Z6Y-11389-88709
2 vaccinations
4 coded responses
28 check-ins
4 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 26-30
- ZIP prefix
- 032 / NH
- Registered
- 2021-04-13
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-04-12
Dose 1 — Janssen/Johnson & Johnson
-
2021-04-13
Registered in v-safe
-
2021-04-13
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to workAdult check-in
-
2021-04-14
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
- 2021-04-15
- 2021-04-16
- 2021-04-17
- 2021-04-18
- 2021-04-19
- 2021-04-26
- 2021-05-03
- 2021-05-12
- 2021-05-17
- 2021-05-24
- 2021-07-13
- 2021-10-11
-
2021-11-02
Dose 2 — Moderna
- 2021-11-02
-
2021-11-03
Survey response — days 1–6 daily, dose 2MedDRA: Syncope — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: FaintingMedDRA releases: 2024-11 · check-in free text available
- 2021-11-04
- 2021-11-05
- 2021-11-06
-
2021-11-07
Survey response — days 1–6 daily, dose 2MedDRA: Pregnancy test positive — Feeling: GoodFree text: Positive pregnancy testMedDRA releases: 2024-11 · check-in free text available
- 2021-11-08
- 2021-11-09
- 2021-11-16
- 2021-11-23
-
2021-11-30
Survey response — day 28, dose 2MedDRA: Morning sickness — Feeling: Good · Be unable to do your normal daily activitiesFree text: Morning SicknessMedDRA releases: 2024-11 · check-in free text available
- 2021-12-07
- 2021-12-14
-
2022-02-01
Survey response — 3 months, dose 2MedDRA: Abortion spontaneous — 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: Miscarriage at 9 weeks. I was pregnant at the time of my booster shot.MedDRA releases: 2024-11 · check-in free text available
-
2022-02-01
Report sent to call center — 3 months, dose 2Be 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)
-
2022-02-04
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-12 | Janssen/Johnson & Johnson | |
| 2 | 2021-11-02 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-02-01 | Successful 2022-02-04 |
Not applicable (accidental reporting or does not believe symptoms are related to vaccine) |
Free text
Release 10 — days 1–6 daily, dose 2
Systemic reaction (other): Fainting
Systemic reaction (other): Positive pregnancy test
Release 10 — day 28, dose 2
Symptoms: Morning Sickness
Release 11 — 3 months, dose 2
Symptoms: Miscarriage at 9 weeks. I was pregnant at the time of my booster shot.
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 | Abortion spontaneous | · | · | ✓ |
| SD | Morning sickness | · | · | ✓ |
| SRO | Pregnancy test positive | · | · | ✓ |
| SRO | Syncope | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release