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Z96-31423-56195

2 vaccinations 7 coded responses 25 check-ins 7 free-text entries 0 call cases
Sex
Female
Age at first dose
36-40
ZIP prefix
953 / CA
Registered
2021-03-12
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-11
    Dose 1 — Janssen/Johnson & Johnson
  2. 2021-03-12
    Registered in v-safe
  3. 2021-03-12
    Survey response — days 1–6 daily, dose 1
    MedDRA: Disturbance in attention, Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea
    Free text: Unable to concentrate, brain fog
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-13
    Survey response — days 1–6 daily, dose 1
    MedDRA: Tinnitus — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness
    Free text: My tinnitus is worse and happened after vaccination. My tinnitus hasnt lessened.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Dizziness, Tinnitus — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea, Diarrhea
    Free text: Dizziness and still noticed my tinnitus is worse
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-15
    Survey response — days 1–6 daily, dose 1
    MedDRA: Feeling abnormal, Tinnitus — Feeling: Good · Site: Pain · Fatigue or tiredness, Diarrhea
    Free text: Ears are still ringing louder than usual and still having some brain fog.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-16
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  8. 2021-03-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  9. 2021-03-19
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-27
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-04-02
    Survey response — day 21, single dose
    MedDRA: Balance disorder, Dizziness — Feeling: Fair
    Free text: Dizziness and feeling unsteady
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-08
    Survey response — day 28, single dose
    MedDRA: Balance disorder, Dizziness — Feeling: Fair
    Free text: Still off balance and felling a little dizzy. Feels like I'm moving when I'm sitting still.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-04-15
    Health check-in — day 35, single dose
    Feeling: Good
    Adult check-in
  14. 2021-04-22
    Health check-in — day 42, single dose
    Feeling: Good
    Adult check-in
  15. 2021-06-10
    Health check-in — 3 months, dose 1
    Feeling: Good
    Adult check-in
  16. 2021-09-09
    Health check-in — 6 months, dose 1
    Feeling: Good
    Adult check-in
  17. 2021-10-28
    Dose 2 — Moderna
  18. 2021-11-01
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chills, Fatigue, Pyrexia — Feeling: Good
    Free text: After I got the vaccine on 10/28/2021 I had felt fatigued and tired. 24hrs later I got a low grade fever and chills. Nothing out of the ordinary for the vaccine side effects.
    MedDRA releases: 2024-11 · check-in free text available
  19. 2021-11-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-11-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-11-04
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-11-11
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-11-18
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-11-27
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-12-02
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-12-09
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  27. 2022-01-27
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2022-10-28
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-11Janssen/Johnson & Johnson
22021-10-28Moderna No

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-12

Systemic reaction (other): Unable to concentrate, brain fog

2021-03-13

Systemic reaction (other): My tinnitus is worse and happened after vaccination. My tinnitus hasnt lessened.

2021-03-14

Systemic reaction (other): Dizziness and still noticed my tinnitus is worse

2021-03-15

Systemic reaction (other): Ears are still ringing louder than usual and still having some brain fog.

Release 6 — day 21, single dose

2021-04-02

Symptoms: Dizziness and feeling unsteady

Release 7 — day 28, single dose

2021-04-08

Symptoms: Still off balance and felling a little dizzy. Feels like I'm moving when I'm sitting still.

Release 10 — days 1–6 daily, dose 2

2021-11-01

Systemic reaction (other): After I got the vaccine on 10/28/2021 I had felt fatigued and tired. 24hrs later I got a low grade fever and chills. Nothing out of the ordinary for the vaccine side effects.

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

FieldPreferred term2021-092023-042024-11
SDBalance disorder ✓ ✓ ✓
SDDizziness ✓ ✓ ✓
SROChills · · ✓
SRODisturbance in attention ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROFatigue · · ✓
SROFeeling abnormal ✓ ✓ ✓
SROPyrexia · · ✓
SROTinnitus ✓ ✓ ✓

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