Z4J-26079-78633

2 vaccinations 14 coded responses 24 check-ins 14 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 223 / VA
Registered: 2021-01-29

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

2021-01-28
Dose 1 — Moderna
2021-01-29
Registered in v-safe
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pain — Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: eyes hurting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 1
MedDRA: Gait disturbance, Limb discomfort — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Legs feel very heavy. Hard to go forward when go to walk

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle spasms — Feeling: Good · Site: Pain, Redness · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work

Free text: Cramping

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · Fatigue or tiredness

Adult check-in
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-11
Survey response — day 14, dose 1
MedDRA: Abdominal pain upper, Body temperature abnormal, Chills, Feeling abnormal, Headache, Injection site erythema, Sleep disorder — Feeling: Good · Be unable to do your normal daily activities

Free text: the shot area got very red and hotstomach cramps more headache Chills and not able to self regulate body temperature more brain fog and sleep distress

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pain — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Eyes hurt to see

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Eye pain, Rash — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Yesterday cheeks bright redCheeks with rash. todayEyes hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Eyes hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pain, Gait disturbance, Hypokinesia, Movement disorder — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Eyes hurt. Hard to walk/move in space

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Eye pain — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy, eyes hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Eye pain — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Eyes hurt , dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 7, dose 2
MedDRA: Eye pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Eyes hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-19
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-25
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Survey response — day 42, dose 2
MedDRA: Acupuncture, Arthralgia, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Ringing/white noise in my ears since my last vaccine And continuing muscle joint pain · Healthcare visit (other): acupuncture

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Medical counselling, Myalgia, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Constant Ringing in my ears and hard to hear since 2nd vaccineMuscles and joints are painful and do not always move · Healthcare visit (other): Chiropractor, acupuncture

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Fatigue, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue that not able to get ovet · Healthcare visit (other): Visit md

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
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)
2021-08-27
Call 1 — Left Voicemail
2021-08-30
Call 2 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-08	Unsuccessful
2021-05-27	Unsuccessful
2021-08-26	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): eyes hurting

2021-01-30

Systemic reaction (other): Legs feel very heavy. Hard to go forward when go to walk

2021-02-01

Systemic reaction (other): Cramping

Release 4 — day 14, dose 1

2021-02-11

Symptoms: the shot area got very red and hotstomach cramps more headache Chills and not able to self regulate body temperature more brain fog and sleep distress

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): Eyes hurt to see

2021-02-27

Systemic reaction (other): Yesterday cheeks bright redCheeks with rash. todayEyes hurt

2021-02-28

Systemic reaction (other): Eyes hurt

2021-03-01

Systemic reaction (other): Eyes hurt. Hard to walk/move in space

2021-03-02

Systemic reaction (other): Dizzy, eyes hurt

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Eyes hurt , dizzy

Release 5 — day 7, dose 2

2021-03-04

Systemic reaction (other): Eyes hurt

Release 7 — day 42, dose 2

2021-04-08

Symptoms: Ringing/white noise in my ears since my last vaccine And continuing muscle joint pain

Healthcare visit (other): acupuncture

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: Constant Ringing in my ears and hard to hear since 2nd vaccineMuscles and joints are painful and do not always move

Healthcare visit (other): Chiropractor, acupuncture

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: Fatigue that not able to get ovet

Healthcare visit (other): Visit md

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	Acupuncture	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	·	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Body temperature abnormal	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Sleep disorder	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Gait disturbance	✓	✓	✓
SRO	Hypokinesia	○	✓	○
SRO	Limb discomfort	✓	✓	✓
SRO	Movement disorder	✓	·	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Rash	✓	✓	✓

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