YJ2-69367-77654

3 vaccinations 17 coded responses 39 check-ins 17 free-text entries 8 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 468 / IN
Registered: 2021-03-17

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

2021-03-17
Registered in v-safe
2021-03-17
Dose 1 — Pfizer-BioNTech
2021-03-17
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Confusional state — Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Words confused - say one word but meant another

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Aphasia — Feeling: Good · Muscle or body aches

Free text: Switching words - think I've said one word but said another instead

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Muscle or body aches · 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: Making appt with my surgeon - prednisone didn't work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-06
Dose 2 — Pfizer-BioNTech
2021-04-06
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Tremor — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Both 3rd fingers and both thumbs shaky when picking up food

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

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Survey response — day 7, dose 2
MedDRA: Cough, Discomfort, Dyspnoea — Feeling: Good

Free text: Can't breathe fully and have "deep"cough that hurts - discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-04
Survey response — day 28, dose 2
MedDRA: Cough — Feeling: Good

Free text: Not improving cough that doesn't respond to rescue inhaler

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — day 35, dose 2
MedDRA: Cough, Dyspnoea, Office visit, Respiratory tract congestion — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Lungs are the same as last time: chronic cough by this time with mild discomfort in chest and continued SOB. · Healthcare visit (other): Allergy/ asthma in-office visit; reported to Primary Care Physician at routine visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
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)
2021-05-18
Survey response — day 42, dose 2
MedDRA: Cough, Dyspnoea, Limb discomfort, Muscular weakness, Oedema — Feeling: Good · Be unable to do your normal daily activities

Free text: GFR went from 71 to 55 in March. Bil feet and legs were edematous for almost 8 weeks despite my diuretic, elevating feet, etc. Legs feel heavy and weak. Cough improving; breathing isn't.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Survey response — 3 months, dose 2
MedDRA: Back pain, Cough, Mobility decreased, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Back pain; decreased agile mobility; non-asthma- related cough when lying down especially · Healthcare visit (other): In office pain management; in office visit for cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-08
Call 1 — Left Voicemail
2021-10-05
Survey response — 6 months, dose 2
MedDRA: Balance disorder, Choking, Diplopia, Dysphagia, Eye disorder, Food intolerance, Neurological symptom, Office visit, Physiotherapy, Speech rehabilitation — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Balance much worse; neurological changes with eyes (double vision in some tests, for example); choking when swallowing some foods or on my saliva · Healthcare visit (other): The (b)(6) clinic; Physical therapy and speech therapy, ENT for swallowing/ choking issues

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-07
Call successful
Participant prefers to complete VAERS report online
2021-11-05
Dose 3 — Moderna
2021-11-05
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Fatigue, Presyncope — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Almost passed out in shower. Totally exhausted - couldn't finish shower. Husband helped me get out.

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-11-08
Survey response — days 1–6 daily, dose 3
MedDRA: Rash — Feeling: Fair · Site: Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Rash over torso, neck, and face

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-11
Survey response — days 1–6 daily, dose 3
MedDRA: Pruritus, Rash — Feeling: Fair · Site: Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Rash on upper torso, head and face extremely itchy!

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-26
Survey response — day 21, dose 3
MedDRA: Choking, Cough, Dysphagia, Muscular weakness, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Tongue and esophagus muscles weak. Cannot swallow properly causing food to possibly enter airway. This causes choking and more testing in hospital. Uncontolled sometimes violent coughing. Will need surgery to correct. · Healthcare visit (other): Many Dr's visits, hospital testing (EGD for ex.)

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
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)
2021-11-29
Call successful
Participant prefers to complete VAERS report online
2021-12-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-04
Survey response — 3 months, dose 3
MedDRA: Adverse reaction, Asthenia, Balance disorder, Dizziness, Office visit, Physiotherapy — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: More severe dizziness, poor balance, loss of stamina · Healthcare visit (other): Primary Care Physician in office. P.T. has helped with problems

MedDRA releases: 2024-11 · check-in free text available
2022-02-04
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-08
Call successful
Does not wish to fill out VAERS report
2022-05-06
Survey response — 6 months, dose 3
MedDRA: Balance disorder, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Lose my balance easily when walking, turning around · Healthcare visit (other): Dr ordered Post Covid Clinic. They ordered P.T.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-09
Call successful
Does not wish to fill out VAERS report
2022-11-05
Survey response — 12 months, dose 3
MedDRA: Balance disorder, Laryngitis, Office visit, Physiotherapy, Sputum discoloured, Throat irritation — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Loss of balance, scratchy throat, green sputum, laryngitis. · Healthcare visit (other): Physical therapy; appt for throat irritations

