · Site: Pain · Chills, Headache, Fatigue or tiredness, NauseaFree text: Most of my mild symptoms didn't appear until about 10 hours after the injection - they were very mild nausea, chills & fatigue which were gone by the time I woke up this morning. However, the arm site pain didnt really appear until this morning.MedDRA releases: 2024-11 · check-in free text available
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2022-04-11
Survey response — days 1–6 daily, dose 3MedDRA: Brain fog, Disturbance in attention, Fatigue — Feeling: Fair · Site: Pain · Fatigue or tirednessFree text: Brain fog, inability to concentrate & focus. Fatigue to the point of inertia.MedDRA releases: 2024-11 · check-in free text available
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2022-04-12
Survey response — days 1–6 daily, dose 3MedDRA: Pain in extremity — Feeling: Good · Site: PainFree text: The arm pain is reduced from yesterday.MedDRA releases: 2024-11 · check-in free text available
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2022-04-13
Survey response — days 1–6 daily, dose 3MedDRA: Injection site pain — Feeling: Good · Site: PainFree text: Residual tenderness only when injection site is pressedMedDRA releases: 2024-11 · check-in free text available
- 2022-04-14
- 2022-04-15
- 2022-04-16
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2022-04-23
Survey response — day 14, dose 3MedDRA: Respiratory tract congestion — Feeling: GoodFree text: Chest congestion this past week, two days; no fever, did not feel sickMedDRA releases: 2024-11 · check-in free text available
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2022-04-30
Survey response — day 21, dose 3MedDRA: Diarrhoea, Gastrointestinal pain, Self-medication — Feeling: GoodFree text: Intestinal cramping & loose stools for about 3-4 hrs beginning about 4-5 hrs after eating full meal. Controlled with anti diarrheal meds. Suspect raw vegetable salad or improperly cooked fish at meal.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-07
- 2022-05-14
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2022-05-21
Survey response — day 42, dose 3MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: FairFree text: Chesty cold. Tested negative for covid.MedDRA releases: 2024-11 · check-in free text available
- 2022-07-09
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2022-09-28
Dose 4 — Moderna
- 2022-09-28
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2022-09-29
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
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2022-09-30
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: Good · Site: Pain, SwellingFree text:MedDRA releases: 2024-11 · check-in free text available
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2022-10-01
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tirednessAdult check-in
- 2022-10-02
- 2022-10-03
- 2022-10-04
- 2022-10-05
- 2022-10-12
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2022-10-19
Survey response — day 21, dose 4MedDRA: Balance disorder, Dizziness exertional, Sinus congestion — Feeling: FairFree text: Very mild sinus congestion very mild dizziness or off balance sensation after intense physical activity.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-26
- 2022-11-02
- 2022-11-11
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2022-12-28
Survey response — 3 months, dose 4MedDRA: Cough, Dysphonia, Fatigue, Influenza, Mobility decreased, Pain, Pyrexia, Respiratory tract congestion — Feeling: Good · 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 visitFree text: Probable influenza - negative antigen test during first 24 hours of symptoms but sudden onset, fever, fatigue, aches, cough, congestion, hoarse voice. In bed 4 days. Felt exhausted 9 days.MedDRA releases: 2024-11 · check-in free text available
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2022-12-28
Report sent to call center — 3 months, dose 4Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-12-29
- 2023-03-29
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-16 | Janssen/Johnson & Johnson | |
| 2 | 2021-10-25 | Pfizer-BioNTech | No |
| 3 | 2022-04-09 | Moderna | No |
| 4 | 2022-09-28 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-12-28 | Unsuccessful |
Free text
Release 5 — day 0, dose 1
Systemic reaction (other): None
Release 5 — days 1–6 daily, dose 1
Systemic reaction (other): Lack of mental acuity
Systemic reaction (other): None
Release 6 — days 1–6 daily, dose 1
Systemic reaction (other): Feeling a bit short of breath, which I forgot to report yesterday too.
Release 10 — day 0, dose 2
Systemic reaction (other): A slightly vague, increasing lack of energy that isn't really tiredness but more like brain fog
Release 11 — days 1–6 daily, dose 3
Systemic reaction (other): Most of my mild symptoms didn't appear until about 10 hours after the injection - they were very mild nausea, chills & fatigue which were gone by the time I woke up this morning. However, the arm site pain didnt really appear until this morning.
Systemic reaction (other): Brain fog, inability to concentrate & focus. Fatigue to the point of inertia.
Systemic reaction (other): The arm pain is reduced from yesterday.
Systemic reaction (other): Residual tenderness only when injection site is pressed
Release 11 — day 14, dose 3
Symptoms: Chest congestion this past week, two days; no fever, did not feel sick
Release 11 — day 21, dose 3
Symptoms: Intestinal cramping & loose stools for about 3-4 hrs beginning about 4-5 hrs after eating full meal. Controlled with anti diarrheal meds. Suspect raw vegetable salad or improperly cooked fish at meal.
Release 11 — day 42, dose 3
Symptoms: Chesty cold. Tested negative for covid.
Release 12 — days 1–6 daily, dose 4
Release 12 — day 21, dose 4
Symptoms: Very mild sinus congestion very mild dizziness or off balance sensation after intense physical activity.
Release 12 — 3 months, dose 4
Symptoms: Probable influenza - negative antigen test during first 24 hours of symptoms but sudden onset, fever, fatigue, aches, cough, congestion, hoarse voice. In bed 4 days. Felt exhausted 9 days.
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 | Balance disorder | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dizziness exertional | · | · | ✓ |
| SD | Dysphonia | · | · | ✓ |
| SD | Fatigue | · | · | ✓ |
| SD | Gastrointestinal pain | · | · | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Mobility decreased | · | · | ✓ |
| SD | Nasopharyngitis | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Pyrexia | · | · | ✓ |
| SD | Respiratory tract congestion | · | · | ✓ |
| SD | SARS-CoV-2 test negative | · | · | ✓ |
| SD | Self-medication | · | · | ✓ |
| SD | Sinus congestion | · | · | ✓ |
| SRO | Asthenia | · | · | ✓ |
| SRO | Brain fog | · | · | ✓ |
| SRO | Chills | · | · | ✓ |
| SRO | Disturbance in attention | ✓ | ✓ | ✓ |
| SRO | Dyspnoea | ✓ | ✓ | ✓ |
| SRO | Fatigue | · | · | ✓ |
| SRO | Injection site pain | · | · | ✓ |
| SRO | Nausea | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release