4ZB-22994-98011

2 vaccinations 7 coded responses 24 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 981 / WA
Registered: 2021-02-02

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
Dose 1 — Moderna
2021-02-02
Registered in v-safe
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

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

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-15
Survey response — day 14, dose 1
MedDRA: Body temperature decreased, Erythema, Malaise, Rash — Feeling: Fair · Be unable to do your normal daily activities

Free text: Rash on arm of shot. Noticed last Thursday AM; quite red but not itchy. Clearly more each day and now almost gone with just a few small lumps. Feeling sickly but no extreme symptoms except lowly temperature than usual 97.1 high to 94.8 low.

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
2021-03-01
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-02
Dose 2 — Moderna
2021-03-02
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Slightly dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Slightly dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 7, dose 2
MedDRA: Dizziness — Feeling: Fair · Muscle or body aches

Free text: Still slightly dizzy but better than yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-23
Survey response — day 21, dose 2
MedDRA: Body temperature decreased, Dizziness, Fatigue, Feeling cold, Nasopharyngitis, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dizzy and low body temp easily getting cold and fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-17
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2022-03-04
Survey response — 12 months, dose 2
MedDRA: Lichenoid keratosis — 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: LICHENOID DERMATITIS From vaccination

MedDRA releases: 2024-11 · check-in free text available
2022-03-04
Report sent to call center — 12 months, dose 2
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)
2022-03-08
Call 1 — Left Voicemail
2022-04-04
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-01	Moderna
2	2021-03-02	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-15

Symptoms: Rash on arm of shot. Noticed last Thursday AM; quite red but not itchy. Clearly more each day and now almost gone with just a few small lumps. Feeling sickly but no extreme symptoms except lowly temperature than usual 97.1 high to 94.8 low.

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Light headed

2021-03-06

Systemic reaction (other): Slightly dizzy

2021-03-07

Systemic reaction (other): Slightly dizzy

Release 5 — day 7, dose 2

2021-03-09

Systemic reaction (other): Still slightly dizzy but better than yesterday

Release 6 — day 21, dose 2

2021-03-23

Symptoms: Dizzy and low body temp easily getting cold and fatigue

Release 11 — 12 months, dose 2

2022-03-04

Symptoms: LICHENOID DERMATITIS From vaccination

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
SD	Body temperature decreased	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling cold	·	·	✓
SD	Lichenoid keratosis	·	·	✓
SD	Malaise	✓	✓	✓
SD	Nasopharyngitis	✓	✓	○
SD	Pyrexia	✓	✓	○
SD	Rash	✓	✓	✓
SRO	Dizziness	✓	✓	✓

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