2TU-32736-92540

4 vaccinations 14 coded responses 45 check-ins 14 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 982 / WA
Registered: 2021-02-01

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

2021-02-01
Registered in v-safe
2021-02-01
Dose 1 — Moderna
2021-02-01
Health check-in — day 0, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

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
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Neuralgia, Pre-existing disease — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Nerve pain at site of previous shingles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Medical counselling, Neuralgia, Self-medication — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Continued shingles like nerve pain, using topical lidocaine and ibuprofen. · Healthcare visit (other): Pharmacist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-08
Survey response — day 7, dose 1
MedDRA: Neuralgia — Feeling: Good

Free text: Still shingle like nerve pain, but lessening.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — day 14, dose 1
MedDRA: Pruritus, Rash erythematous — Feeling: Fair

Free text: Arm became itchy on the night of the last check-in, Red rash next day near injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-28
Dose 2 — Moderna
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Herpes zoster, Neuralgia — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Shingles like nerve pain just started again where I had shingles years ago. It happened after the first one but a week out.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease, Pruritus — Feeling: Good

Free text: Itching and shingle like pain in area where I had shingles 11 years ago. I got this one week after the first dose also.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Headache, Joint pains

Adult check-in
2021-03-14
Survey response — day 14, dose 2
MedDRA: Burning sensation, Herpes zoster, Pruritus — Feeling: Good

Free text: Itching and burning along previous Shingles path

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 21, dose 2
MedDRA: Erythema, Pruritus, Self-medication, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Foot redness and itching starting in the evening for three consecutive nights. Extended to leg rash/hives on legs, buttocks and arms and hands. Second night excruciating itching that kept me awake for hours. Doctor prescribed Benadryl/better last eve

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-28
Health check-in — day 28, dose 2
Feeling: Good

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

Adult check-in
2021-04-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-30
Survey response — 3 months, dose 2
MedDRA: Confusional state, Gait disturbance, Memory impairment, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Forgetfulness, mild confusion, slight imbalance when walking. CT scan and other tests negative for stroke or UTI. · Healthcare visit (other): Primary care nurse check, to doctor, to CT scan at hospital, follow up with primary, urinalysis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-15
Call 1 — Left Voicemail
2021-08-29
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-19
Call successful
Does not wish to fill out VAERS report
2021-10-19
Call successful
Does not wish to fill out VAERS report
2021-10-19
Call successful
Does not wish to fill out VAERS report
2021-10-25
Dose 3 — Moderna
2021-10-25
Health check-in — day 0, dose 3
Feeling: Fair · None

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Diarrhea

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Diarrhea, Abdominal pain

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Abdominal pain

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Fair · Headache

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Survey response — day 28, dose 3
MedDRA: Herpes zoster — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Increased Shingles like symptoms

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-29
Survey response — day 35, dose 3
MedDRA: Arthralgia, Herpes zoster, Myalgia, Vaccine positive rechallenge — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Shingles like symptoms that I got after the two vaccines and the booster came back with a vengeance after a first time yearly infusion of Zoledronic Acid on November 20, also have muscle and joint aches.

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-01
Call successful
Does not wish to fill out VAERS report
2021-12-01
Call successful
Does not wish to fill out VAERS report
2021-12-06
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-25
Dose 4 — Moderna
2022-04-25
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-05-14
Survey response — day 14, dose 4
MedDRA: Diverticulitis — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Diverticulitis

MedDRA releases: 2024-11 · check-in free text available
2022-05-14
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-16
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-17
Call successful
Does not wish to fill out VAERS report
2022-05-23
Survey response — day 28, dose 4
MedDRA: Arthralgia — Feeling: Fair

Free text: Hip joint ache for three days

MedDRA releases: 2024-11 · check-in free text available
2022-05-30
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-06
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-25
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-24
Survey response — 6 months, dose 4
MedDRA: Fall — Feeling: Fair · 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: Fell while running

MedDRA releases: 2024-11 · check-in free text available
2022-10-24
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-25
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-01	Moderna
2	2021-02-28	Moderna
3	2021-10-25	Moderna	No
4	2022-04-25	Moderna	No

Call center

7 call center cases

7 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-06

Systemic reaction (other): Nerve pain at site of previous shingles

2021-02-07

Systemic reaction (other): Continued shingles like nerve pain, using topical lidocaine and ibuprofen.

Healthcare visit (other): Pharmacist

Release 3 — day 7, dose 1

2021-02-08

Systemic reaction (other): Still shingle like nerve pain, but lessening.

Release 4 — day 14, dose 1

2021-02-15

Symptoms: Arm became itchy on the night of the last check-in, Red rash next day near injection site.

Release 4 — days 1–6 daily, dose 2

2021-03-01

Systemic reaction (other): Shingles like nerve pain just started again where I had shingles years ago. It happened after the first one but a week out.

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): Itching and shingle like pain in area where I had shingles 11 years ago. I got this one week after the first dose also.

Release 5 — day 14, dose 2

2021-03-14

Symptoms: Itching and burning along previous Shingles path

Release 6 — day 21, dose 2

2021-03-23

Symptoms: Foot redness and itching starting in the evening for three consecutive nights. Extended to leg rash/hives on legs, buttocks and arms and hands. Second night excruciating itching that kept me awake for hours. Doctor prescribed Benadryl/better last eve cut off by CDC

Release 8 — 3 months, dose 2

2021-05-30

Symptoms: Forgetfulness, mild confusion, slight imbalance when walking. CT scan and other tests negative for stroke or UTI.

Healthcare visit (other): Primary care nurse check, to doctor, to CT scan at hospital, follow up with primary, urinalysis.

Release 10 — day 28, dose 3

2021-11-22

Symptoms: Increased Shingles like symptoms

Release 10 — day 35, dose 3

2021-11-29

Symptoms: Shingles like symptoms that I got after the two vaccines and the booster came back with a vengeance after a first time yearly infusion of Zoledronic Acid on November 20, also have muscle and joint aches.

Release 11 — day 14, dose 4

2022-05-14

Symptoms: Diverticulitis

Release 11 — day 28, dose 4

2022-05-23

Symptoms: Hip joint ache for three days

Release 12 — 6 months, dose 4

2022-10-24

Symptoms: Fell while running

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	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Burning sensation	✓	✓	✓
SD	Confusional state	✓	✓	✓
SD	Diverticulitis	·	·	✓
SD	Erythema	✓	✓	✓
SD	Fall	·	·	✓
SD	Gait disturbance	✓	✓	✓
SD	Herpes zoster	✓	✓	✓
SD	Memory impairment	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Urticaria	✓	✓	✓
SD	Vaccine positive rechallenge	·	·	✓
SRO	Herpes zoster	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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