XZH-14310-58845

2 vaccinations 9 coded responses 23 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 700 / LA
Registered: 2021-03-03

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

2021-03-01
Dose 1 — Moderna
2021-03-03
Registered in v-safe
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Anosmia — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Anosmia — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — 7 day, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — 14 day, dose 1
Feeling: Fair

Adult check-in
2021-03-22
Survey response — 21 day, dose 1
MedDRA: Dysuria, Fatigue, Pelvic pain, Unevaluable event, White blood cells urine — 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

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-22
Report sent to call center — 21 day, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-29
Dose 2 — Moderna
2021-03-29
Survey response — 0 day, dose 2
MedDRA: Diverticulitis — Feeling: Poor · Nausea, Abdominal pain · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Nausea

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

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

Adult check-in
2021-04-05
Health check-in — 7 day, dose 2
Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain

Adult check-in
2021-04-13
Health check-in — 14 day, dose 2
Feeling: Fair

Adult check-in
2021-04-19
Survey response — 21 day, dose 2
MedDRA: Gastrointestinal disorder, Pain — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-26
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-05-03
Survey response — 35 day, dose 2
MedDRA: Ageusia, Anosmia, Condition aggravated, Contusion, Immunisation reaction, Pain in extremity, Pre-existing disease, Sleep deficit — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-10
Survey response — 42 day, dose 2
MedDRA: Contusion, Decreased appetite, Fatigue, Hypogeusia, Hyposmia, Oedema peripheral — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-28
Survey response — 3 month, dose 2
MedDRA: Cough, Fatigue, Oropharyngeal pain, Paranasal sinus discomfort, Sinus congestion — 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

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-06-28
Report sent to call center — 3 month, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-29
Call successful
Participant prefers to complete VAERS report online
2021-09-29
Health check-in — 6 month, dose 2
Feeling: Fair

Adult check-in
2022-03-29
Survey response — 12 month, dose 2
MedDRA: Decreased appetite, Gastrointestinal disorder, Inflammatory marker increased, Pre-existing disease, Weight decreased — 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, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2022-03-29
Report sent to call center — 12 month, dose 2
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 · 1 call case(s)
2022-03-30
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-03-29	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-22	Successful	Participant prefers to complete VAERS report online
2021-06-28	Successful 2021-06-29	Participant prefers to complete VAERS report online
2022-03-29	Successful 2022-03-30	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 5

Systemic reaction (other): Loss of taste and smell just like when I had COVID

Systemic reaction (other): I still cant taste or smell anything and I have a slight cough

Release 6

Symptoms: Ever present Chronic Fatigue since Covid in 03/20. Pelvic pain. Burning upon urination. WBC present in urine. WBC normal in blood work. RBC low end of normal. All other labs appear to be normal.

Healthcare visit (other): Urine sample and blood work

Systemic reaction (other): Diverticulitis

Release 7

Symptoms: Ongoing gastrointestinal issues. Body aches and pains

Release 8

Symptoms: Pain in my calves and unexplained bruising. I still cant smell or taste much of anything. Im still getting the COVID headaches that came back with the vaccine. My chronic fatigue syndrome is way worse. I cant get enough sleep.

Symptoms: Edema/swelling in my left leg and unexplained bruising. Im constantly tired. Like I can never get enough sleep. I still cant taste or smell much & I dont have much appetite.

Release 9

Symptoms: Sore throat, dry hacking cough, sinus congestion and pressure, severe fatigue and exhaustion for 2 weeks now.

Release 11

Symptoms: Gastrointestinal problems. Chronic diarrhea. I see my GI Doctor on 4/1 I've had a CT Scan, blood work, & stool samples analyzed. No parasites. Nothing on the scan, labs did show a raised marker for inflammation. I can't eat much & I've lost weight. 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
HCVO	Unevaluable event	✓	✓	✓
SD	Ageusia	✓	✓	✓
SD	Anosmia	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Contusion	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Dysuria	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Hypogeusia	✓	✓	✓
SD	Hyposmia	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Inflammatory marker increased	·	·	✓
SD	Oedema peripheral	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Paranasal sinus discomfort	✓	✓	✓
SD	Pelvic pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SD	Sleep deficit	✓	✓	✓
SD	Weight decreased	·	·	✓
SD	White blood cells urine	✓	✓	✓
SRO	Ageusia	✓	✓	✓
SRO	Anosmia	✓	✓	✓
SRO	Diverticulitis	✓	✓	✓

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