SZ8-41202-29449

4 vaccinations 18 coded responses 33 check-ins 17 free-text entries 4 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 982 / WA
Registered: 2021-04-18

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

2021-04-18
Registered in v-safe
2021-04-18
Dose 1 — Moderna
2021-04-18
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-20
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Lip dry — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: Dizziness, dry lips

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-24
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — day 7, dose 1
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — day 14, dose 1
MedDRA: Dizziness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Super dizzy. Not sure its related to the vaccine though.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — day 21, dose 1
MedDRA: Dizziness — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness persist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Dose 2 — Moderna
2021-05-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Vertigo — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness and vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Vertigo — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness and vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Injection site bruising, Vertigo — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Dizziness/vertigo, bruise at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Injection site bruising — Feeling: Fair · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Dizziness, bruising at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Injection site bruising — Feeling: Good · Site: Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Fading bruise at injection site, mild dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-26
Survey response — day 14, dose 2
MedDRA: Dizziness, Vertigo — Feeling: Good · Be unable to do your normal daily activities

Free text: Periods of off and on dizziness/vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-06-09
Survey response — day 28, dose 2
MedDRA: Dizziness, Intermenstrual bleeding, Syncope — Feeling: Fair

Free text: Midcycle menstrual spotting, dizziness/fainting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-23
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-10
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-19
Dose 3 — Moderna
2022-05-12
Survey response — 12 months, dose 2
MedDRA: Cystitis interstitial, Endometriosis, Intestinal obstruction — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Diagnosed with endometriosis and interstitial cystitis in January 2022, small bowel obstruction in October 2021 (all unrelated to COVID-19 or the vaccine)

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-05-13
Call successful
Not applicable - Accidental Reporting
2022-05-15
Dose 4 — Moderna
2022-05-22
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-05-29
Survey response — day 14, dose 4
MedDRA: Back pain, Groin pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Groin pain, lower back pain

MedDRA releases: 2024-11 · check-in free text available
2022-06-05
Health check-in — day 21, dose 4
Feeling: Poor

Adult check-in
2022-06-12
Health check-in — day 28, dose 4
Feeling: Poor

Adult check-in
2022-06-19
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-26
Survey response — day 42, dose 4
MedDRA: Arthralgia — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Probably not related. Severe elbow pain in opposite arm from injection

MedDRA releases: 2024-11 · check-in free text available
2022-06-26
Report sent to call center — day 42, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-27
Call 1 — Left Voicemail
2022-06-27
Call 1 — Left Voicemail
2022-08-14
Survey response — 3 months, dose 4
MedDRA: Abdominal pain lower, Endometrial thickening, Endometriosis, Inflammation, Magnetic resonance imaging abnormal, Unevaluable event — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Symptoms: The symptoms are unlikely to be related to COVID-19, but are related to my stage 4 endometriosis diagnosed in January 2022. LLQ pain/inflammation was determined on MRI to be endometriotic thickening around my left ovary/adnexa and sigmoid colon · Healthcare visit (other): Endometriosis excision surgery tentatively scheduled for September 2022

MedDRA releases: 2024-11 · check-in free text available
2022-08-14
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-08-15
Call successful
Participant prefers to complete VAERS report online
2022-08-15
Call successful
Participant prefers to complete VAERS report online
2022-11-13
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-05-15
Survey response — 12 months, dose 4
MedDRA: Adenomyosis, Amenorrhoea, Endometriosis, Generalised oedema, Intervertebral disc degeneration, Pain, Spinal retrolisthesis, Spondylolisthesis — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11
2023-05-15
Report sent to call center — 12 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2023-05-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-18	Moderna
2	2021-05-12	Moderna
3	2021-11-19	Moderna	No
4	2022-05-15	Moderna	No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-20

Systemic reaction (other): Dizziness, dry lips

2021-04-24

Systemic reaction (other): Dizziness

Release 7 — day 7, dose 1

2021-04-25

Systemic reaction (other): Dizziness

Release 8 — day 14, dose 1

2021-05-02

Symptoms: Super dizzy. Not sure its related to the vaccine though.

Release 8 — day 21, dose 1

2021-05-09

Symptoms: Dizziness persist

Release 8 — days 1–6 daily, dose 2

2021-05-13

Systemic reaction (other): Dizziness

2021-05-14

Systemic reaction (other): Dizziness and vertigo

2021-05-15

Systemic reaction (other): Dizziness and vertigo

2021-05-16

Systemic reaction (other): Dizziness/vertigo, bruise at injection site

2021-05-17

Systemic reaction (other): Dizziness, bruising at injection site

2021-05-18

Systemic reaction (other): Fading bruise at injection site, mild dizziness

Release 8 — day 14, dose 2

2021-05-26

Symptoms: Periods of off and on dizziness/vertigo

Release 9 — day 28, dose 2

2021-06-09

Symptoms: Midcycle menstrual spotting, dizziness/fainting

Release 11 — 12 months, dose 2

2022-05-12

Symptoms: Diagnosed with endometriosis and interstitial cystitis in January 2022, small bowel obstruction in October 2021 (all unrelated to COVID-19 or the vaccine)

Release 11 — day 14, dose 4

2022-05-29

Symptoms: Groin pain, lower back pain

Release 12 — day 42, dose 4

2022-06-26

Symptoms: Probably not related. Severe elbow pain in opposite arm from injection

Release 12 — 3 months, dose 4

2022-08-14

Symptoms: The symptoms are unlikely to be related to COVID-19, but are related to my stage 4 endometriosis diagnosed in January 2022. LLQ pain/inflammation was determined on MRI to be endometriotic thickening around my left ovary/adnexa and sigmoid colon

Healthcare visit (other): Endometriosis excision surgery tentatively scheduled for September 2022

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	Abdominal pain lower	·	·	✓
SD	Adenomyosis	·	·	✓
SD	Amenorrhoea	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Cystitis interstitial	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Endometrial thickening	·	·	✓
SD	Endometriosis	·	·	✓
SD	Generalised oedema	·	·	✓
SD	Groin pain	·	·	✓
SD	Inflammation	·	·	✓
SD	Intermenstrual bleeding	✓	✓	✓
SD	Intervertebral disc degeneration	·	·	✓
SD	Intestinal obstruction	·	·	✓
SD	Magnetic resonance imaging abnormal	·	·	✓
SD	Pain	·	·	✓
SD	Spinal retrolisthesis	·	·	✓
SD	Spondylolisthesis	·	·	✓
SD	Syncope	✓	✓	✓
SD	Vertigo	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Lip dry	✓	✓	✓
SRO	Vertigo	✓	✓	✓

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