ZL8-36284-41168
4 vaccinations
7 coded responses
56 check-ins
7 free-text entries
3 call cases
- Sex
- Female
- Age at first dose
- 61-65
- ZIP prefix
- 801 / CO
- Registered
- 2021-03-24
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
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2021-03-24
Registered in v-safe
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2021-04-07
Dose 1 — Janssen/Johnson & Johnson
- 2021-04-07
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2021-04-08
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
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2021-04-09
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to workAdult check-in
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2021-04-10
Health check-in — days 1–6 daily, dose 1Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-04-11
Health check-in — days 1–6 daily, dose 1Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tirednessAdult check-in
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2021-04-12
Health check-in — days 1–6 daily, dose 1Feeling: Good · Joint pains, Fatigue or tirednessAdult check-in
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2021-04-13
Health check-in — days 1–6 daily, dose 1Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesAdult check-in
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2021-04-14
Survey response — day 7, dose 1MedDRA: Lymph node pain — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activitiesFree text: Lymph node pain in groin and jointsMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-21
Survey response — day 14, dose 1MedDRA: Abdominal distension, Fatigue, Gastrointestinal disorder, Loss of personal independence in daily activities, Malaise, Pain in extremity, Sinusitis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: Yes since last week I have continued fatigue, calf aches and have been having bloating and intestinal symptoms. Also have had sinusitis and generally dont feel great. I was very healthy before and havent even been able to take a walk sinceMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-04-28
Survey response — day 21, single doseMedDRA: Exercise tolerance decreased, Fatigue, Insomnia, Pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: Ongoing fatigue and body aches. Very low endurance and difficulty sleeping.These symptoms were not happening prior to the vaccination.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-05
Survey response — day 28, single doseMedDRA: Abdominal distension, Arthralgia, Fatigue, Headache, Unevaluable event — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professionalFree text: Symptoms: Continued fatigue, joint pain, intestinal bloating m, intermittent headaches · Healthcare visit (other): Family physician visit scheduled for 5/6MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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2021-05-05
Report sent to call center — day 28, single doseBe unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-12
- 2021-05-19
- 2021-05-27
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2021-05-27
Call successfulParticipant prefers to complete VAERS report online
- 2021-07-07
- 2021-10-06
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2021-11-18
Dose 2 — Moderna
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2021-11-18
Health check-in — day 0, dose 2Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
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2021-11-19
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
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2021-11-20
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
- 2021-11-21
- 2021-11-22
- 2021-11-23
- 2021-11-24
- 2021-11-25
- 2021-12-02
- 2021-12-09
- 2021-12-16
- 2021-12-23
- 2021-12-30
- 2022-02-17
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2022-05-02
Dose 3 — Moderna
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2022-05-02
Health check-in — day 0, dose 3Feeling: Good · Site: Pain · Chills, Fatigue or tirednessAdult check-in
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2022-05-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend schoolAdult check-in
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2022-05-04
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Fatigue or tirednessAdult check-in
- 2022-05-05
- 2022-05-06
- 2022-05-07
- 2022-05-08
- 2022-05-09
- 2022-05-16
- 2022-05-23
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2022-05-30
Survey response — day 28, dose 3MedDRA: Sinusitis — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Sinus infectionMedDRA releases: 2024-11 · check-in free text available
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2022-06-06
Survey response — day 35, dose 3MedDRA: Hemiparesis, Neuralgia, Neurological symptom, Sinusitis, Visual impairment — 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 · Outpatient clinic or urgent care clinic visitFree text: Sinus infection with neurological symptoms including right sided weakness and right sided nerve pain with vision difficultiesMedDRA releases: 2024-11 · check-in free text available
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2022-06-06
Report sent to call center — day 35, dose 3Be 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)
- 2022-06-07
- 2022-06-07
- 2022-06-13
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2022-08-01
Survey response — 3 months, dose 3MedDRA: Sinusitis — 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, Outpatient clinic or urgent care clinic visitFree text: Sinus infectionMedDRA releases: 2024-11 · check-in free text available
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2022-08-01
Report sent to call center — 3 months, dose 3Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
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2022-08-02
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
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2022-09-09
Dose 4 — Moderna
- 2022-09-09
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2022-09-10
Health check-in — days 1–6 daily, dose 4Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
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2022-09-11
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2022-09-12
- 2022-09-14
- 2022-09-16
- 2022-09-23
- 2022-09-30
- 2022-10-07
- 2022-10-14
- 2022-10-21
- 2022-12-09
- 2023-03-10
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-04-07 | Janssen/Johnson & Johnson | |
| 2 | 2021-11-18 | Moderna | No |
| 3 | 2022-05-02 | Moderna | No |
| 4 | 2022-09-09 | Moderna | No |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2021-05-05 | Successful 2021-05-27 |
Participant prefers to complete VAERS report online |
| 2022-06-06 | Successful | Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
| 2022-08-01 | Successful 2022-08-02 |
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill |
Free text
Release 7 — day 7, dose 1
Systemic reaction (other): Lymph node pain in groin and joints
Release 7 — day 14, dose 1
Symptoms: Yes since last week I have continued fatigue, calf aches and have been having bloating and intestinal symptoms. Also have had sinusitis and generally dont feel great. I was very healthy before and havent even been able to take a walk since
Release 8 — day 21, single dose
Symptoms: Ongoing fatigue and body aches. Very low endurance and difficulty sleeping.These symptoms were not happening prior to the vaccination.
Release 8 — day 28, single dose
Symptoms: Continued fatigue, joint pain, intestinal bloating m, intermittent headaches
Healthcare visit (other): Family physician visit scheduled for 5/6
Release 11 — day 28, dose 3
Symptoms: Sinus infection
Release 11 — day 35, dose 3
Symptoms: Sinus infection with neurological symptoms including right sided weakness and right sided nerve pain with vision difficulties
Release 12 — 3 months, dose 3
Symptoms: Sinus infection
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 | Unevaluable event | ✓ | ✓ | ✓ |
| SD | Abdominal distension | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Exercise tolerance decreased | ✓ | ✓ | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Gastrointestinal disorder | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Hemiparesis | · | · | ✓ |
| SD | Insomnia | ✓ | ✓ | ✓ |
| SD | Loss of personal independence in daily activities | ✓ | ✓ | ✓ |
| SD | Malaise | ✓ | ✓ | ✓ |
| SD | Neuralgia | · | · | ✓ |
| SD | Neurological symptom | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | ✓ | ✓ | ✓ |
| SD | Sinusitis | ✓ | ✓ | ✓ |
| SD | Visual impairment | · | · | ✓ |
| SRO | Lymph node pain | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release