Z4F-17729-18229

3 vaccinations 9 coded responses 34 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 531 / WI
Registered: 2021-02-04

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-02-03
Dose 1 — Moderna
2021-02-04
Registered in v-safe
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Swelling · Fatigue or tiredness, Nausea, Abdominal pain

Free text: Lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Nausea, Diarrhea

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Nausea

Adult check-in
2021-02-10
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-02-17
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Specialist consultation — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: The redness, pain, swelling and warmth to touch at the injection site came back worse and larger. It had subsided for 4 days then returned. · Healthcare visit (other): Primary care doctor in person visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-24
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-03
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Irritability — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Free text: Irritable, almost feel crazy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-11
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-25
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-01
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-15
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-03
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-05
Call 1 — Left Voicemail
2021-09-02
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-30
Dose 3 — Moderna
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Hypoaesthesia, Hypoaesthesia oral — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: On October 30 had severe reaction. Numbness in left hand and entire left side of face and tongue.

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Report sent to call center — days 1–6 daily, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-03
Call 1 — Left Voicemail
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Pain in jaw — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Jaw pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — day 7, dose 3
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-11-13
Survey response — day 14, dose 3
MedDRA: Fatigue, Hypoaesthesia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Numb face. Severe fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Survey response — day 21, dose 3
MedDRA: Arthralgia, Myalgia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Severe muscle and joint pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Health check-in — day 28, dose 3
Feeling: Poor

Adult check-in
2021-12-04
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-11
Health check-in — day 42, dose 3
Feeling: Poor

Adult check-in
2022-01-29
Survey response — 3 months, dose 3
MedDRA: Arthralgia, Joint swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Swelling and achy knees

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Survey response — 6 months, dose 3
MedDRA: Arthralgia, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: All over body muscle and joint pain

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-04	Moderna
3	2021-10-30	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-17	Unsuccessful
2021-11-02	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-05

Systemic reaction (other): Lightheaded

Release 4 — day 14, dose 1

2021-02-17

Symptoms: The redness, pain, swelling and warmth to touch at the injection site came back worse and larger. It had subsided for 4 days then returned.

Healthcare visit (other): Primary care doctor in person visit

Release 5 — days 1–6 daily, dose 2

2021-03-08

Systemic reaction (other): Irritable, almost feel crazy

Release 10 — days 1–6 daily, dose 3

2021-11-02

Systemic reaction (other): On October 30 had severe reaction. Numbness in left hand and entire left side of face and tongue.

2021-11-05

Systemic reaction (other): Jaw pain

Release 10 — day 14, dose 3

2021-11-13

Symptoms: Numb face. Severe fatigue

Release 10 — day 21, dose 3

2021-11-20

Symptoms: Severe muscle and joint pain

Release 11 — 3 months, dose 3

2022-01-29

Symptoms: Swelling and achy knees

Release 11 — 6 months, dose 3

2022-04-30

Symptoms: All over body muscle and joint pain

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	Specialist consultation	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Fatigue	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Joint swelling	·	·	✓
SD	Myalgia	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Hypoaesthesia oral	·	·	✓
SRO	Irritability	✓	✓	✓
SRO	Pain in jaw	·	·	✓

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