Z2L-12230-28655

4 vaccinations 7 coded responses 22 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 993 / WA
Registered: 2020-12-29

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

2020-12-23
Dose 1 — Moderna
2020-12-29
Registered in v-safe
2020-12-29
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Good · Site: Pain

Free text: When i first received the vaccine, i had a weird sensation of it moving through the injected arm. It lasted about 30 minutes and then dissipated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-30
Survey response — day 7, dose 1
MedDRA: Paranasal sinus hypersecretion — Feeling: Good

Free text: Some nasal drainage in the morning. Might be allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-20
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-21
Dose 2 — Moderna
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Headache, Malaise, Pain — Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: The night after my 2nd vaccine, i had shivering, pain, malaise, body and headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — day 7, dose 2
Feeling: Good · None

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

Adult check-in
2021-02-11
Survey response — day 21, dose 2
MedDRA: Abdominal discomfort, Diarrhoea, Migraine — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Diarrhea, upset stomach on Feb 9 & 10, migraine on Feb 5 & 6

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-19
Dose 3 — Moderna
2022-01-21
Survey response — 12 months, dose 2
MedDRA: Cough, Headache, Malaise, Medical counselling, SARS-CoV-2 test, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I had a chronic headache, malaise, and dry cough for about 1 week between Chrisman and New Years. But 3 rapid covid 19 tests were negative · Healthcare visit (other): Employee health nurse at my job evaluated and tested me for covid

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-26
Call 1 — Left Voicemail
2022-01-27
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-01
Dose 4 — Moderna
2022-04-22
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-29
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-06
Survey response — day 35, dose 4
MedDRA: Abdominal discomfort, Cough, Fatigue — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Some dry cough. Fatigue, gastrointestinal distress

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-01
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-02
Survey response — 6 months, dose 4
MedDRA: Asthenia, COVID-19 — 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 · Telehealth, virtual health, or email health consultation

Free text: I had covid over the summer and had a while of reduced strength, but it's better now

MedDRA releases: 2024-11 · check-in free text available
2022-10-02
Report sent to call center — 6 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 · 1 call case(s)
2022-10-04
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-05
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-23	Moderna
2	2021-01-21	Moderna
3	2021-11-19	Moderna	No
4	2022-04-01	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-21	Successful 2022-01-27	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-10-02	Successful 2022-10-04	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-29

Systemic reaction (other): When i first received the vaccine, i had a weird sensation of it moving through the injected arm. It lasted about 30 minutes and then dissipated

Release 1 — day 7, dose 1

2020-12-30

Systemic reaction (other): Some nasal drainage in the morning. Might be allergies

Release 2 — days 1–6 daily, dose 2

2021-01-27

Systemic reaction (other): The night after my 2nd vaccine, i had shivering, pain, malaise, body and headaches

Release 4 — day 21, dose 2

2021-02-11

Symptoms: Diarrhea, upset stomach on Feb 9 & 10, migraine on Feb 5 & 6

Release 11 — 12 months, dose 2

2022-01-21

Symptoms: I had a chronic headache, malaise, and dry cough for about 1 week between Chrisman and New Years. But 3 rapid covid 19 tests were negative

Healthcare visit (other): Employee health nurse at my job evaluated and tested me for covid

Release 11 — day 35, dose 4

2022-05-06

Symptoms: Some dry cough. Fatigue, gastrointestinal distress

Release 12 — 6 months, dose 4

2022-10-02

Symptoms: I had covid over the summer and had a while of reduced strength, but it's better now

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	Medical counselling	·	·	✓
HCVO	SARS-CoV-2 test	·	·	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Asthenia	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Malaise	·	·	✓
SD	Migraine	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Paranasal sinus hypersecretion	✓	✓	✓
SRO	Sinus operation	○	○	○

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