Z4E-15491-43931

2 vaccinations 9 coded responses 26 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 232 / VA
Registered: 2020-12-28

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

2020-12-28
Registered in v-safe
2020-12-28
Dose 1 — Moderna
2020-12-28
Survey response — day 0, dose 1
MedDRA: Paraesthesia oral — Feeling: Good

Free text: Lips tingle mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-30
Survey response — days 1–6 daily, dose 1
MedDRA: Dry eye, Pruritus, Skin burning sensation — Feeling: Fair · Site: Redness, Swelling, Itching · Chills, Headache, Fatigue or tiredness

Free text: Continue to have sensation of wind burn itch head to toe. Less intense thsn yesterday. Dry eye sensation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Itching · Chills, Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Itching · Headache, Muscle or body aches, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-01
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-01-04
Health check-in — day 7, dose 1
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Nausea

Adult check-in
2021-01-11
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-18
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-01-25
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-01-29
Dose 2 — Moderna
2021-01-29
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Tension headache, Vertigo — Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Feel like a tight band around my head. Vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Ear discomfort, Nasal congestion — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Free text: Less nasal congestion. Ears feel full

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Fair · Site: Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Continue with ear fullness starting to hear crackling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Tinnitus — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dizziness. Light headed conyinues with ears full crackling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Ear discomfort, Nasal congestion — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Nasal congestion ears still full

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — day 7, dose 2
MedDRA: Ear discomfort, Nasal congestion — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Ears still full, mild nasal digestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-31
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-28	Moderna
2	2021-01-29	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-01	priority 2/3

Free text

Release 1 — day 0, dose 1

2020-12-28

Systemic reaction (other): Lips tingle mild

Release 1 — days 1–6 daily, dose 1

2020-12-30

Systemic reaction (other): Continue to have sensation of wind burn itch head to toe. Less intense thsn yesterday. Dry eye sensation

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): Feel like a tight band around my head. Vertigo

2021-01-31

Systemic reaction (other): Light headed

2021-02-01

Systemic reaction (other): Less nasal congestion. Ears feel full

2021-02-02

Systemic reaction (other): Continue with ear fullness starting to hear crackling

2021-02-03

Systemic reaction (other): Dizziness. Light headed conyinues with ears full crackling

2021-02-04

Systemic reaction (other): Nasal congestion ears still full

Release 3 — day 7, dose 2

2021-02-05

Systemic reaction (other): Ears still full, mild nasal digestion

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
SRO	Dizziness	✓	✓	✓
SRO	Dry eye	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Skin burning sensation	✓	✓	✓
SRO	Tension headache	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Vertigo	✓	✓	✓

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