3CJ-28916-60333

2 vaccinations 7 coded responses 19 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 786 / TX
Registered: 2021-03-07

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

2021-03-04
Dose 1 — Moderna
2021-03-07
Registered in v-safe
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Vision blurred — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: Blurry Vision and Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Fatigue or tiredness, Diarrhea

Free text: Shortness of breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-01
Survey response — day 28, dose 1
MedDRA: Hypersensitivity, Pre-existing disease, Respiratory tract congestion, Sinus congestion, Sinus disorder — Feeling: Good

Free text: Congestion and sinus from allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Dose 2 — Moderna
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Good · Fatigue or tiredness

Free text: Short of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 42, dose 2
MedDRA: Vision blurred — Feeling: Fair · Be unable to do your normal daily activities

Free text: Blurred vision still an issue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Survey response — 3 months, dose 2
MedDRA: Bronchitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Bronchitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-07
Call successful
Participant prefers to complete VAERS report online
2021-10-03
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-02
Survey response — 12 months, dose 2
MedDRA: Asthenia, Blood pressure increased, Disturbance in attention, Eye pain, Eye swelling, Feeling cold, Hyperhidrosis, Office visit, Pain in extremity, Respiratory disorder, Tremor, Vision blurred — Feeling: Poor · 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: Symptoms: Tremors, Breathing issues, Difficulty concentrating, weakness and pain in legs. High blood pressure, blurred vision, sweats and cold spells sharp pain and swelling in eyes · Healthcare visit (other): Ultra sounds, mri, X-rays, eye exam, bloodwork, neurologist, pulmonologist. Family physician

MedDRA releases: 2024-11 · check-in free text available
2022-04-02
Report sent to call center — 12 months, dose 2
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)
2022-04-04
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-02	Moderna

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-08

Systemic reaction (other): Blurry Vision and Shortness of breath

2021-03-10

Systemic reaction (other): Shortness of breath.

Release 6 — day 28, dose 1

2021-04-01

Symptoms: Congestion and sinus from allergies

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): Short of breath

Release 8 — day 42, dose 2

2021-05-14

Symptoms: Blurred vision still an issue

Release 9 — 3 months, dose 2

2021-07-02

Symptoms: Bronchitis

Release 11 — 12 months, dose 2

2022-04-02

Symptoms: Tremors, Breathing issues, Difficulty concentrating, weakness and pain in legs. High blood pressure, blurred vision, sweats and cold spells sharp pain and swelling in eyes

Healthcare visit (other): Ultra sounds, mri, X-rays, eye exam, bloodwork, neurologist, pulmonologist. Family physician

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	Asthenia	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Bronchitis	✓	✓	✓
SD	Disturbance in attention	·	·	✓
SD	Eye pain	·	·	✓
SD	Eye swelling	·	·	✓
SD	Feeling cold	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sinus congestion	✓	✓	○
SD	Sinus disorder	·	·	✓
SD	Tremor	·	·	✓
SD	Vision blurred	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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