5H2-75439-52866

6 vaccinations 10 coded responses 38 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 481 / MI
Registered: 2021-03-10

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

2021-03-10
Registered in v-safe
2021-03-10
Dose 1 — Pfizer-BioNTech
2021-03-10
Health check-in — day 0, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Somnolence — Feeling: Good · Site: Pain

Free text: Needed about a 2 hour nap, despite a full night sleep.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
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 · Diarrhea

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Somnolence — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Had to stop and take a nap.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Survey response — day 7, dose 1
MedDRA: Seasonal allergy — Feeling: Good

Free text: Seasonal allergies are kicking in with beautiful weather.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Dose 2 — Pfizer-BioNTech
2021-03-31
Health check-in — day 0, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-21
Survey response — day 21, dose 2
MedDRA: Abdominal distension, Back pain, Constipation, Loss of personal independence in daily activities, Mobility decreased, Pain — Feeling: Fair

Free text: Lower back muscles ache and internal abdomen feels like an over stuffed tire for 2 weeks now, although I am constipated. Movement is a bit limited and a bit painful. Im doing only some of my daily activities.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Survey response — 6 months, dose 2
MedDRA: Artificial crown procedure, Atrial fibrillation, Cardioversion, Cryotherapy, Pre-existing disease, Sinus congestion — 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: 1. For cardiac atrial fibrillation I have had a cryo ablation, then 2.5 months later a cardioversion to restore Normal Sinus Rhythm. 2. Dental - have had 2 permanent crowns installed. 3. Mild seasonal allergies (sinus congestion) managed with meds.

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-10-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-03
Dose 3 — Moderna
2022-03-31
Survey response — 12 months, dose 2
MedDRA: Cardiac operation — Feeling: Good · Be unable to do your normal daily activities

Free text: January I had a heart surgery which has an expected 6 month recovery period. Some days or weeks I am more debilitated than others, but I'm retired, and thus have the leisure for a long recovery.

MedDRA releases: 2024-11 · check-in free text available
2022-04-08
Dose 4 — Moderna
2022-04-19
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · None · Be unable to do your normal daily activities

Adult check-in
2022-04-22
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-29
Survey response — day 21, dose 4
MedDRA: Nasal congestion, Pre-existing disease, Rhinorrhoea, Sinus congestion — Feeling: Good

Free text: Seasonal allergies: nasal and sinus congestion, snotty nose.

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-08
Survey response — 3 months, dose 4
MedDRA: Cardiac failure congestive, Left ventricular failure — Feeling: Good

Free text: Congestive Heart Failure diastolic. New Dx. New treatment.

MedDRA releases: 2024-11 · check-in free text available
2022-10-08
Survey response — 6 months, dose 4
MedDRA: Cardiac failure congestive, Dyspnoea, Fluid intake restriction, Hospitalisation, Medical diet — Feeling: Good · 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: Symptoms: #1 A reminder of when I last checked in would help. 3 months? 6 months? #2 June 2022 difficulty breathing, hospitalization, new diagnosis of Congestive Heart Failure. After 2 months treatment (restrict fluids & sodium), I feel better since 2or 3 yrs · Healthcare visit (other): Restrict fluids & sodium

MedDRA releases: 2024-11 · check-in free text available
2022-10-08
Report sent to call center — 6 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)
2022-10-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-14
Dose 5 — Moderna
2023-04-10
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in
2023-04-21
Dose 6 — Moderna
2023-05-17
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in
2023-05-19
Health check-in — day 28, dose 6
Feeling: Good

Adult check-in
2023-05-26
Health check-in — day 35, dose 6
Feeling: Good

Adult check-in
2023-06-02
Survey response — day 42, dose 6
MedDRA: Arthralgia, Gait disturbance, Insomnia, Memory impairment, Office visit — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Pfizer-BioNTech
2	2021-03-31	Pfizer-BioNTech
3	2021-11-03	Moderna	No
4	2022-04-08	Moderna	No
5	2022-11-14	Moderna	No
6	2023-04-21	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-11

Systemic reaction (other): Needed about a 2 hour nap, despite a full night sleep.

2021-03-15

Systemic reaction (other): Had to stop and take a nap.

Release 5 — day 7, dose 1

2021-03-17

Systemic reaction (other): Seasonal allergies are kicking in with beautiful weather.

Release 7 — day 21, dose 2

2021-04-21

Symptoms: Lower back muscles ache and internal abdomen feels like an over stuffed tire for 2 weeks now, although I am constipated. Movement is a bit limited and a bit painful. Im doing only some of my daily activities.

Release 9 — 6 months, dose 2

2021-09-29

Symptoms: 1. For cardiac atrial fibrillation I have had a cryo ablation, then 2.5 months later a cardioversion to restore Normal Sinus Rhythm. 2. Dental - have had 2 permanent crowns installed. 3. Mild seasonal allergies (sinus congestion) managed with meds. cut off by CDC

Release 11 — 12 months, dose 2

2022-03-31

Symptoms: January I had a heart surgery which has an expected 6 month recovery period. Some days or weeks I am more debilitated than others, but I'm retired, and thus have the leisure for a long recovery.

Release 11 — day 21, dose 4

2022-04-29

Symptoms: Seasonal allergies: nasal and sinus congestion, snotty nose.

Release 12 — 3 months, dose 4

2022-07-08

Symptoms: Congestive Heart Failure diastolic. New Dx. New treatment.

Release 12 — 6 months, dose 4

2022-10-08

Symptoms: #1 A reminder of when I last checked in would help. 3 months? 6 months? #2 June 2022 difficulty breathing, hospitalization, new diagnosis of Congestive Heart Failure. After 2 months treatment (restrict fluids & sodium), I feel better since 2or 3 yrs cut off by CDC

Healthcare visit (other): Restrict fluids & sodium

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	Fluid intake restriction	·	·	✓
HCVO	Medical diet	·	·	✓
SD	Abdominal distension	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Artificial crown procedure	·	·	✓
SD	Atrial fibrillation	·	·	✓
SD	Back pain	✓	✓	✓
SD	Cardiac failure congestive	·	·	✓
SD	Cardiac operation	·	·	✓
SD	Cardioversion	·	·	✓
SD	Constipation	✓	✓	✓
SD	Cryotherapy	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fluid intake restriction	·	·	✓
SD	Gait disturbance	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Insomnia	·	·	✓
SD	Left ventricular failure	·	·	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Medical diet	·	·	✓
SD	Memory impairment	·	·	✓
SD	Mobility decreased	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Office visit	·	·	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinus congestion	·	·	✓
SRO	Seasonal allergy	✓	✓	✓
SRO	Somnolence	✓	✓	✓

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