ZNC-79677-03426

2 vaccinations 9 coded responses 26 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 760 / TX
Registered: 2021-04-06

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

2021-04-06
Registered in v-safe
2021-04-06
Dose 1 — Janssen/Johnson & Johnson
2021-04-07
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Self-medication — Feeling: Fair · Fever · Headache, Fatigue or tiredness

Free text: Any symptoms have all been mild so far... one Tylenol for headache....took a nap... so all is good so far

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: None happily!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: Thanks for making this easy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · 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
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: Just heard about the blood clots. But no symptoms at all today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-27
Survey response — day 21, single dose
MedDRA: Limb injury, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: I dont know that this is vaccine related... but my right arm... the one I got the shot in... I reached high to a shelf and pulled a muscle or tore the rotator cuff possibly. Waiting to see a doctor. · Healthcare visit (other): Awaiting in person visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Report sent to call center — day 21, single dose
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-04
Health check-in — day 28, single dose
Feeling: Fair

Adult check-in
2021-05-11
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-06-11
Call 1 — Left Voicemail
2021-07-06
Survey response — 3 months, dose 1
MedDRA: Limb injury, Pain in extremity, Rotator cuff syndrome — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I have had a small rotator cuff / arm injury on my vaccinated arm. Just fyi. I dont think its relatedi had hyper extended at the grocery store to reach an item. Arm has ached since 23 may.after initially feeling fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Report sent to call center — 3 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-09
Call successful
Does not wish to fill out VAERS report
2021-10-07
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2022-01-20
Dose 2 — Moderna
2022-01-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-01-24
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

Free text: This got mostly better by end of day

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Loss of personal independence in daily activities — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Shortness of breathall symptoms are mostly mild somewhat alters activity at home

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2022-01-27
Survey response — day 7, dose 2
MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness

Free text: My fatigue while slowing me down, has not prevented necessary activity

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2022-02-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2022-02-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2022-02-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2022-03-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-07-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2023-01-20
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Janssen/Johnson & Johnson
2	2022-01-20	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-27	Unsuccessful
2021-07-06	Successful 2021-07-09	Does not wish to fill out VAERS report

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-07

Systemic reaction (other): Any symptoms have all been mild so far... one Tylenol for headache....took a nap... so all is good so far

2021-04-09

Systemic reaction (other): None happily!

2021-04-10

Systemic reaction (other): Thanks for making this easy

Release 7 — day 7, dose 1

2021-04-13

Systemic reaction (other): Just heard about the blood clots. But no symptoms at all today

Release 8 — day 21, single dose

2021-04-27

Symptoms: I dont know that this is vaccine related... but my right arm... the one I got the shot in... I reached high to a shelf and pulled a muscle or tore the rotator cuff possibly. Waiting to see a doctor.

Healthcare visit (other): Awaiting in person visit

Release 9 — 3 months, dose 1

2021-07-06

Symptoms: I have had a small rotator cuff / arm injury on my vaccinated arm. Just fyi. I dont think its relatedi had hyper extended at the grocery store to reach an item. Arm has ached since 23 may.after initially feeling fine.

Release 11 — days 1–6 daily, dose 2

2022-01-24

Systemic reaction (other): This got mostly better by end of day

2022-01-25

Systemic reaction (other): Shortness of breathall symptoms are mostly mild somewhat alters activity at home

Release 11 — day 7, dose 2

2022-01-27

Systemic reaction (other): My fatigue while slowing me down, has not prevented necessary activity

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	Limb injury	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Rotator cuff syndrome	✓	✓	✓
SRO	Adverse reaction	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Loss of personal independence in daily activities	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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