ZLU-13876-83380

3 vaccinations 16 coded responses 45 check-ins 16 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 052 / VT
Registered: 2021-04-10

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

2021-04-10
Registered in v-safe
2021-04-10
Dose 1 — Janssen/Johnson & Johnson
2021-04-10
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-17
Survey response — day 7, dose 1
MedDRA: Ear pain, Paranasal sinus discomfort, Pre-existing disease, Sneezing — Feeling: Good · Headache

Free text: Earache and sinus pressure with sneezing- probably seasonal allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 21, single dose
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, single dose
Feeling: Good

Adult check-in
2021-05-15
Survey response — day 35, single dose
MedDRA: Dry mouth, Swollen tongue — Feeling: Good

Free text: For the last couple of weeks I have had a feeling of thickness in my tongue and my mouth is dry and sticky feeling.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-07-10
Survey response — 3 months, dose 1
MedDRA: Dry mouth — Feeling: Good

Free text: Dry mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-09
Survey response — 6 months, dose 1
MedDRA: Dry mouth, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Dry mouth is getting worse · Healthcare visit (other): Primary Care referral to Rheumatologist

MedDRA releases: 2024-11 · check-in free text available
2021-10-09
Report sent to call center — 6 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-08
Dose 2 — Janssen/Johnson & Johnson
2021-12-08
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-09
Survey response — days 1–6 daily, dose 2
MedDRA: Dry mouth — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Free text: Dry mouth

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Call 1 — Left Voicemail
2021-12-10
Survey response — days 1–6 daily, dose 2
MedDRA: Dry mouth — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dry mouth

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dry mouth — Feeling: Good · Muscle or body aches

Free text: Dry mouth

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Survey response — days 1–6 daily, dose 2
MedDRA: Dry mouth — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dry mouth

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye, Dry mouth, Paranasal sinus hyposecretion — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Mouth is still horribly dry, since early May, as are my eyes and sinuses

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye, Dry mouth, Headache — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dry mouth, eyes, headache

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Survey response — day 7, dose 2
MedDRA: Dry mouth, Unevaluable event — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dry mouth, eyes, sinuses, throat

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-12-29
Survey response — day 21, dose 2
MedDRA: Dry eye, Dry mouth, Oesophageal disorder, Paranasal sinus hyposecretion — Feeling: Good

Free text: Dry mouth, sinuses, esophagus, eyes

MedDRA releases: 2024-11 · check-in free text available
2022-01-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2022-01-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2022-01-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-03-11
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2022-06-08
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-06-22
Dose 3 — Moderna
2022-06-22
Survey response — day 0, dose 3
MedDRA: Dry mouth — Feeling: Good

Free text: Still fighting dry mouth since soon after my first shot in April of 2021.

MedDRA releases: 2024-11 · check-in free text available
2022-06-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-06-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2022-06-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-06-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-06-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-06-29
Survey response — day 7, dose 3
MedDRA: Dry mouth — Feeling: Good

Free text: Only the persistent dry mouth since soon after my first shot.

MedDRA releases: 2024-11 · check-in free text available
2022-07-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-07-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-07-20
Survey response — day 28, dose 3
MedDRA: Dry mouth — Feeling: Good

Free text: Dry mouth is still a chronic problem since 2 weeks after my first shot.

MedDRA releases: 2024-11 · check-in free text available
2022-07-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-08-03
Survey response — day 42, dose 3
MedDRA: Dry mouth — Feeling: Good

Free text: Still fighting the dry mouth

MedDRA releases: 2024-11 · check-in free text available
2022-09-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-12-21
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2023-06-22
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-10	Janssen/Johnson & Johnson
2	2021-12-08	Janssen/Johnson & Johnson	No
3	2022-06-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-09	Unsuccessful

Free text

Release 7 — day 7, dose 1

2021-04-17

Systemic reaction (other): Earache and sinus pressure with sneezing- probably seasonal allergies

Release 8 — day 35, single dose

2021-05-15

Symptoms: For the last couple of weeks I have had a feeling of thickness in my tongue and my mouth is dry and sticky feeling.

Release 9 — 3 months, dose 1

2021-07-10

Symptoms: Dry mouth

Release 10 — 6 months, dose 1

2021-10-09

Symptoms: Dry mouth is getting worse

Healthcare visit (other): Primary Care referral to Rheumatologist

Release 10 — days 1–6 daily, dose 2

2021-12-09

Systemic reaction (other): Dry mouth

2021-12-10

Systemic reaction (other): Dry mouth

2021-12-11

Systemic reaction (other): Dry mouth

2021-12-12

Systemic reaction (other): Dry mouth

2021-12-13

Systemic reaction (other): Mouth is still horribly dry, since early May, as are my eyes and sinuses

2021-12-14

Systemic reaction (other): Dry mouth, eyes, headache

Release 10 — day 7, dose 2

2021-12-15

Systemic reaction (other): Dry mouth, eyes, sinuses, throat

Release 10 — day 21, dose 2

2021-12-29

Symptoms: Dry mouth, sinuses, esophagus, eyes

Release 12 — day 0, dose 3

2022-06-22

Systemic reaction (other): Still fighting dry mouth since soon after my first shot in April of 2021.

Release 12 — day 7, dose 3

2022-06-29

Systemic reaction (other): Only the persistent dry mouth since soon after my first shot.

Release 12 — day 28, dose 3

2022-07-20

Symptoms: Dry mouth is still a chronic problem since 2 weeks after my first shot.

Release 12 — day 42, dose 3

2022-08-03

Symptoms: Still fighting the dry mouth

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	Office visit	·	·	✓
SD	Dry eye	·	·	✓
SD	Dry mouth	✓	✓	✓
SD	Oesophageal disorder	·	·	✓
SD	Paranasal sinus hyposecretion	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Swollen tongue	✓	✓	✓
SRO	Dry eye	·	·	✓
SRO	Dry mouth	·	·	✓
SRO	Ear pain	✓	✓	✓
SRO	Headache	·	·	✓
SRO	Paranasal sinus discomfort	✓	✓	✓
SRO	Paranasal sinus hyposecretion	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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