Z2R-82529-37733

3 vaccinations 8 coded responses 22 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 760 / TX
Registered: 2021-04-15

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-14
Dose 1 — Moderna
2021-04-15
Registered in v-safe
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-23
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Good · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Rainy day. I dont think my ailments are caused by shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — day 14, dose 1
MedDRA: Muscle tightness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very tight muscles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — day 21, dose 1
MedDRA: Joint range of motion decreased, Self-medication — Feeling: Poor · Be unable to do your normal daily activities

Free text: Joints neck knees can barely move. Since Saturday. Today actually was a little better. Took pain meds.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Dose 2 — Moderna
2021-05-12
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to work

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-06-04
Survey response — day 21, dose 2
MedDRA: Fatigue, Impaired work ability, Musculoskeletal stiffness, Neck pain — Feeling: Fair · Be unable to work

Free text: Neck pain and body stiffness and un normal fatigue. I made an appointment to see a doctor. June 18. I also took off work for 3 days last week.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-16
Health check-in — day 35, dose 2
Feeling: Good

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

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

Adult check-in
2022-03-02
Dose 3 — Moderna
Co-administered: Flu
2022-06-01
Survey response — 3 months, dose 3
MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Allergies

MedDRA releases: 2024-11 · check-in free text available
2022-09-07
Survey response — 6 months, dose 3
MedDRA: Painful respiration — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: When I breath I am having pain on my upper left side. I could have pulled something

MedDRA releases: 2024-11 · check-in free text available
2022-09-07
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-04
Survey response — 12 months, dose 3
MedDRA: Bronchitis — Feeling: Good · 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: 2024-11
2023-03-04
Report sent to call center — 12 months, dose 3
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)
2023-03-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-14	Moderna
2	2021-05-12	Moderna
3	2022-03-02	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-09-07	Successful 2022-09-08	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-04	Successful 2023-03-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — day 7, dose 1

2021-04-23

Systemic reaction (other): Rainy day. I dont think my ailments are caused by shot

Release 8 — day 14, dose 1

2021-04-28

Symptoms: Very tight muscles

Release 8 — day 21, dose 1

2021-05-05

Symptoms: Joints neck knees can barely move. Since Saturday. Today actually was a little better. Took pain meds.

Release 8 — day 0, dose 2

2021-05-12

Systemic reaction (other): No

Release 8 — day 21, dose 2

2021-06-04

Symptoms: Neck pain and body stiffness and un normal fatigue. I made an appointment to see a doctor. June 18. I also took off work for 3 days last week.

Release 11 — 3 months, dose 3

2022-06-01

Symptoms: Allergies

Release 12 — 6 months, dose 3

2022-09-07

Symptoms: When I breath I am having pain on my upper left side. I could have pulled something

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
SD	Bronchitis	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Impaired work ability	✓	✓	✓
SD	Joint range of motion decreased	✓	✓	✓
SD	Muscle tightness	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Painful respiration	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Self-medication	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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