63U-20070-30996

5 vaccinations 20 coded responses 27 check-ins 20 free-text entries 17 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 770 / TX
Registered: 2021-01-09

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

2021-01-09
Registered in v-safe
2021-01-09
Dose 1 — Moderna
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-11
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Office visit — Feeling: Good · Abdominal pain · Get care from a doctor or other healthcare professional

Free text: office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Gastrooesophageal reflux disease — Feeling: Fair · Site: Pain · Nausea · Be unable to do your normal daily activities

Free text: dizziness, acid reflux

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Survey response — day 14, dose 1
MedDRA: Arthralgia, Neuralgia — Feeling: Good

Free text: Nerve pain sharp stinging in circular area on my rt elbow and right hip. Feels topical not deep. Taking 1000mg valtrex and gabapentin for pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Dose 2 — Moderna
2021-02-06
Survey response — day 0, dose 2
MedDRA: Herpes simplex — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, 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: Herpes simplex outbreak

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Report sent to call center — day 0, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event, Urticaria — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Large raised welps upper thigh/buttock that sting. Im assuming it caused a reactivaciÃ³n of herpes · Healthcare visit (other): Going in a bit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction, Headache — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, 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: Terrible headache. Herpes outbreak

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Oedema — Feeling: Fair · Site: Pain, Redness, Swelling · Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Shortness of breath edema · Healthcare visit (other): Labs also edema

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Emergency care — Feeling: Fair · Site: Pain · Headache · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Shortness of breath · Healthcare visit (other): CT scan in hospital

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-13
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Headache, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-22
Survey response — day 14, dose 2
MedDRA: Arthralgia, Dyspnoea, Fatigue, Hypertension, Lymphadenopathy — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Shortness of breath. Enlarged lymph nodes. High blood pressure. Fatigue. Shoulder pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-02
Call 1 — Left Voicemail
2021-03-07
Survey response — day 28, dose 2
MedDRA: Anaemia, Hypertension, Oedema — 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: Edema. Anemia. High blood pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
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)
2021-03-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-14
Call successful
Participant prefers to complete VAERS report online
2021-08-07
Survey response — 6 months, dose 2
MedDRA: Arrhythmia, Arthralgia, Atrial fibrillation — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: AFib, arrhythmia, shoulder pain

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-07
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-14
Dose 3 — Moderna
2021-08-15
Call 1 — Left Voicemail
2021-08-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-08-22
Survey response — day 7, dose 3
MedDRA: Dyspnoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Hard to breathe

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-29
Survey response — day 14, dose 3
MedDRA: Hypertension, Photopsia, Postural orthostatic tachycardia syndrome, Visual impairment — Feeling: Fair · 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

Free text: POTS with flashing black and white vision changes. High blood pressure uncontrolled by meds

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-29
Report sent to call center — day 14, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-01
Call successful
Participant prefers to complete VAERS report online
2021-09-04
Survey response — day 21, dose 3
MedDRA: Chills, Diarrhoea, Headache — 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: Headache, chills, diarrhea

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

1 call case(s)
2021-09-09
Call 1 — Left Voicemail
2021-09-13
Survey response — day 28, dose 3
MedDRA: Diarrhoea — 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: Diarrhea

MedDRA releases: 2024-11 · check-in free text available
2021-09-13
Report sent to call center — day 28, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-14
Call 1 — Left Voicemail
2021-09-20
Survey response — day 35, dose 3
MedDRA: Animal bite, Sepsis — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Sepsis from animal bite

MedDRA releases: 2024-11 · check-in free text available
2021-09-20
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-22
Call successful
Does not wish to fill out VAERS report
2021-09-22
Call successful
Does not wish to fill out VAERS report
2021-09-22
Call successful
Does not wish to fill out VAERS report
2022-02-23
Dose 4 — Pfizer-BioNTech
2022-05-25
Survey response — 3 months, dose 4
MedDRA: Atrial fibrillation, Cardiac ablation, Cardiovascular symptom, Oesophageal hypomotility, Tracheal haemorrhage — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: A fib w cardiac ablation. Paratracheal bleed. Lack of Esophageal motility. Collapsed lungs. Cardiac symptoms got worse after each vaccine culminating in a fib and now this

MedDRA releases: 2024-11 · check-in free text available
2022-05-25
Report sent to call center — 3 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

