ZBT-27279-66158

3 vaccinations 8 coded responses 35 check-ins 8 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 958 / CA
Registered: 2021-02-03

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

2021-02-03
Registered in v-safe
2021-02-03
Dose 1 — Pfizer-BioNTech
2021-02-03
Health check-in — day 0, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Pfizer-BioNTech
2021-02-25
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Eye swelling — Feeling: Poor · Chills, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Her right eye bulged yesterday is some better today. Shot given on right

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Fair · Chills, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-03-04
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Survey response — day 14, dose 2
MedDRA: Chills, Disturbance in attention, Fatigue, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue is the same not improving still have chills and ability to think and organize thoughts is still poor IE she emptied dishwasher and had to rest. Dr visit gave no information of pertinence · Healthcare visit (other): Dr office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Survey response — day 21, dose 2
MedDRA: Dyspnoea, Feeling abnormal, Parosmia, Taste disorder, Thinking abnormal — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sence of taste and smell has not improved. She is 93 and still feels horrid and her head still does not think well. She says her breathing is bad shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 28, dose 2
Feeling: Poor

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Ageusia, Anosmia, Brain fog, Cough, Fatigue, Nausea, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: It was like she had some kind of relapse. Severe fatigue and worse brain fog. Dry cough. All lasted about a week then got incrementally better. Still no taste or smell. Had to force her to give dr a urine sample cause she was too exhausted to deal wi · Healthcare visit (other): GPVisit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
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)
2021-06-21
Call 1 — Left Voicemail
2021-06-22
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-06-24
Call 2 — Left Voicemail
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Appetite disorder, Chills, Cognitive disorder, Cough, Decreased appetite, Hypogeusia, Hyposmia, Memory impairment, Muscle twitching, Office visit, Pruritus — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Itchy random places mostly near joints. increased desire for burnt toast charcoal. muscle twitching lower legs. Still extreme chills. Still little taste or smell which hampers desire for food. Dry cough. Cognitive ability still affected memory poor · Healthcare visit (other): GP and (b)(6) Neurology referral

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-24
Call successful
Completed over the phone
2022-02-25
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-09-25
Dose 3 — Moderna
2022-09-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-09-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Chills

Adult check-in
2022-09-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Itching · Chills, Fatigue or tiredness, Nausea · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2022-09-30
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-02
Survey response — day 7, dose 3
MedDRA: Cough — Feeling: Fair · Site: Itching · Chills, Nausea

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2022-10-04
Call 1 — Left Voicemail
2022-10-04
Call successful
Does not wish to fill out VAERS report
2022-10-09
Survey response — day 14, dose 3
MedDRA: Brain fog, Chills, Cough, Pruritus — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chills cough brain fog itching

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-10-25
Survey response — day 28, dose 3
MedDRA: Abnormal faeces, Asthenia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Extremely weak and explosive bowel movement

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-11-06
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-12-27
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Pfizer-BioNTech
2	2021-02-25	Pfizer-BioNTech
3	2022-09-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-04	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-03-11	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-05-27	Successful 2021-06-22	Reported to VAERS voluntarily prior to GDIT contact
2021-08-26	Successful 2021-09-24	Completed over the phone
2022-09-30	Successful 2022-10-04	Does not wish to fill out VAERS report

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Her right eye bulged yesterday is some better today. Shot given on right

Release 5 — day 14, dose 2

2021-03-11

Symptoms: Fatigue is the same not improving still have chills and ability to think and organize thoughts is still poor IE she emptied dishwasher and had to rest. Dr visit gave no information of pertinence

Healthcare visit (other): Dr office

Release 5 — day 21, dose 2

2021-03-18

Symptoms: Sence of taste and smell has not improved. She is 93 and still feels horrid and her head still does not think well. She says her breathing is bad shortness of breath

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: It was like she had some kind of relapse. Severe fatigue and worse brain fog. Dry cough. All lasted about a week then got incrementally better. Still no taste or smell. Had to force her to give dr a urine sample cause she was too exhausted to deal wi cut off by CDC

Healthcare visit (other): GPVisit

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: Itchy random places mostly near joints. increased desire for burnt toast charcoal. muscle twitching lower legs. Still extreme chills. Still little taste or smell which hampers desire for food. Dry cough. Cognitive ability still affected memory poor cut off by CDC

Healthcare visit (other): GP and (b)(6) Neurology referral

redacted (b)(6)

Release 12 — day 7, dose 3

2022-10-02

Systemic reaction (other): Cough

Release 12 — day 14, dose 3

2022-10-09

Symptoms: Chills cough brain fog itching

Release 12 — day 28, dose 3

2022-10-25

Symptoms: Extremely weak and explosive bowel movement

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	Abnormal faeces	·	·	✓
SD	Ageusia	✓	✓	✓
SD	Anosmia	✓	✓	✓
SD	Appetite disorder	✓	·	✓
SD	Asthenia	·	·	✓
SD	Brain fog	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cognitive disorder	✓	·	✓
SD	Cough	✓	✓	✓
SD	Decreased appetite	✓	·	✓
SD	Disturbance in attention	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Hypogeusia	✓	·	✓
SD	Hyposmia	✓	·	✓
SD	Memory impairment	✓	·	✓
SD	Muscle twitching	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Parosmia	✓	✓	✓
SD	Pruritus	✓	·	✓
SD	Taste disorder	✓	✓	✓
SD	Thinking abnormal	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Eye swelling	✓	✓	✓

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