H7U-20485-28922

5 vaccinations 22 coded responses 32 check-ins 20 free-text entries 6 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 100 / NY
Registered: 2021-01-18

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-13
Dose 1 — Moderna
2021-01-18
Registered in v-safe
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Injected limb mobility decreased — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Cannot lift arm up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-22
Survey response — day 7, dose 1
MedDRA: Acne — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pimples.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-13
Dose 2 — Moderna
2021-02-13
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: For three days after I felt HORRIBLE and could not lift my arm! I had COVID in March!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Emotional distress — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sad

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — day 7, dose 2
MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness

Free text: Sad

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — day 14, dose 2
MedDRA: Sunburn — Feeling: Fair · Be unable to do your normal daily activities

Free text: I got a sunburn super quick!?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-28
Survey response — day 42, dose 2
MedDRA: Fatigue, Pharyngeal erythema — Feeling: Poor · Be unable to do your normal daily activities

Free text: Exhaustion and a red throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Survey response — 3 months, dose 2
MedDRA: Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Fatigue. I need to take naps in the afternoon now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-11-01
Dose 3 — Moderna
2022-02-13
Survey response — 12 months, dose 2
MedDRA: COVID-19, Cough, Endoscopy abnormal, Fatigue, Gastrooesophageal reflux disease, Heavy menstrual bleeding, Hiatus hernia, Menopause, Pneumonia bacterial — Feeling: Poor · 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, Emergency room or emergency department visit

Free text: Last January heavy menstration, then menapause. Ever since fatigue. Experienced GERD with endoscopy which revealed a hiatal hernia at the end of my esohogus top of my stomach due to coughing from COVID. 2 weeks ago bacterial pneumonia.

MedDRA releases: 2024-11 · check-in free text available
2022-02-13
Report sent to call center — 12 months, dose 2
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 · Emergency room or emergency department visit · 1 call case(s)
2022-02-15
Call 1 — Requested Callback
2022-02-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-05
Dose 4 — Pfizer-BioNTech
2022-05-09
Survey response — days 1–6 daily, dose 4
MedDRA: Dyspepsia — Feeling: Poor · Site: Pain

Free text: Heartburn

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia, Joint stiffness — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Aches in joints and stiffness

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-12
Health check-in — day 7, dose 4
Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-19
Survey response — day 14, dose 4
MedDRA: Menopause, Vaginal haemorrhage — Feeling: Poor · Be unable to do your normal daily activities

Free text: Excessive vagianl bleeding all of a sudden after a yeat and a half of menapause.

MedDRA releases: 2024-11 · check-in free text available
2022-05-26
Survey response — day 21, dose 4
MedDRA: Diarrhoea, Haemorrhoids, Postmenopausal haemorrhage — Feeling: Poor · Be unable to work or attend school, 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: St menaupausal bleeding, diahrrea, and hemeroids.

MedDRA releases: 2024-11 · check-in free text available
2022-05-26
Report sent to call center — day 21, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-27
Call successful
Participant prefers to complete VAERS report online
2022-06-02
Survey response — day 28, dose 4
MedDRA: Dyspepsia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Heartburn.

MedDRA releases: 2024-11 · check-in free text available
2022-06-16
Survey response — day 42, dose 4
MedDRA: Oropharyngeal pain, Pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Soreness and soee throat.

MedDRA releases: 2024-11 · check-in free text available
2022-08-04
Survey response — 3 months, dose 4
MedDRA: Fatigue, Insomnia, Middle insomnia, Nightmare, Sleep disorder — Feeling: Poor · Be unable to do your normal daily activities

Free text: I have terrible insomnia awak til 5 then I want to sleep til 2. I am exhasted all the time because of unteruptwd sleep due to nightmares.

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Survey response — 6 months, dose 4
MedDRA: Fatigue, Insomnia, Polypectomy, Postmenopausal haemorrhage, Uterine dilation and curettage, Uterine polyp — 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, Hospitalization

Free text: Symptoms: Exhaustion. Insomnia. Post menaupausal bleeding. Endometrial Polyp. · Healthcare visit (other): Surgery D and C. Polyectomy. HYSTERICOPY, tansvaginal and pelvic ultrasounds.

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Report sent to call center — 6 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

Telehealth, virtual health, or email health consultation · Hospitalization · 1 call case(s)
2022-11-04
Call successful
Does not wish to fill out VAERS report
2022-11-17
Dose 5 — Pfizer-BioNTech
2022-12-01
Survey response — day 14, dose 5
MedDRA: Cyst removal, Heavy menstrual bleeding, Polypectomy, Postmenopausal haemorrhage, Pre-existing disease, Surgery, Uterine dilation and curettage — Feeling: Poor · 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: Symptoms: As a 53 year old women in menapause no period for over a year I have now had a few post menapausal bleeding episodes that were very heavy. I had to have pelvic and trans vaginal ultrasounds, a D and C, surgery for a polyectomy and cysts. Bleeding aga · Healthcare visit (other): Surgery

MedDRA releases: 2024-11 · check-in free text available
2022-12-01
Report sent to call center — day 14, 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

Hospitalization · 1 call case(s)
2022-12-02
Call successful
Participant prefers to complete VAERS report online
2022-12-08
Health check-in — day 21, dose 5
Feeling: Poor

Adult check-in
2022-12-17
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-12-22
Survey response — day 35, dose 5
MedDRA: Hypogeusia — Feeling: Poor

Free text: Taste has been dull.