Hospitalization · 1 call case(s)
2022-05-26
Call 1 — Left Voicemail
2022-09-11
Dose 5 — Pfizer-BioNTech
2022-10-26
Survey response — day 42, dose 5
MedDRA: Concussion, Heart rate increased, Sinusitis, Tendon injury — Feeling: Fair · 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, Emergency room or emergency department visit

Free text: Achilles strain. Sinus infection. Concussion. High heart rate

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Report sent to call center — day 42, 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 · Emergency room or emergency department visit · 1 call case(s)
2022-10-27
Call 2 — Left Voicemail
2022-10-27
Call 1 — Left Voicemail
2023-03-12
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-09	Moderna
2	2021-02-06	Moderna
3	2021-08-14	Moderna	No
4	2022-02-23	Pfizer-BioNTech	No
5	2022-09-11	Pfizer-BioNTech	No

Call center

17 call center cases

15 successful · 2 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-10

Systemic reaction (other): Sore throat

2021-01-13

Healthcare visit (other): office visit

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): dizziness, acid reflux

2021-01-15

Systemic reaction (other): Dizziness

Release 2 — day 14, dose 1

2021-01-23

Symptoms: Nerve pain sharp stinging in circular area on my rt elbow and right hip. Feels topical not deep. Taking 1000mg valtrex and gabapentin for pain

Release 3 — day 0, dose 2

2021-02-06

Systemic reaction (other): Herpes simplex outbreak

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): Large raised welps upper thigh/buttock that sting. Im assuming it caused a reactivaciÃ³n of herpes

Healthcare visit (other): Going in a bit

2021-02-08

Systemic reaction (other): Terrible headache. Herpes outbreak

2021-02-10

Systemic reaction (other): Shortness of breath edema

Healthcare visit (other): Labs also edema

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Shortness of breath

Healthcare visit (other): CT scan in hospital

Release 4 — day 14, dose 2

2021-02-22

Symptoms: Shortness of breath. Enlarged lymph nodes. High blood pressure. Fatigue. Shoulder pain

Release 5 — day 28, dose 2

2021-03-07

Symptoms: Edema. Anemia. High blood pressure

Release 9 — 6 months, dose 2

2021-08-07

Symptoms: AFib, arrhythmia, shoulder pain

Release 9 — day 7, dose 3

2021-08-22

Systemic reaction (other): Hard to breathe

Release 9 — day 14, dose 3

2021-08-29

Symptoms: POTS with flashing black and white vision changes. High blood pressure uncontrolled by meds

Release 9 — day 21, dose 3

2021-09-04

Symptoms: Headache, chills, diarrhea

Release 9 — day 28, dose 3

2021-09-13

Symptoms: Diarrhea

Release 9 — day 35, dose 3

2021-09-20

Symptoms: Sepsis from animal bite

Release 11 — 3 months, dose 4

2022-05-25

Symptoms: A fib w cardiac ablation. Paratracheal bleed. Lack of Esophageal motility. Collapsed lungs. Cardiac symptoms got worse after each vaccine culminating in a fib and now this

Release 12 — day 42, dose 5

2022-10-26

Symptoms: Achilles strain. Sinus infection. Concussion. High heart rate

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	Emergency care	✓	✓	✓
HCVO	Oedema	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Anaemia	✓	✓	✓
SD	Animal bite	·	·	✓
SD	Arrhythmia	✓	·	✓
SD	Arthralgia	✓	✓	✓
SD	Atrial fibrillation	✓	·	✓
SD	Cardiac ablation	·	·	✓
SD	Cardiovascular symptom	·	·	✓
SD	Chills	✓	·	✓
SD	Concussion	·	·	✓
SD	Diarrhoea	✓	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	·	✓
SD	Heart rate increased	·	·	✓
SD	Hypertension	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Neuralgia	✓	✓	✓
SD	Oedema	✓	✓	✓
SD	Oesophageal hypomotility	·	·	✓
SD	Photopsia	✓	·	✓
SD	Postural orthostatic tachycardia syndrome	✓	·	✓
SD	Sepsis	·	·	✓
SD	Sinusitis	·	·	✓
SD	Tendon injury	·	·	✓
SD	Tracheal haemorrhage	·	·	✓
SD	Visual impairment	✓	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Gastrooesophageal reflux disease	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Herpes simplex	✓	✓	✓
SRO	Oedema	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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