YTZ-22148-67731

2 vaccinations 7 coded responses 19 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 959 / CA
Registered: 2021-09-24

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-09-16
Dose 1 — Janssen/Johnson & Johnson
2021-09-24
Registered in v-safe
2021-09-24
Survey response — day 7, dose 1
MedDRA: Urinary incontinence — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Incontinence with bladder

MedDRA releases: 2024-11 · check-in free text available
2021-09-30
Survey response — day 14, dose 1
MedDRA: Bladder disorder, Fatigue, Muscle tightness — Feeling: Poor · Be unable to do your normal daily activities

Free text: Uncontrollable bladder leakage. Leg pain, muscle tightness in both and fatigue.

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Survey response — day 21, single dose
MedDRA: Muscle spasms, Urinary incontinence — Feeling: Poor · 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: Uncontrollable bladder leakage and leg craps

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Report sent to call center — day 21, single dose
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-12
Call 1 — Left Voicemail
2021-10-13
Call 2 — Left Voicemail
2021-10-14
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-10-16
Survey response — day 28, single dose
MedDRA: Impaired work ability, Incontinence, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: Incontinence has increased to the point I can't stay at work the entire without changing clothes from leakage · Healthcare visit (other): Women's health doctor

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Report sent to call center — day 28, single dose
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2021-10-18
Call 1 — Left Voicemail
2021-10-18
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-10-21
Survey response — day 35, single dose
MedDRA: Hypoaesthesia — Feeling: Fair

Free text: Numbing in finger and legs

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Survey response — day 42, single dose
MedDRA: Office visit, Urinary incontinence — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Increased in lost of bladder control. · Healthcare visit (other): Being referred to primary doctor after seeing my ob/gyn docyor. Still waiting to see specialist

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Report sent to call center — day 42, single dose
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2021-10-29
Call 1 — Could Not Reach Participant
2021-11-03
Call 2 — Could Not Reach Participant
2021-12-16
Survey response — 3 months, dose 1
MedDRA: Guillain-Barre syndrome, Hospitalisation, Hypoaesthesia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Numbing in hands and lower legs. Was in hospital for GBS treatment after vaccine from November 11 to November 15.

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Report sent to call center — 3 months, dose 1
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-18
Call 1 — Left Voicemail
2022-01-14
Dose 2 — Moderna
2022-01-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2022-01-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-01-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-01-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-01-21
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-01-30
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2022-02-04
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2022-02-12
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2022-02-18
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2022-02-27
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2022-04-15
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2022-07-17
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-16	Janssen/Johnson & Johnson	No
2	2022-01-14	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-07	Successful 2021-10-14	Reported to VAERS voluntarily prior to GDIT contact
2021-10-16	Successful 2021-10-18	Reported to VAERS voluntarily prior to GDIT contact
2021-10-28	Unsuccessful	Reported to VAERS voluntarily prior to GDIT contact
2021-12-16	Unsuccessful

Free text

Release 9 — day 7, dose 1

2021-09-24

Systemic reaction (other): Incontinence with bladder

Release 9 — day 14, dose 1

2021-09-30

Symptoms: Uncontrollable bladder leakage. Leg pain, muscle tightness in both and fatigue.

Release 10 — day 21, single dose

2021-10-07

Symptoms: Uncontrollable bladder leakage and leg craps

Release 10 — day 28, single dose

2021-10-16

Symptoms: Incontinence has increased to the point I can't stay at work the entire without changing clothes from leakage

Healthcare visit (other): Women's health doctor

Release 10 — day 35, single dose

2021-10-21

Symptoms: Numbing in finger and legs

Release 10 — day 42, single dose

2021-10-28

Symptoms: Increased in lost of bladder control.

Healthcare visit (other): Being referred to primary doctor after seeing my ob/gyn docyor. Still waiting to see specialist

Release 10 — 3 months, dose 1

2021-12-16

Symptoms: Numbing in hands and lower legs. Was in hospital for GBS treatment after vaccine from November 11 to November 15.

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	Bladder disorder	·	·	✓
SD	Fatigue	·	·	✓
SD	Guillain-Barre syndrome	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Impaired work ability	·	·	✓
SD	Incontinence	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Muscle tightness	·	·	✓
SD	Urinary incontinence	·	·	✓
SRO	Urinary incontinence	·	·	✓

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