2XY-15995-14278

2 vaccinations 6 coded responses 26 check-ins 6 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 654 / MO
Registered: 2021-02-05

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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Moderna
2021-02-05
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-08
Dose 2 — Moderna
2021-03-08
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Central auditory processing disorder, Dementia Alzheimer's type, Disorientation, Gait inability, Mobility decreased, Pre-existing disease, Somnolence — Feeling: Poor · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Patient has Alzheimers but was extremely Disoriented, sleepy, couldnt walk, trouble following directions

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Condition aggravated, Confusional state, Dementia Alzheimer's type, Disorientation, Dysstasia, Fatigue, Gait inability, Incoherent, Lethargy, Pre-existing disease, Sitting disability, Tremor — Feeling: Poor · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Weakness, lethargic, fatigue, shaking, incoherent, confused, disoriented, cant walk, stand or sit, patient does have Alzheimers but conditions are extremely worse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Confusional state, Disorientation, Gait inability, Hallucination, Incoherent, Mobility decreased, Pre-existing disease — Feeling: Poor · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Disoriented, confused, incoherent, unable to walk, stand sit, hallucinating (new), patient has Alzheimers

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Confusional state, Disorientation, Feeding disorder, Incoherent, Mobility decreased — Feeling: Poor · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Confused, disoriented, unable to walk, stand or sit, incoherent, unable to feed self, is an Alzheimers patient but was able to do all of these things the day of vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Adult check-in
2021-03-14
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-15
Survey response — day 7, dose 2
MedDRA: Adverse reaction — Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Same as reported before

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — day 7, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-22
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-29
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-05
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-12
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-19
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-07
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-06
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-05
Call 1 — Left Voicemail
2022-03-08
Survey response — 12 months, dose 2
MedDRA: Office visit, SARS-CoV-2 test positive — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Tested positive for covid · Healthcare visit (other): In house nursing home attending physician

MedDRA releases: 2024-11 · check-in free text available
2022-03-08
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-09
Call 1 — Could Not Reach Participant
2022-03-14
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-08	Moderna

Call center

6 call center cases

6 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-09

Systemic reaction (other): Patient has Alzheimers but was extremely Disoriented, sleepy, couldnt walk, trouble following directions

2021-03-10

Systemic reaction (other): Weakness, lethargic, fatigue, shaking, incoherent, confused, disoriented, cant walk, stand or sit, patient does have Alzheimers but conditions are extremely worse

2021-03-11

Systemic reaction (other): Disoriented, confused, incoherent, unable to walk, stand sit, hallucinating (new), patient has Alzheimers

2021-03-13

Systemic reaction (other): Confused, disoriented, unable to walk, stand or sit, incoherent, unable to feed self, is an Alzheimers patient but was able to do all of these things the day of vaccination

Release 5 — day 7, dose 2

2021-03-15

Systemic reaction (other): Same as reported before

Release 11 — 12 months, dose 2

2022-03-08

Symptoms: Tested positive for covid

Healthcare visit (other): In house nursing home attending physician

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	SARS-CoV-2 test positive	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Central auditory processing disorder	✓	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Dementia Alzheimer's type	○	✓	○
SRO	Disorientation	✓	✓	✓
SRO	Dysstasia	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeding disorder	✓	✓	✓
SRO	Gait inability	✓	✓	✓
SRO	Hallucination	✓	✓	✓
SRO	Incoherent	✓	✓	✓
SRO	Lethargy	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sitting disability	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Tremor	✓	✓	✓

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