MedDRA releases: 2024-11 · check-in free text available
2022-12-29
Survey response — day 42, dose 5
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Aches in my joints suh as my ankles and fingers.

MedDRA releases: 2024-11 · check-in free text available
2023-02-16
Survey response — 3 months, dose 5
MedDRA: Anxiety, Fatigue, Insomnia, Laboratory test abnormal, Nasopharyngitis, Poor quality sleep, Rhinorrhoea, Tooth fracture, Trigger finger — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-18
Survey response — 6 months, dose 5
MedDRA: Occupational therapy, Pain, Trigger finger — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-05-18
Report sent to call center — 6 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

1 call case(s)
2023-05-19
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-13	Moderna
3	2021-11-01	Moderna	No
4	2022-05-05	Pfizer-BioNTech	No
5	2022-11-17	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-18	priority 2/3
2022-02-13	Successful 2022-02-17	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-26	Successful 2022-05-27	Participant prefers to complete VAERS report online
2022-11-03	Successful 2022-11-04	Does not wish to fill out VAERS report
2022-12-01	Successful 2022-12-02	Participant prefers to complete VAERS report online
2023-05-18	Successful 2023-05-19	Participant prefers to complete VAERS report online

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-18

Systemic reaction (other): Cannot lift arm up.

Release 2 — day 7, dose 1

2021-01-22

Systemic reaction (other): Pimples.

Release 4 — days 1–6 daily, dose 2

2021-02-18

Systemic reaction (other): For three days after I felt HORRIBLE and could not lift my arm! I had COVID in March!

2021-02-19

Systemic reaction (other): Sad

Release 4 — day 7, dose 2

2021-02-20

Systemic reaction (other): Sad

Release 4 — day 14, dose 2

2021-02-27

Symptoms: I got a sunburn super quick!?

Release 6 — day 42, dose 2

2021-03-28

Symptoms: Exhaustion and a red throat.

Release 8 — 3 months, dose 2

2021-05-17

Symptoms: Fatigue. I need to take naps in the afternoon now.

Release 11 — 12 months, dose 2

2022-02-13

Symptoms: Last January heavy menstration, then menapause. Ever since fatigue. Experienced GERD with endoscopy which revealed a hiatal hernia at the end of my esohogus top of my stomach due to coughing from COVID. 2 weeks ago bacterial pneumonia.

Release 11 — days 1–6 daily, dose 4

2022-05-09

Systemic reaction (other): Heartburn

2022-05-10

Systemic reaction (other): Aches in joints and stiffness

Release 11 — day 14, dose 4

2022-05-19

Symptoms: Excessive vagianl bleeding all of a sudden after a yeat and a half of menapause.

Release 11 — day 21, dose 4

2022-05-26

Symptoms: St menaupausal bleeding, diahrrea, and hemeroids.

Release 11 — day 28, dose 4

2022-06-02

Symptoms: Heartburn.

Release 12 — day 42, dose 4

2022-06-16

Symptoms: Soreness and soee throat.

Release 12 — 3 months, dose 4

2022-08-04

Symptoms: I have terrible insomnia awak til 5 then I want to sleep til 2. I am exhasted all the time because of unteruptwd sleep due to nightmares.

Release 12 — 6 months, dose 4

2022-11-03

Symptoms: Exhaustion. Insomnia. Post menaupausal bleeding. Endometrial Polyp.

Healthcare visit (other): Surgery D and C. Polyectomy. HYSTERICOPY, tansvaginal and pelvic ultrasounds.

Release 12 — day 14, dose 5

2022-12-01

Symptoms: As a 53 year old women in menapause no period for over a year I have now had a few post menapausal bleeding episodes that were very heavy. I had to have pelvic and trans vaginal ultrasounds, a D and C, surgery for a polyectomy and cysts. Bleeding aga cut off by CDC

Healthcare visit (other): Surgery

Release 12 — day 35, dose 5

2022-12-22

Symptoms: Taste has been dull.

Release 12 — day 42, dose 5

2022-12-29

Symptoms: Aches in my joints suh as my ankles and fingers.

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	Occupational therapy	·	·	✓
HCVO	Polypectomy	·	·	✓
HCVO	Surgery	·	·	✓
HCVO	Uterine dilation and curettage	·	·	✓
SD	Anxiety	·	·	✓
SD	Arthralgia	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Cyst removal	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dyspepsia	·	·	✓
SD	Endoscopy abnormal	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Haemorrhoids	·	·	✓
SD	Heavy menstrual bleeding	·	·	✓
SD	Hiatus hernia	·	·	✓
SD	Hypogeusia	·	·	✓
SD	Insomnia	·	·	✓
SD	Laboratory test abnormal	·	·	✓
SD	Menopause	·	·	✓
SD	Middle insomnia	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nightmare	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pharyngeal erythema	✓	✓	✓
SD	Pneumonia bacterial	·	·	✓
SD	Polypectomy	·	·	✓
SD	Poor quality sleep	·	·	✓
SD	Postmenopausal haemorrhage	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sleep disorder	·	·	✓
SD	Sunburn	✓	✓	✓
SD	Tooth fracture	·	·	✓
SD	Trigger finger	·	·	✓
SD	Uterine dilation and curettage	·	·	✓
SD	Uterine polyp	·	·	✓
SD	Vaginal haemorrhage	·	·	✓
SRO	Acne	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Arthralgia	·	·	✓
SRO	Dyspepsia	·	·	✓
SRO	Emotional distress	✓	✓	✓
SRO	Injected limb mobility decreased	✓	✓	✓
SRO	Joint stiffness	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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