6BR-18488-00183

2 vaccinations 8 coded responses 23 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 057 / VT
Registered: 2021-01-29

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

2021-01-27
Dose 1 — Moderna
2021-01-29
Registered in v-safe
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Herpes zoster — Feeling: Poor · Headache, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: It may not be related but I developed shingles in the left side of my waist yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Headache

Free text: Developed shingles so can not accurately report vaccine systems

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Herpes zoster, Rash — Feeling: Fair · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Diagnosis is shingles. Appeared 24 hrs after vaccine.Rssh on left side of waist around to middle of back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-04
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-10
Survey response — day 14, dose 1
MedDRA: Herpes zoster, Pre-existing disease — Feeling: Poor

Free text: Postherpetic pain from shingles which appeared 24 hrs after initial vaccine.Vaccine - Moderna.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 21, dose 1
MedDRA: Nerve injury — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Nerve damage in the left side where the shingles erupted.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-24
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-26
Dose 2 — Moderna
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Chills, Headache

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Increased sensitivity in the area of the shingles breakout.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Herpes zoster, Neuralgia — Feeling: Fair · Site: Pain · Headache

Free text: Nerve pain from shingles (previously reported)

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: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-19
Survey response — day 21, dose 2
MedDRA: Condition aggravated, Pre-existing disease, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Return of nerve damage from the shingles after first vaccine.Not as severe but definitely problematic. · Healthcare visit (other): Renewed medication prescribed before

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-24
Call 1 — Left Voicemail
2021-08-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-26
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Moderna
2	2021-02-26	Moderna

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): It may not be related but I developed shingles in the left side of my waist yesterday.

2021-01-31

Systemic reaction (other): Developed shingles so can not accurately report vaccine systems

2021-02-01

Systemic reaction (other): Diagnosis is shingles. Appeared 24 hrs after vaccine.Rssh on left side of waist around to middle of back

Release 4 — day 14, dose 1

2021-02-10

Symptoms: Postherpetic pain from shingles which appeared 24 hrs after initial vaccine.Vaccine - Moderna.

Release 4 — day 21, dose 1

2021-02-17

Symptoms: Nerve damage in the left side where the shingles erupted.

Release 4 — days 1–6 daily, dose 2

2021-03-02

Systemic reaction (other): Increased sensitivity in the area of the shingles breakout.

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Nerve pain from shingles (previously reported)

Release 6 — day 21, dose 2

2021-03-19

Symptoms: Return of nerve damage from the shingles after first vaccine.Not as severe but definitely problematic.

Healthcare visit (other): Renewed medication prescribed before

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	Unevaluable event	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Herpes zoster	✓	✓	✓
SD	Nerve injury	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Herpes zoster	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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