3YJ-19929-61090

5 vaccinations 9 coded responses 54 check-ins 7 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 950 / CA
Registered: 2021-01-29

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

2021-01-29
Registered in v-safe
2021-01-29
Dose 1 — Moderna
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Itching without sign of rash over entire body.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-21
Survey response — day 21, dose 2
MedDRA: Palpitations — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Heart palpitations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-02
Survey response — day 35, dose 2
MedDRA: Oral herpes, Rhinalgia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I have a cold sore on lip and in nose, and what feels like a head cold.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-09
Survey response — day 42, dose 2
MedDRA: Anxiety, Depression, Lower respiratory tract infection, Nasopharyngitis — 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: Chest cold and cough accompanied by Significant anxiety and depression

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-28
Survey response — 3 months, dose 2
MedDRA: Atrial fibrillation, Condition aggravated, Herpes simplex, Mood altered, Palpitations, Pre-existing disease, Pruritus — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Heart palpitations/diagnosed with Afib, intense itching without rash, significant mood fluctuations, one bout of herpes outbreak and one bout of autoimmune recurrence.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-15
Call successful
Participant prefers to complete VAERS report online
2021-06-15
Call successful
Participant prefers to complete VAERS report online
2021-06-15
Call successful
Participant prefers to complete VAERS report online
2021-06-15
Call successful
Participant prefers to complete VAERS report online
2021-06-15
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-08-27
Survey response — 6 months, dose 2
MedDRA: Atrial fibrillation, Palpitations — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Heart palpitations diagnosed as Afib

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-27
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-02
Call 2 — Left Voicemail
2021-11-26
Dose 3 — Pfizer-BioNTech
2021-11-26
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-10
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-09
Survey response — day 42, dose 3
MedDRA: Vertigo — Feeling: Good · Be unable to do your normal daily activities

Free text: Vertigo

MedDRA releases: 2024-11 · check-in free text available
2022-02-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-19
Dose 4 — Pfizer-BioNTech
2022-05-15
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-17
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-31
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-21
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-07
Dose 5 — Pfizer-BioNTech
2022-10-10
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-11
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-12
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-13
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-14
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-21
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-28
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-04
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-18
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-06
Survey response — 3 months, dose 5
MedDRA: Brain fog, COVID-19, Cough, Influenza, SARS-CoV-2 test negative, SARS-CoV-2 test positive — 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
2023-01-06
Report sent to call center — 3 months, dose 5
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)
2023-01-09
Call 1 — Left Voicemail
2023-01-09
Call 1 — Left Voicemail
2023-04-07
Survey response — 6 months, dose 5
MedDRA: COVID-19, Cough — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-07
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-11-26	Pfizer-BioNTech	No
4	2022-04-19	Pfizer-BioNTech	No
5	2022-10-07	Pfizer-BioNTech	No

Call center

7 call center cases

7 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Itching without sign of rash over entire body.

Release 6 — day 21, dose 2

2021-03-21

Symptoms: Heart palpitations

Release 6 — day 35, dose 2

2021-04-02

Symptoms: I have a cold sore on lip and in nose, and what feels like a head cold.

Release 7 — day 42, dose 2

2021-04-09

Symptoms: Chest cold and cough accompanied by Significant anxiety and depression

Release 8 — 3 months, dose 2

2021-05-28

Symptoms: Heart palpitations/diagnosed with Afib, intense itching without rash, significant mood fluctuations, one bout of herpes outbreak and one bout of autoimmune recurrence.

Release 9 — 6 months, dose 2

2021-08-27

Symptoms: Heart palpitations diagnosed as Afib

Release 10 — day 42, dose 3

2022-01-09

Symptoms: Vertigo

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
SD	Anxiety	✓	✓	✓
SD	Atrial fibrillation	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Depression	✓	✓	✓
SD	Herpes simplex	✓	✓	✓
SD	Influenza	·	·	✓
SD	Lower respiratory tract infection	✓	✓	✓
SD	Mood altered	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Oral herpes	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rhinalgia	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Vertigo	·	·	✓
SRO	Pruritus	✓	✓	✓

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