ZSA-11055-91522

5 vaccinations 6 coded responses 32 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 744 / OK
Registered: 2021-03-12

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

2021-03-10
Dose 1 — Moderna
2021-03-12
Registered in v-safe
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Gait disturbance, Hyperhidrosis, No adverse event, Pyrexia — Feeling: Poor · Site: Pain, Redness, 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, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Much, much worse yesterday. Could not walk, bedsheets drenched from fever. · Healthcare visit (other): None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — days 1–6 daily, 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)
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Hypersensitivity, Pre-existing disease — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cough, but that's probably allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Still very winded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 7, dose 1
MedDRA: Dyspnoea — Feeling: Good · Fatigue or tiredness

Free text: Still very winded. I was climbing 3 flights of stairs at work before and now feel right back at 0.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-07
Survey response — day 28, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

Free text: Still very winded. I felt great before I got the first dose, but that reaction seriously set me back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-04-21
Health check-in — day 42, dose 1
Feeling: Good

Adult check-in
2021-04-29
Dose 2 — Moderna
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches · Be unable to work

Adult check-in
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Good · Site: Redness, Swelling

Free text: Still winded, but I think that's a combination of being trapped on Zoom for over a year and getting knocked flat on my back for 4+ days by the first dose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-05-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-29
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-31
Dose 3 — Pfizer-BioNTech
Co-administered: Flu:Pneumonia
2022-03-02
Call successful
Does not wish to fill out VAERS report
2022-05-01
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-16
Dose 4 — Pfizer-BioNTech
2022-10-02
Dose 5 — Pfizer-BioNTech
Co-administered: Pneumonia
2022-10-10
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-18
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-23
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-30
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-06
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-13
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-01
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-02
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-29	Moderna
3	2021-10-31	Pfizer-BioNTech	Flu:Pneumonia
4	2022-05-16	Pfizer-BioNTech	No
5	2022-10-02	Pfizer-BioNTech	Pneumonia

Call center

Reported	Outcome	VAERS-related outcome
2021-03-12	Successful 2022-03-02	Does not wish to fill out VAERS report

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-12

Systemic reaction (other): Much, much worse yesterday. Could not walk, bedsheets drenched from fever.

Healthcare visit (other): None

2021-03-13

Systemic reaction (other): Cough, but that's probably allergies

2021-03-16

Systemic reaction (other): Still very winded

Release 5 — day 7, dose 1

2021-03-17

Systemic reaction (other): Still very winded. I was climbing 3 flights of stairs at work before and now feel right back at 0.

Release 7 — day 28, dose 1

2021-04-07

Symptoms: Still very winded. I felt great before I got the first dose, but that reaction seriously set me back.

Release 8 — days 1–6 daily, dose 2

2021-05-03

Systemic reaction (other): Still winded, but I think that's a combination of being trapped on Zoom for over a year and getting knocked flat on my back for 4+ days by the first dose.

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	No adverse event	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Gait disturbance	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Hypersensitivity	○	✓	○
SRO	Pre-existing disease	✓	·	✓
SRO	Pyrexia	✓	✓	✓

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