2TN-30013-53220

4 vaccinations 8 coded responses 15 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 700 / LA
Registered: 2022-01-27

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

2021-03-19
Dose 1 — Moderna
2021-04-27
Dose 2 — Moderna
2021-08-16
Dose 3 — Moderna
2022-01-26
Dose 4 — Pfizer-BioNTech
2022-01-27
Registered in v-safe
2022-01-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Nausea

Adult check-in
2022-01-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-01-29
Survey response — days 1–6 daily, dose 4
MedDRA: Mouth ulceration — Feeling: Good

Free text: Ulcers in my mouth

MedDRA releases: 2024-11 · check-in free text available
2022-01-30
Survey response — days 1–6 daily, dose 4
MedDRA: Pre-existing disease — Feeling: Good

Free text: Just the ulcers on my tongue which I got with covid before and I get any time I'm sick.

MedDRA releases: 2024-11 · check-in free text available
2022-01-31
Survey response — days 1–6 daily, dose 4
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good

Free text: Ulcers on my tongue that I've gotten both times with covid and every time I'm sick.

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Survey response — days 1–6 daily, dose 4
MedDRA: COVID-19, Mouth ulceration — Feeling: Good

Free text: Some new mouth ulcers. Added L-lysine. This is something I got both times I had covid

MedDRA releases: 2024-11 · check-in free text available
2022-02-02
Survey response — day 7, dose 4
MedDRA: Asthma, Pre-existing disease, Ulcer — Feeling: Good

Free text: Ulcers are getting better, but I had a very bad asthma attack last night. I don't have asthma issues much unless I get sick. I had to do a steroid inhaler and my rescue inhaler.

MedDRA releases: 2024-11 · check-in free text available
2022-02-09
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-02-16
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-02-23
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-03-02
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-03-09
Survey response — day 42, dose 4
MedDRA: Facial paralysis, Hypoaesthesia, Myalgia, Neuralgia, Office visit, Pain, Palpitations — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: My entire body has gone haywire. I'm experiencing muscle and nerve pain everywhere. My knees down are going numb. My eye lid on the left side of my face was hanging, I'm in crazy pain and heart palpitations and the doctors can't figure out why. · Healthcare visit (other): Specialists

MedDRA releases: 2024-11 · check-in free text available
2022-03-09
Report sent to call center — day 42, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-17
Call 1 — Left Voicemail
2022-04-27
Survey response — 3 months, dose 4
MedDRA: Back disorder, Neuralgia, Neuropathy peripheral, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Serious back and neck issues, nerve pain and diagnosed with peripheral neuropathy

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-04-28
Call 1 — Left Voicemail
2022-07-27
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-01-28
Survey response — 12 months, dose 4
MedDRA: Blood immunoglobulin G decreased, Blood potassium decreased, Blood sodium decreased, Inflammation, Laboratory test abnormal, Mean cell haemoglobin increased, Office visit, Vitamin B12 decreased — Feeling: Good · Be unable to work or attend school, 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
2023-01-28
Report sent to call center — 12 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-01-30
Call successful
Completed over the phone
2023-01-30
Call successful
Completed over the phone
2023-01-30
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna	No
2	2021-04-27	Moderna	No
3	2021-08-16	Moderna	No
4	2022-01-26	Pfizer-BioNTech	No

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 3

See the call center timeline

Free text

Release 11 — days 1–6 daily, dose 4

2022-01-29

Systemic reaction (other): Ulcers in my mouth

2022-01-30

Systemic reaction (other): Just the ulcers on my tongue which I got with covid before and I get any time I'm sick.

2022-01-31

Systemic reaction (other): Ulcers on my tongue that I've gotten both times with covid and every time I'm sick.

2022-02-01

Systemic reaction (other): Some new mouth ulcers. Added L-lysine. This is something I got both times I had covid

Release 11 — day 7, dose 4

2022-02-02

Systemic reaction (other): Ulcers are getting better, but I had a very bad asthma attack last night. I don't have asthma issues much unless I get sick. I had to do a steroid inhaler and my rescue inhaler.

Release 11 — day 42, dose 4

2022-03-09

Symptoms: My entire body has gone haywire. I'm experiencing muscle and nerve pain everywhere. My knees down are going numb. My eye lid on the left side of my face was hanging, I'm in crazy pain and heart palpitations and the doctors can't figure out why.

Healthcare visit (other): Specialists

Release 11 — 3 months, dose 4

2022-04-27

Symptoms: Serious back and neck issues, nerve pain and diagnosed with peripheral neuropathy

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	Back disorder	·	·	✓
SD	Blood immunoglobulin G decreased	·	·	✓
SD	Blood potassium decreased	·	·	✓
SD	Blood sodium decreased	·	·	✓
SD	Facial paralysis	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Inflammation	·	·	✓
SD	Laboratory test abnormal	·	·	✓
SD	Mean cell haemoglobin increased	·	·	✓
SD	Myalgia	·	·	✓
SD	Neuralgia	·	·	✓
SD	Neuropathy peripheral	·	·	✓
SD	Office visit	·	·	✓
SD	Pain	·	·	✓
SD	Palpitations	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Vitamin B12 decreased	·	·	✓
SRO	Asthma	·	·	✓
SRO	Condition aggravated	·	·	✓
SRO	COVID-19	·	·	✓
SRO	Mouth ulceration	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Ulcer	·	·	✓

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