Z3Z-27361-38523

4 vaccinations 8 coded responses 39 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 049 / ME
Registered: 2021-03-27

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

2021-03-25
Dose 1 — Moderna
2021-03-27
Registered in v-safe
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-09
Survey response — day 14, dose 1
MedDRA: Headache — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe headache x 3 days now in left temporal area & left eye. I NEVER get headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-22
Dose 2 — Moderna
2021-04-22
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-07
Survey response — day 14, dose 2
MedDRA: Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Massive headache for several days now n I rarely have headaches. Also, severely fatigued since getting vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — day 21, dose 2
MedDRA: Chills, Headache, Myalgia, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headaches, muscle aches, low grade fever that comes n goes, chills. Some day I feel pretty good n the next day I feel like crap.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-22
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Survey response — 6 months, dose 2
MedDRA: Fatigue, Infection, Malaise, Office visit, Respiratory tract infection, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Respiratory infection. Sinusitis. Fatigue/malaise · Healthcare visit (other): Appt w/PCP associate made for annual PE n got checked out n treated during that visit for current infections

MedDRA releases: 2024-11 · check-in free text available
2021-10-22
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-25
Call 1 — Left Voicemail
2021-12-01
Dose 3 — Moderna
Co-administered: Flu
2022-04-22
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-11-09
Dose 4 — Moderna
Co-administered: Shingles
2022-11-09
Survey response — day 0, dose 4
MedDRA: No adverse event — Feeling: Fair · Site: Pain

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-10
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Fair · Muscle or body aches

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Fair

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-11-12
Survey response — days 1–6 daily, dose 4
MedDRA: Adverse reaction, Medical counselling — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Having adverse reaction to shingles vaccine I got same day as my COVID shot · Healthcare visit (other): Visit w/pharmacist - recommended further f/u for & treatment w/antibiotic

MedDRA releases: 2024-11 · check-in free text available
2022-11-12
Report sent to call center — days 1–6 daily, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · None

Adult check-in
2022-11-14
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · None

Adult check-in
2022-11-14
Call 2 — Left Voicemail
2022-11-14
Call 1 — Left Voicemail
2022-11-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · None

Adult check-in
2022-11-16
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-11-23
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-11-30
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-12-07
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-14
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-02-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-05-10
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-25	Moderna
2	2021-04-22	Moderna
3	2021-12-01	Moderna	Flu
4	2022-11-09	Moderna	Shingles

Call center

Reported	Outcome	VAERS-related outcome
2021-10-22	Unsuccessful
2022-11-12	Unsuccessful

Free text

Release 7 — day 14, dose 1

2021-04-09

Symptoms: Severe headache x 3 days now in left temporal area & left eye. I NEVER get headaches

Release 8 — day 14, dose 2

2021-05-07

Symptoms: Massive headache for several days now n I rarely have headaches. Also, severely fatigued since getting vaccination.

Release 8 — day 21, dose 2

2021-05-13

Symptoms: Headaches, muscle aches, low grade fever that comes n goes, chills. Some day I feel pretty good n the next day I feel like crap.

Release 10 — 6 months, dose 2

2021-10-22

Symptoms: Respiratory infection. Sinusitis. Fatigue/malaise

Healthcare visit (other): Appt w/PCP associate made for annual PE n got checked out n treated during that visit for current infections

Release 12 — day 0, dose 4

2022-11-09

Systemic reaction (other): No

Release 12 — days 1–6 daily, dose 4

2022-11-10

Systemic reaction (other): No

2022-11-11

Systemic reaction (other): No

2022-11-12

Systemic reaction (other): Having adverse reaction to shingles vaccine I got same day as my COVID shot

Healthcare visit (other): Visit w/pharmacist - recommended further f/u for & treatment w/antibiotic

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	Infection	·	·	✓
HCVO	Medical counselling	·	·	✓
HCVO	Office visit	·	·	✓
SD	Chills	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Malaise	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract infection	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Adverse reaction	·	·	✓
SRO	No adverse event	·	·	✓

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