XZ2-28757-27037

2 vaccinations 8 coded responses 28 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 955 / CA
Registered: 2021-02-07

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

2021-02-07
Registered in v-safe
2021-02-07
Dose 1 — Moderna
2021-02-07
Health check-in — 0 day, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — 7 day, dose 1
Feeling: Good · Abdominal pain

Adult check-in
2021-02-21
Survey response — 14 day, dose 1
MedDRA: Fatigue, Myalgia, Vision blurred — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-28
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-03-07
Health check-in — 28 day, dose 1
Feeling: Good

Adult check-in
2021-03-14
Health check-in — 35 day, dose 1
Feeling: Fair

Adult check-in
2021-03-19
Dose 2 — Moderna
2021-03-19
Health check-in — 0 day, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Restless legs syndrome — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspepsia — Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-26
Health check-in — 7 day, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — 21 day, dose 2
Feeling: Fair

Adult check-in
2021-04-19
Survey response — 28 day, dose 2
MedDRA: Chest discomfort, Fatigue — Feeling: Poor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-23
Survey response — 35 day, dose 2
MedDRA: Abdominal pain, Back pain, Headache, Nausea — Feeling: Poor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-30
Health check-in — 42 day, dose 2
Feeling: Fair

Adult check-in
2021-06-18
Survey response — 3 month, dose 2
MedDRA: Intervertebral disc protrusion — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-18
Report sent to call center — 3 month, 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

1 call case(s)
2021-06-28
Call 1 — Left Voicemail
2021-09-19
Survey response — 6 month, dose 2
MedDRA: Neurological symptom, Office visit, Vitreous detachment — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-03-26
Survey response — 12 month, dose 2
MedDRA: C-reactive protein increased, Chest pain, Gait disturbance, Inflammation, Pre-existing disease, Vertigo, Vitreous detachment — 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

MedDRA releases: 2024-11 · check-in answers available
2022-03-26
Report sent to call center — 12 month, 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 · 1 call case(s)
2022-03-28
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-07	Moderna
2	2021-03-19	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-06-18	Unsuccessful
2022-03-26	Unsuccessful

Free text

Release 4

Symptoms: Muscle pa in n fatigue and some blurry vision

Release 6

Systemic reaction (other): Restless legs bad

Systemic reaction (other): Heartburn really bad since the shot. Not food related

Release 7

Symptoms: Some chest discomfort and super tired.

Symptoms: Miserable headache, nausea, lower back and abdominal pain.

Release 9

Symptoms: Schmoris nodes with moderate disc dessication

Symptoms: Experienced sudden posterior vitreous detachment in left eye followed by minor stroke like symptoms June 29. Saw eye Dr. Could not get into go and did not want to go to er due to large amount of covid and long waits.

Release 11

Symptoms: I experienced an inflammatory response with CRP 15, posterior vitreous detachment,trouble walking, chest pain and vertigo. I have Sjogrens and had to go on plaquenil to get inflammation to go down. Still having trouble walking but pain is going away. cut off by CDC

Free-text releases are not linked to a specific 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	Abdominal pain	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	C-reactive protein increased	·	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gait disturbance	·	·	✓
SD	Headache	✓	✓	✓
SD	Inflammation	·	·	✓
SD	Intervertebral disc protrusion	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Neurological symptom	·	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Vertigo	·	·	✓
SD	Vision blurred	✓	✓	✓
SD	Vitreous detachment	·	·	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Restless legs syndrome	✓	✓	✓

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