Z5V-15932-28271

3 vaccinations 10 coded responses 27 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 335 / FL
Registered: 2021-04-18

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

2021-04-06
Dose 1 — Janssen/Johnson & Johnson
2021-04-18
Registered in v-safe
2021-04-18
Health check-in — day 7, dose 1
Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work

Adult check-in
2021-04-20
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-27
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-12-17
Dose 2 — Moderna
2021-12-17
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-12-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-12-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Diarrhea, Abdominal pain

Adult check-in
2021-12-26
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains

Adult check-in
2021-12-31
Survey response — day 14, dose 2
MedDRA: Fatigue, Nasal congestion, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue, stuffy nose, mild sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Survey response — day 21, dose 2
MedDRA: Fatigue, Hypoaesthesia, Sciatica — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sciatica nerve pain so bad my left foot was going numb. Fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-01-15
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2022-01-21
Survey response — day 35, dose 2
MedDRA: Neuralgia — Feeling: Good

Free text: Nerve pain under my upper right arm

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Survey response — day 42, dose 2
MedDRA: Brain fog, Facial nerve disorder, Fatigue, Nervous system disorder, Neuralgia — Feeling: Good

Free text: Nerve pain under right upper arm and some nerve tension in face and neck m. Brain fog. Fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-03-20
Survey response — 3 months, dose 2
MedDRA: Insomnia, Sleep apnoea syndrome — Feeling: Good · Be unable to do your normal daily activities

Free text: Sleep apnea and insomnia

MedDRA releases: 2024-11 · check-in free text available
2022-11-22
Dose 3 — Pfizer-BioNTech
2022-11-22
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Redness · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-23
Survey response — days 1–6 daily, dose 3
MedDRA: Hypoaesthesia — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Foot going numb

MedDRA releases: 2024-11 · check-in free text available
2022-11-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2022-11-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Diarrhea, Abdominal pain

Adult check-in
2022-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-11-29
Survey response — day 7, dose 3
MedDRA: Nausea — Feeling: Fair · Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Nausea

MedDRA releases: 2024-11 · check-in free text available
2022-12-11
Survey response — day 14, dose 3
MedDRA: Anxiety, Headache, Heart rate increased, Insomnia, Muscle tightness, Palpitations — Feeling: Poor · Be unable to do your normal daily activities

Free text: Heart beating faster and stronger for no reason. Insomnia. Increased anxiety. Muscle tension. Headaches.

MedDRA releases: 2024-11 · check-in free text available
2022-12-13
Survey response — day 21, dose 3
MedDRA: Fatigue, Muscle tightness, Neck pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fatigue. Neck pain and tension in muscle in upper body and feet.

MedDRA releases: 2024-11 · check-in free text available
2023-01-03
Survey response — day 42, dose 3
MedDRA: Insomnia — 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

MedDRA releases: 2024-11
2023-01-03
Report sent to call center — day 42, 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)
2023-01-04
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Janssen/Johnson & Johnson
2	2021-12-17	Moderna	No
3	2022-11-22	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2023-01-03	Unsuccessful

Free text

Release 10 — day 14, dose 2

2021-12-31

Symptoms: Fatigue, stuffy nose, mild sore throat

Release 10 — day 21, dose 2

2022-01-08

Symptoms: Sciatica nerve pain so bad my left foot was going numb. Fatigue.

Release 11 — day 35, dose 2

2022-01-21

Symptoms: Nerve pain under my upper right arm

Release 11 — day 42, dose 2

2022-01-29

Symptoms: Nerve pain under right upper arm and some nerve tension in face and neck m. Brain fog. Fatigue.

Release 11 — 3 months, dose 2

2022-03-20

Symptoms: Sleep apnea and insomnia

Release 12 — days 1–6 daily, dose 3

2022-11-23

Systemic reaction (other): Foot going numb

Release 12 — day 7, dose 3

2022-11-29

Systemic reaction (other): Nausea

Release 12 — day 14, dose 3

2022-12-11

Symptoms: Heart beating faster and stronger for no reason. Insomnia. Increased anxiety. Muscle tension. Headaches.

Release 12 — day 21, dose 3

2022-12-13

Symptoms: Fatigue. Neck pain and tension in muscle in upper body and feet.

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	Anxiety	·	·	✓
SD	Brain fog	·	·	✓
SD	Facial nerve disorder	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Insomnia	·	·	✓
SD	Muscle tightness	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Neck pain	·	·	✓
SD	Nervous system disorder	·	·	✓
SD	Neuralgia	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Palpitations	·	·	✓
SD	Sciatica	·	·	✓
SD	Sleep apnoea syndrome	·	·	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Nausea	·	·	✓

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