ZH5-22975-98996

2 vaccinations 6 coded responses 9 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 150 / PA
Registered: 2021-02-25

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

2021-02-08
Dose 1 — Moderna
2021-02-25
Registered in v-safe
2021-02-25
Survey response — day 14, dose 1
MedDRA: Medical counselling, Mouth ulceration, Oral disorder, Oral pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Painful mouth ulcerations and lesions.4 days after Covid vaccinationDoctor prescribed a tube of Triamcinolone Acetonide Dental Paste which does not seem to help. Vaccine received Feb 8 My second vaccination schedMar. 8. Hurts eating and drinking.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — day 21, dose 1
MedDRA: Mouth ulceration, Office visit, Oral disorder, Pain, Specialist consultation, Swollen tongue — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Mouth ulcerations turned into lesions on the roof of my mouth. I first experienced painful ulcers and swollen tongue on February 11 four days after my Moderna vaccine. Dentist and PCP advised magic swizzle & glycoxide. Reluctant to get 2nd vacc ????? · Healthcare visit (other): Dr. Office visit with PA

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Report sent to call center — day 21, dose 1
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)
2021-05-13
Survey response — 3 months, dose 1
MedDRA: Erythema, Eye irritation, Eyelids pruritus, Medical counselling, Skin burning sensation, Swelling of eyelid — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Facial Skin flareups- redness when I wash the face and then burning if I put anything on itEye Irritation and itchiness and swelling of the lids · Healthcare visit (other): Phone call

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — 3 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-09
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-12-30
Call 1 — Left Voicemail
2022-01-06
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-01-21
Dose 2 — Pfizer-BioNTech
2022-02-09
Survey response — 12 months, dose 1
MedDRA: Gallbladder disorder, Herpes zoster, Limb discomfort, Pain in extremity, Peripheral swelling, Sensory disturbance, Skin irritation, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Symptoms: Fingers and large toe irritated. Tips of Fingers hurting. Big toe has a strange sensation/heaviness or swelling. Shingles flared up in same problematic areas. Gall bladder flare up week following my vaccine. 1st Moderna 02/21: 2nd Pfizer 01/22 · Healthcare visit (other): Two tests for gallbladder

MedDRA releases: 2024-11 · check-in free text available
2022-02-09
Report sent to call center — 12 months, dose 1
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-02-10
Call 1 — Left Voicemail
2022-03-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-04-22
Survey response — 3 months, dose 2
MedDRA: Office visit, Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Serious UTI's during all of March 2022. Two scripts of Macrobid did not eradicate the infection. Only After a 500 mg Levaquin script the urinary infection finally was healed. I never experienced anything like this-one script cleared UTI infectionS. · Healthcare visit (other): Dr. Visits

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-25
Call successful
Participant prefers to complete VAERS report online
2022-04-25
Call successful
Participant prefers to complete VAERS report online
2022-07-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2023-01-21
Survey response — 12 months, dose 2
MedDRA: Cough, Malaise, Sputum discoloured — Feeling: Fair

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Moderna
2	2022-01-21	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-01	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-05-13	Successful 2022-01-06	Reported to VAERS voluntarily prior to GDIT contact
2022-02-09	Successful 2022-04-25	Participant prefers to complete VAERS report online
2022-04-22	Successful 2022-04-25	Participant prefers to complete VAERS report online

Free text

Release 4 — day 14, dose 1

2021-02-25

Symptoms: Painful mouth ulcerations and lesions.4 days after Covid vaccinationDoctor prescribed a tube of Triamcinolone Acetonide Dental Paste which does not seem to help. Vaccine received Feb 8 My second vaccination schedMar. 8. Hurts eating and drinking.

Release 4 — day 21, dose 1

2021-03-01

Symptoms: Mouth ulcerations turned into lesions on the roof of my mouth. I first experienced painful ulcers and swollen tongue on February 11 four days after my Moderna vaccine. Dentist and PCP advised magic swizzle & glycoxide. Reluctant to get 2nd vacc ????? cut off by CDC

Healthcare visit (other): Dr. Office visit with PA

Release 8 — 3 months, dose 1

2021-05-13

Symptoms: Facial Skin flareups- redness when I wash the face and then burning if I put anything on itEye Irritation and itchiness and swelling of the lids

Healthcare visit (other): Phone call

Release 11 — 12 months, dose 1

2022-02-09

Symptoms: Fingers and large toe irritated. Tips of Fingers hurting. Big toe has a strange sensation/heaviness or swelling. Shingles flared up in same problematic areas. Gall bladder flare up week following my vaccine. 1st Moderna 02/21: 2nd Pfizer 01/22

Healthcare visit (other): Two tests for gallbladder

Release 11 — 3 months, dose 2

2022-04-22

Symptoms: Serious UTI's during all of March 2022. Two scripts of Macrobid did not eradicate the infection. Only After a 500 mg Levaquin script the urinary infection finally was healed. I never experienced anything like this-one script cleared UTI infectionS. cut off by CDC

Healthcare visit (other): Dr. Visits

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Cough	·	·	✓
SD	Erythema	✓	✓	✓
SD	Eye irritation	✓	✓	✓
SD	Eyelids pruritus	✓	✓	✓
SD	Gallbladder disorder	·	·	✓
SD	Herpes zoster	·	·	✓
SD	Limb discomfort	·	·	✓
SD	Malaise	·	·	✓
SD	Medical counselling	✓	✓	✓
SD	Mouth ulceration	✓	✓	✓
SD	Oral disorder	✓	✓	✓
SD	Oral pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Peripheral swelling	·	·	✓
SD	Sensory disturbance	·	·	✓
SD	Skin burning sensation	✓	✓	✓
SD	Skin irritation	·	·	✓
SD	Specialist consultation	✓	✓	✓
SD	Sputum discoloured	·	·	✓
SD	Swelling of eyelid	✓	✓	✓
SD	Swollen tongue	✓	✓	✓
SD	Urinary tract infection	·	·	✓

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