XZT-12082-03016

3 vaccinations 16 coded responses 28 check-ins 16 free-text entries 8 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 329 / FL
Registered: 2021-03-13

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

2021-03-13
Registered in v-safe
2021-03-13
Dose 1 — Moderna
2021-03-13
Survey response — day 0, dose 1
MedDRA: Headache — Feeling: Good · Headache

Free text: Headache could be pollen related too

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat - could be allergies / pollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Sore throat - maybe pollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Fair · Site: Redness

Free text: Body just feels numb - like a tingling sensation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 7, dose 1
MedDRA: SARS-CoV-2 test positive — Feeling: Fair · Site: Redness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Tested positive for Covid today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-27
Survey response — day 14, dose 1
MedDRA: COVID-19 — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Diagnosed with Covid a week after my vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Report sent to call center — day 14, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-03
Survey response — day 21, dose 1
MedDRA: Axillary pain, Pruritus — Feeling: Fair

Free text: Strange soreness/itchy sensation under both of my arms, worse in the arm that I received the shot it. Sore and becomes itchy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Survey response — 3 months, dose 1
MedDRA: Arthralgia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Joint pain - fingers, toes and ankles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Report sent to call center — 3 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-17
Call 1 — Left Voicemail
2021-06-21
Call successful
Other
2021-06-21
Call successful
Other
2021-06-21
Call successful
Other
2021-07-28
Dose 2 — Moderna
2021-07-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Joint pains, Diarrhea

Adult check-in
2021-07-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache

Adult check-in
2021-08-06
Health check-in — day 7, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-08-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-08-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-08-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-09-07
Survey response — day 35, dose 2
MedDRA: Arthropathy, Menstruation delayed, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I just realized that my periods have stopped - havent had one since April. Still having joint issues. · Healthcare visit (other): Regular visit for a nerve conduction study

MedDRA releases: 2024-11 · check-in free text available
2021-09-07
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-13
Call 1 — Left Voicemail
2022-01-26
Survey response — 6 months, dose 2
MedDRA: Dyspnoea, Palpitations — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Racing heart and shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-01-27
Call 1 — Left Voicemail
2022-03-18
Dose 3 — Moderna
2022-03-18
Health check-in — day 0, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-03-19
Survey response — days 1–6 daily, dose 3
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain

Free text: Just pain in my arm

MedDRA releases: 2024-11 · check-in free text available
2022-03-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · None

Adult check-in
2022-03-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2022-03-25
Health check-in — day 7, dose 3
Feeling: Good · Joint pains

Adult check-in
2022-04-02
Survey response — day 14, dose 3
MedDRA: Heart rate increased — Feeling: Fair

Free text: Rapid heart rate

MedDRA releases: 2024-11 · check-in free text available
2022-04-08
Survey response — day 21, dose 3
MedDRA: Heart rate increased, Office visit, Panic attack — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Panic attacks and feel like rapid heart rate · Healthcare visit (other): Primary care

MedDRA releases: 2024-11 · check-in free text available
2022-04-08
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-13
Call 1 — Left Voicemail
2022-04-24
Survey response — day 35, dose 3
MedDRA: Cough, Nasal congestion, Nasopharyngitis, Oropharyngeal pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Cold - cough, sore throat, nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Survey response — day 42, dose 3
MedDRA: Alopecia, Anaemia, Office visit, Panic attack — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Panic attacks, anemic, hair falling out - not sure if from vaccination or from covid · Healthcare visit (other): Primary care, ultrasounds, lab work, B13 injections

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-02
Call 1 — Left Voicemail
2022-09-17
Survey response — 6 months, dose 3
MedDRA: Anaemia, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Anemic · Healthcare visit (other): Multiple primary care visits

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Moderna
2	2021-07-28	Moderna	No
3	2022-03-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-20	Successful 2021-06-21	Other
2021-03-27	Successful 2021-06-21	Other
2021-06-15	Successful 2021-06-21	Other
2021-09-07	Unsuccessful
2022-01-26	Unsuccessful
2022-04-08	Unsuccessful
2022-05-01	Unsuccessful
2022-09-17	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-13

Systemic reaction (other): Headache could be pollen related too

Release 5 — days 1–6 daily, dose 1

2021-03-14

Systemic reaction (other): Sore throat - could be allergies / pollen

2021-03-15

Systemic reaction (other): Sore throat - maybe pollen

2021-03-19

Systemic reaction (other): Body just feels numb - like a tingling sensation

Release 6 — day 7, dose 1

2021-03-20

Systemic reaction (other): Tested positive for Covid today

Release 6 — day 14, dose 1

2021-03-27

Symptoms: Diagnosed with Covid a week after my vaccine

Release 6 — day 21, dose 1

2021-04-03

Symptoms: Strange soreness/itchy sensation under both of my arms, worse in the arm that I received the shot it. Sore and becomes itchy.

Release 9 — 3 months, dose 1

2021-06-15

Symptoms: Joint pain - fingers, toes and ankles

Release 9 — day 35, dose 2

2021-09-07

Symptoms: I just realized that my periods have stopped - havent had one since April. Still having joint issues.

Healthcare visit (other): Regular visit for a nerve conduction study

Release 11 — 6 months, dose 2

2022-01-26

Symptoms: Racing heart and shortness of breath

Release 11 — days 1–6 daily, dose 3

2022-03-19

Systemic reaction (other): Just pain in my arm

Release 11 — day 14, dose 3

2022-04-02

Symptoms: Rapid heart rate

Release 11 — day 21, dose 3

2022-04-08

Symptoms: Panic attacks and feel like rapid heart rate

Healthcare visit (other): Primary care

Release 11 — day 35, dose 3

2022-04-24

Symptoms: Cold - cough, sore throat, nasal congestion

Release 11 — day 42, dose 3

2022-05-01

Symptoms: Panic attacks, anemic, hair falling out - not sure if from vaccination or from covid

Healthcare visit (other): Primary care, ultrasounds, lab work, B13 injections

Release 12 — 6 months, dose 3

2022-09-17

Symptoms: Anemic

Healthcare visit (other): Multiple primary care visits

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	Office visit	·	·	✓
SD	Alopecia	·	·	✓
SD	Anaemia	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Arthropathy	·	·	✓
SD	Axillary pain	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Menstruation delayed	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Palpitations	·	·	✓
SD	Panic attack	·	·	✓
SD	Pruritus	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain in extremity	·	·	✓
SRO	Paraesthesia	✓	✓	✓
SRO	SARS-CoV-2 test positive	✓	✓	✓

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