3ZK-18362-51959

4 vaccinations 20 coded responses 44 check-ins 19 free-text entries 11 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 234 / VA
Registered: 2021-03-08

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

2021-03-08
Registered in v-safe
2021-03-08
Dose 1 — Moderna
2021-03-08
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Echocardiogram — Feeling: Good · Site: Pain · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Echocardiogram today showed dramatic decrease in ejection factor.

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 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Urinary tract infection — Feeling: Poor · Abdominal pain · Be unable to do your normal daily activities

Free text: UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — day 7, dose 1
MedDRA: Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

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

Adult check-in
2021-03-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-05
Dose 2 — Moderna
2021-04-05
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspepsia — Feeling: Good · Be unable to do your normal daily activities

Free text: Two hours after shot I developed severe heartburn. It lasted about four hours. This was highly unusual. No change in diet that would have caused it. Concern that it might be heart related caused me to limit my activities.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose decreased, Dyspepsia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Heartburn and low glucose (52) and difficulty getting it to rise

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit, Urinary tract infection — Feeling: Poor · Chills, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): I have a UTI · Healthcare visit (other): Urogynecologist office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
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)
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose decreased, Hypotension, Urinary tract infection — Feeling: Poor · Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: UTI, low blood pressure, low blood sugar

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Hypotension, Urinary tract infection — Feeling: Fair · Joint pains · Be unable to do your normal daily activities

Free text: UTI LOW Blood pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 7, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-04-19
Survey response — day 14, dose 2
MedDRA: Arthralgia, Asthenia, Myalgia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Multiple joint and muscle aches and weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — day 21, dose 2
MedDRA: Arthralgia, Chest pain, Muscle spasms, Neck pain, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Intense joint pain in right wrist, right fingers, right hip, neck, left shoulder. Intense enough to wake me during the night. Muscle cramps in calves, very sore upper left arm and left rib cage. Worsening daily over last week. No known cause.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — day 28, dose 2
MedDRA: Hypotension, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Extreme Low blood pressure. · Healthcare visit (other): In person at doctors office.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-10
Survey response — day 35, dose 2
MedDRA: Chills, Vomiting — Feeling: Poor · 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: Chills and vomiting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-17
Survey response — day 42, dose 2
MedDRA: Vomiting — Feeling: Good · 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: Extreme shakes and vomiting.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
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)
2021-06-21
Call 1 — Left Voicemail
2021-10-04
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-07
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-06
Dose 3 — Moderna
2022-05-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-13
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-05-20
Survey response — day 14, dose 3
MedDRA: Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: UTI

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-23
Call 1 — Left Voicemail
2022-05-29
Survey response — day 21, dose 3
MedDRA: Urinary tract infection — Feeling: Fair · 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: UTI severity increased. Required a second antibiotic.

MedDRA releases: 2024-11 · check-in free text available
2022-05-29
Report sent to call center — day 21, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-31
Call 1 — Left Voicemail
2022-06-09
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-06-11
Survey response — day 35, dose 3
MedDRA: Urinary tract infection — Feeling: Poor · 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: UTI

MedDRA releases: 2024-11 · check-in free text available
2022-06-11
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-13
Call 1 — Left Voicemail
2022-06-19
Survey response — day 42, dose 3
MedDRA: Urinary tract infection — Feeling: Poor · 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: UTI for about 6 weeks

MedDRA releases: 2024-11 · check-in free text available
2022-06-19
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-21
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-07
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-10-11
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-11
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-10-12
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Headache, Joint pains, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-10-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · None

Adult check-in
2022-10-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-17
Survey response — days 1–6 daily, dose 4
MedDRA: Asthenia, Presyncope — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Weakness to the point of about to pass out

MedDRA releases: 2024-11 · check-in free text available
2022-10-18
Health check-in — day 7, dose 4
Feeling: Fair · None

Adult check-in
2022-10-25
Survey response — day 14, dose 4
MedDRA: Diarrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-11-04
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-09
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-01-10
Survey response — 3 months, dose 4
MedDRA: COVID-19, Hospitalisation, Myocardial infarction, SARS-CoV-2 test positive — 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, Hospitalization

MedDRA releases: 2024-11
2023-01-10
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 · Hospitalization · 1 call case(s)
2023-01-11
Call 1 — Left Voicemail
2023-01-11
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	2021-03-08	Moderna
2	2021-04-05	Moderna
3	2022-05-06	Moderna	No
4	2022-10-11	Pfizer-BioNTech	Flu

Call center

11 call center cases

11 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Echocardiogram today showed dramatic decrease in ejection factor.

2021-03-14

Systemic reaction (other): UTI

Release 5 — day 7, dose 1

2021-03-15

Systemic reaction (other): UTI

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Two hours after shot I developed severe heartburn. It lasted about four hours. This was highly unusual. No change in diet that would have caused it. Concern that it might be heart related caused me to limit my activities.

2021-04-07

Systemic reaction (other): Heartburn and low glucose (52) and difficulty getting it to rise

2021-04-09

Systemic reaction (other): I have a UTI

Healthcare visit (other): Urogynecologist office

2021-04-10

Systemic reaction (other): UTI, low blood pressure, low blood sugar

2021-04-11

Systemic reaction (other): UTI LOW Blood pressure

Release 7 — day 14, dose 2

2021-04-19

Symptoms: Multiple joint and muscle aches and weakness

Release 8 — day 21, dose 2

2021-04-26

Symptoms: Intense joint pain in right wrist, right fingers, right hip, neck, left shoulder. Intense enough to wake me during the night. Muscle cramps in calves, very sore upper left arm and left rib cage. Worsening daily over last week. No known cause.

Release 8 — day 28, dose 2

2021-05-03

Symptoms: Extreme Low blood pressure.

Healthcare visit (other): In person at doctors office.

Release 8 — day 35, dose 2

2021-05-10

Symptoms: Chills and vomiting

Release 8 — day 42, dose 2

2021-05-17

Symptoms: Extreme shakes and vomiting.

Release 11 — day 14, dose 3

2022-05-20

Symptoms: UTI

Release 11 — day 21, dose 3

2022-05-29

Symptoms: UTI severity increased. Required a second antibiotic.

Release 12 — day 35, dose 3

2022-06-11

Symptoms: UTI

Release 12 — day 42, dose 3

2022-06-19

Symptoms: UTI for about 6 weeks

Release 12 — days 1–6 daily, dose 4

2022-10-17

Systemic reaction (other): Weakness to the point of about to pass out

Release 12 — day 14, dose 4

2022-10-25

Symptoms: Diarrhea

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	Arthralgia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Chills	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Hypotension	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Myocardial infarction	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Urinary tract infection	·	·	✓
SD	Vomiting	✓	✓	✓
SRO	Asthenia	·	·	✓
SRO	Blood glucose decreased	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Echocardiogram	✓	✓	✓
SRO	Hypotension	✓	✓	✓
SRO	Presyncope	·	·	✓
SRO	Urinary tract infection	✓	✓	✓

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