ZHK-10107-40100

4 vaccinations 11 coded responses 24 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 945 / CA
Registered: 2021-04-12

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

Timeline

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

2021-04-11
Dose 1 — Janssen/Johnson & Johnson
2021-04-12
Registered in v-safe
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-04-12
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-13
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Myalgia — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Had a particular shoulder muscle ache before the shot though, so that may be unrelated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia — Feeling: Good · Muscle or body aches

Free text: shoulder pain but I've had this before the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 1
MedDRA: Myalgia, Pre-existing disease — Feeling: Good · Site: Pain · Muscle or body aches

Free text: shoulder muscle ache, but had this before the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia — Feeling: Good · Site: Pain · Muscle or body aches

Free text: shoulder pain, but I've had this before vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — day 7, dose 1
MedDRA: Arthralgia, Pre-existing disease — Feeling: Good · Muscle or body aches

Free text: shoulder pain that I've had before vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-05-07
Call 1 — Left Voicemail
2021-05-10
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-05-16
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-24
Survey response — day 42, single dose
MedDRA: Pruritus, Rash, Self-medication — Feeling: Fair

Free text: Starting Thursday 05/20 my arms started itching with a rash. Thought they were hives or allergies. They seem to be spreading to my legs. I've been applying Benadryl and Calamine lotion. I have also taken Benadryl and Claritin (not on the same day).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-11
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-10-10
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-11-24
Dose 2 — Moderna
2022-04-05
Dose 3 — Moderna
2022-04-11
Health check-in — 12 months, dose 1
Feeling: Good

Adult check-in
2022-04-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-04-12
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-04-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-04-26
Survey response — day 21, dose 3
MedDRA: Allergic respiratory symptom, Cough, Nasal dryness — Feeling: Fair

Free text: increased allergy symptoms, dry nasal passages, slight coughing

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Survey response — day 28, dose 3
MedDRA: Hypersensitivity, Pre-existing disease — Feeling: Fair

Free text: increase in allergy symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Survey response — day 35, dose 3
MedDRA: Adverse reaction, Nasal dryness, Rhinorrhoea — Feeling: Fair

Free text: increased allergy symptoms (alternately very dry nasal passages or sometimes runny nose)

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-07-05
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-10-04
Survey response — 6 months, dose 3
MedDRA: Paraesthesia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I have tingling in my arms, hands, and feet after my most recent flu shot (09/30/22).

MedDRA releases: 2024-11 · check-in free text available
2022-10-04
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-06
Call 2 — Left Voicemail
2022-10-06
Call 1 — Left Voicemail
2022-10-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-04
Dose 4 — Pfizer-BioNTech
2023-04-05
Survey response — 12 months, dose 3
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · 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
2023-04-05
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-04-06
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-11	Janssen/Johnson & Johnson
2	2021-11-24	Moderna	No
3	2022-04-05	Moderna	No
4	2022-11-04	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-12	Successful 2022-10-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-04	Successful 2022-10-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-05	Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-13

Systemic reaction (other): Had a particular shoulder muscle ache before the shot though, so that may be unrelated.

2021-04-14

Systemic reaction (other): shoulder pain but I've had this before the vaccine

2021-04-15

Systemic reaction (other): shoulder muscle ache, but had this before the vaccine

2021-04-16

Systemic reaction (other): shoulder pain, but I've had this before vaccine

Release 7 — day 7, dose 1

2021-04-18

Systemic reaction (other): shoulder pain that I've had before vaccine

Release 8 — day 42, single dose

2021-05-24

Symptoms: Starting Thursday 05/20 my arms started itching with a rash. Thought they were hives or allergies. They seem to be spreading to my legs. I've been applying Benadryl and Calamine lotion. I have also taken Benadryl and Claritin (not on the same day). cut off by CDC

Release 11 — day 21, dose 3

2022-04-26

Symptoms: increased allergy symptoms, dry nasal passages, slight coughing

Release 11 — day 28, dose 3

2022-05-03

Symptoms: increase in allergy symptoms

Release 11 — day 35, dose 3

2022-05-11

Symptoms: increased allergy symptoms (alternately very dry nasal passages or sometimes runny nose)

Release 12 — 6 months, dose 3

2022-10-04

Symptoms: I have tingling in my arms, hands, and feet after my most recent flu shot (09/30/22).

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	Adverse reaction	·	·	✓
SD	Allergic respiratory symptom	·	·	✓
SD	Cough	·	·	✓
SD	Hypersensitivity	·	·	✓
SD	Nasal dryness	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Self-medication	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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