MedDRA releases: 2024-11 · check-in free text available
2022-11-05
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-08
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Pfizer-BioNTech
2	2021-04-06	Pfizer-BioNTech
3	2021-11-05	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-23	Successful	Participant prefers to complete VAERS report online
2021-05-11	Successful	Participant prefers to complete VAERS report online
2021-07-06	Successful	Participant prefers to complete VAERS report online
2021-10-05	Successful 2021-10-07	Participant prefers to complete VAERS report online
2021-11-26	Successful 2021-11-29	Participant prefers to complete VAERS report online
2022-02-04	Successful 2022-02-08	Does not wish to fill out VAERS report
2022-05-06	Successful 2022-05-09	Does not wish to fill out VAERS report
2022-11-05	Successful 2022-11-08	Does not wish to fill out VAERS report

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-21

Systemic reaction (other): Words confused - say one word but meant another

2021-03-22

Systemic reaction (other): Switching words - think I've said one word but said another instead

2021-03-23

Healthcare visit (other): Making appt with my surgeon - prednisone didn't work

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Both 3rd fingers and both thumbs shaky when picking up food

Release 7 — day 7, dose 2

2021-04-13

Systemic reaction (other): Can't breathe fully and have "deep"cough that hurts - discomfort

Release 8 — day 28, dose 2

2021-05-04

Symptoms: Not improving cough that doesn't respond to rescue inhaler

Release 8 — day 35, dose 2

2021-05-11

Symptoms: Lungs are the same as last time: chronic cough by this time with mild discomfort in chest and continued SOB.

Healthcare visit (other): Allergy/ asthma in-office visit; reported to Primary Care Physician at routine visit

Release 8 — day 42, dose 2

2021-05-18

Symptoms: GFR went from 71 to 55 in March. Bil feet and legs were edematous for almost 8 weeks despite my diuretic, elevating feet, etc. Legs feel heavy and weak. Cough improving; breathing isn't.

Release 9 — 3 months, dose 2

2021-07-06

Symptoms: Back pain; decreased agile mobility; non-asthma- related cough when lying down especially

Healthcare visit (other): In office pain management; in office visit for cough

Release 10 — 6 months, dose 2

2021-10-05

Symptoms: Balance much worse; neurological changes with eyes (double vision in some tests, for example); choking when swallowing some foods or on my saliva

Healthcare visit (other): The (b)(6) clinic; Physical therapy and speech therapy, ENT for swallowing/ choking issues

redacted (b)(6)

Release 10 — days 1–6 daily, dose 3

2021-11-06

Systemic reaction (other): Almost passed out in shower. Totally exhausted - couldn't finish shower. Husband helped me get out.

2021-11-08

Systemic reaction (other): Rash over torso, neck, and face

2021-11-11

Systemic reaction (other): Rash on upper torso, head and face extremely itchy!

Release 10 — day 21, dose 3

2021-11-26

Symptoms: Tongue and esophagus muscles weak. Cannot swallow properly causing food to possibly enter airway. This causes choking and more testing in hospital. Uncontolled sometimes violent coughing. Will need surgery to correct.

Healthcare visit (other): Many Dr's visits, hospital testing (EGD for ex.)

Release 11 — 3 months, dose 3

2022-02-04

Symptoms: More severe dizziness, poor balance, loss of stamina

Healthcare visit (other): Primary Care Physician in office. P.T. has helped with problems

Release 11 — 6 months, dose 3

2022-05-06

Symptoms: Lose my balance easily when walking, turning around

Healthcare visit (other): Dr ordered Post Covid Clinic. They ordered P.T.

Release 12 — 12 months, dose 3

2022-11-05

Symptoms: Loss of balance, scratchy throat, green sputum, laryngitis.

Healthcare visit (other): Physical therapy; appt for throat irritations

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	Adverse reaction	·	·	✓
HCVO	Choking	·	·	✓
HCVO	Cough	✓	✓	✓
HCVO	Dysphagia	·	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Physiotherapy	·	·	✓
HCVO	Speech rehabilitation	·	·	✓
HCVO	Throat irritation	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Asthenia	·	·	✓
SD	Back pain	✓	✓	✓
SD	Balance disorder	·	·	✓
SD	Choking	·	·	✓
SD	Cough	✓	✓	✓
SD	Diplopia	·	·	✓
SD	Dizziness	·	·	✓
SD	Dysphagia	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Eye disorder	·	·	✓
SD	Food intolerance	·	·	✓
SD	Laryngitis	·	·	✓
SD	Limb discomfort	✓	✓	✓
SD	Mobility decreased	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Neurological symptom	·	·	✓
SD	Oedema	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sputum discoloured	·	·	✓
SD	Throat irritation	·	·	✓
SRO	Aphasia	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Presyncope	·	·	✓
SRO	Pruritus	·	·	✓
SRO	Rash	·	·	✓
SRO	Tremor	✓	✓	✓

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