6KZ-18105-56325

3 vaccinations 17 coded responses 38 check-ins 17 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 085 / NJ
Registered: 2021-02-28

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

2021-02-28
Registered in v-safe
2021-02-28
Dose 1 — Moderna
2021-02-28
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Nervousness — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Shaky inside

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Gingival pain, Pain, Toothache — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Throbbing teeth!!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Toothache — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tooth pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 7, dose 1
MedDRA: Feeling abnormal, Office visit — Feeling: Good · Muscle or body aches · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Mind fog for a few days didnt think it was shot related till now · Healthcare visit (other): 60 min Reflexology appointment

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

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

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

Adult check-in
2021-03-28
Dose 2 — Moderna
2021-03-28
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Dental discomfort — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Throbbing teeth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate increased — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Elevated heart rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Good · Joint pains, Fatigue or tiredness

Free text: Severe Left hip pain till afternoon then passed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — day 7, dose 2
MedDRA: Hypoaesthesia — Feeling: Good

Free text: I had forgotten to mention since my shot the circulation in my legs was lessened & my feet were numb - this is something I worked hard at overcoming - it has taken over a week but today after swimming dancing walking thru the discomfort I feel normal again

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

Adult check-in
2021-04-19
Survey response — day 21, dose 2
MedDRA: Chest discomfort, Eye irritation, Mobility decreased, Office visit, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, Toothache — Feeling: Good · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: On Wed I suffered SERVERLY: vaccine reaction? Covid 19? Descended rapidly 1 at a time: body aches difficulty moving>runny nose>101.5 fever>sore throat>tight chest>throbbing teeth>left eye irritation=VERY SCARY NITE! Gone in a.m.! · Healthcare visit (other): DC/polarity therapy/Reiki

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Report sent to call center — day 21, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-25
Survey response — day 28, dose 2
MedDRA: Arthralgia — Feeling: Good · Be unable to do your normal daily activities

Free text: Right knee & hip pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 35, dose 2
MedDRA: Arthralgia — Feeling: Good

Free text: Right knee pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-15
Dose 3 — Pfizer-BioNTech
2021-12-16
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Poor · Site: Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Vomiting · Be unable to do your normal daily activities

Free text: Woozy

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Call 2 — Left Voicemail
2021-12-16
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-12-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Headache, Joint pains

Adult check-in
2021-12-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-12-22
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-12-29
Survey response — day 14, dose 3
MedDRA: Cough, Fatigue, Headache, Nausea, Oropharyngeal pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat cough nausea headache feverish fatigued

MedDRA releases: 2024-11 · check-in free text available
2022-01-05
Survey response — day 21, dose 3
MedDRA: Biliary colic — Feeling: Fair · Be unable to do your normal daily activities

Free text: My gall bladder is aching

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
Survey response — day 28, dose 3
MedDRA: Ear pain, Oropharyngeal pain — 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: Sore throat ear pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-13
Call 1 — Left Voicemail
2022-01-19
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-26
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-16
Survey response — 3 months, dose 3
MedDRA: Blister, Blood pressure increased, Office visit, Photopsia, Photosensitivity reaction, Urticaria, Vitreous detachment, Vitreous floaters — 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

Free text: Symptoms: I had a sudden Posterior Vitreous Detachment causing floaters & flashes of light - my skin has suddenly become photosensitive & I'm getting blisters & hives even with 70 plus sunscreen AND!!! My normally normal BP has been elevated tooo often of late · Healthcare visit (other): Retina specialist & awaiting dermatologist appt

MedDRA releases: 2024-11 · check-in free text available
2022-03-16
Report sent to call center — 3 months, 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)
2022-03-22
Call 1 — Left Voicemail
2022-06-16
Survey response — 6 months, dose 3
MedDRA: Gastrooesophageal reflux disease, Insomnia, Laryngitis, Photosensitivity reaction, Pruritus — 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, Outpatient clinic or urgent care clinic visit

Free text: Horribly itchy -extremely sun sensitive -not sleeping - lingering laryngitis - reflux

MedDRA releases: 2024-11 · check-in free text available
2022-06-16
Report sent to call center — 6 months, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-17
Call 1 — Left Voicemail
2022-06-17
Call 1 — Left Voicemail
2022-06-17
Call 2 — Left Voicemail
2022-06-17
Call 2 — Left Voicemail
2022-06-17
Call 1 — Left Voicemail
2022-06-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-15
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-28	Moderna
2	2021-03-28	Moderna
3	2021-12-15	Pfizer-BioNTech	No

Call center

5 call center cases

5 successful

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-03-02

Systemic reaction (other): Shaky inside

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): Throbbing teeth!!

2021-03-06

Systemic reaction (other): Tooth pain

Release 5 — day 7, dose 1

2021-03-09

Systemic reaction (other): Mind fog for a few days didnt think it was shot related till now

Healthcare visit (other): 60 min Reflexology appointment

Release 6 — days 1–6 daily, dose 2

2021-03-29

Systemic reaction (other): Throbbing teeth

2021-04-01

Systemic reaction (other): Elevated heart rate

2021-04-03

Systemic reaction (other): Severe Left hip pain till afternoon then passed

Release 7 — day 7, dose 2

2021-04-06

Systemic reaction (other): I had forgotten to mention since my shot the circulation in my legs was lessened & my feet were numb - this is something I worked hard at overcoming - it has taken over a week but today after swimming dancing walking thru the discomfort I feel normal again

Release 7 — day 21, dose 2

2021-04-19

Symptoms: On Wed I suffered SERVERLY: vaccine reaction? Covid 19? Descended rapidly 1 at a time: body aches difficulty moving>runny nose>101.5 fever>sore throat>tight chest>throbbing teeth>left eye irritation=VERY SCARY NITE! Gone in a.m.!

Healthcare visit (other): DC/polarity therapy/Reiki

Release 7 — day 28, dose 2

2021-04-25

Symptoms: Right knee & hip pain

Release 8 — day 35, dose 2

2021-05-04

Symptoms: Right knee pain

Release 10 — days 1–6 daily, dose 3

2021-12-16

Systemic reaction (other): Woozy

Release 10 — day 14, dose 3

2021-12-29

Symptoms: Sore throat cough nausea headache feverish fatigued

Release 10 — day 21, dose 3

2022-01-05

Symptoms: My gall bladder is aching

Release 10 — day 28, dose 3

2022-01-12

Symptoms: Sore throat ear pain

Release 11 — 3 months, dose 3

2022-03-16

Symptoms: I had a sudden Posterior Vitreous Detachment causing floaters & flashes of light - my skin has suddenly become photosensitive & I'm getting blisters & hives even with 70 plus sunscreen AND!!! My normally normal BP has been elevated tooo often of late cut off by CDC

Healthcare visit (other): Retina specialist & awaiting dermatologist appt

Release 12 — 6 months, dose 3

2022-06-16

Symptoms: Horribly itchy -extremely sun sensitive -not sleeping - lingering laryngitis - reflux

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	Biliary colic	·	·	✓
SD	Blister	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Cough	·	·	✓
SD	Ear pain	·	·	✓
SD	Eye irritation	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Headache	·	·	✓
SD	Insomnia	·	·	✓
SD	Laryngitis	·	·	✓
SD	Mobility decreased	✓	✓	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Photopsia	·	·	✓
SD	Photosensitivity reaction	·	·	✓
SD	Pruritus	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Toothache	✓	✓	✓
SD	Urticaria	·	·	✓
SD	Vitreous detachment	·	·	✓
SD	Vitreous floaters	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Dental discomfort	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Gingival pain	○	✓	○
SRO	Heart rate increased	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Nervousness	✓	✓	✓
SRO	Pain	✓	·	✓
SRO	Toothache	✓	✓	✓

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