Z4W-10618-92305

5 vaccinations 12 coded responses 38 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 220 / VA
Registered: 2021-02-04

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

2021-01-25
Dose 1 — Moderna
2021-02-04
Registered in v-safe
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-24
Dose 2 — Moderna
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Ageusia, Cough, Rhinorrhoea, Sneezing — Feeling: Poor · Site: Redness, Swelling · Joint pains, Muscle or body aches

Free text: Sinus drainage, cough, sneezing and loss of taste.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-17
Survey response — day 21, dose 2
MedDRA: Dizziness, Ear pain, Fatigue, Headache, Nausea, Oropharyngeal pain, Pyrexia — Feeling: Poor

Free text: Nauseated, headache, low grade fever, dizzy, fatigued, sore throat and earache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-24
Dose 3 — Moderna
2021-08-25
Survey response — 6 months, dose 2
MedDRA: Confusional state, Feeling abnormal, Impaired driving ability, Impaired work ability, Mental impairment, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities

Free text: Very confused and out of it- difficulty driving and making decisions. Impacted my ability to work at my job effectively. m swollen twice its size.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-25
Survey response — days 1–6 daily, dose 3
MedDRA: Confusional state, Impaired driving ability — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Confusion, difficulty driving.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
Survey response — days 1–6 daily, dose 3
MedDRA: Peripheral swelling, Swelling face — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Facial and arm swelling

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · None

Adult check-in
2021-08-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · None

Adult check-in
2021-08-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · None

Adult check-in
2021-09-01
Health check-in — day 7, dose 3
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-09-07
Survey response — day 14, dose 3
MedDRA: Erythema — Feeling: Good

Free text: A breakout of tiny bright red spots across my torso and limbs. No itching or pain, though.

MedDRA releases: 2024-11 · check-in free text available
2021-09-14
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-09-23
Survey response — day 28, dose 3
MedDRA: Oropharyngeal pain, Pain, Respiratory tract congestion — Feeling: Fair

Free text: Ache all over. Sore throat. Congestion.

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-11-23
Survey response — 3 months, dose 3
MedDRA: Cough — Feeling: Fair

Free text: Coughing

MedDRA releases: 2024-11 · check-in free text available
2022-02-22
Dose 4 — Pfizer-BioNTech
2022-02-24
Survey response — 6 months, dose 3
MedDRA: Vertigo — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Vertigo.

MedDRA releases: 2024-11 · check-in free text available
2022-02-24
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-01
Call 1 — Left Voicemail
2022-08-24
Survey response — 12 months, dose 3
MedDRA: Confusional state, Cough, Myalgia, Oropharyngeal pain, Rhinorrhoea, Sneezing, Vomiting — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sore throat, cough and sneezing, runny nose, mental confusion, muscle aches, vomiting

MedDRA releases: 2024-11 · check-in free text available
2022-08-24
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-08-26
Call 2 — Left Voicemail
2022-08-26
Call 1 — Left Voicemail
2022-09-29
Dose 5 — Moderna
2022-10-03
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2022-10-04
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Itching · Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2022-10-05
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2022-10-13
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-10-20
Survey response — day 21, dose 5
MedDRA: Urticaria — Feeling: Good

Free text: Hives

MedDRA releases: 2024-11 · check-in free text available
2022-10-27
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-05
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-10
Survey response — day 42, dose 5
MedDRA: Migraine, Urticaria — Feeling: Fair

Free text: Increased migraines, urticaria.

MedDRA releases: 2024-11 · check-in free text available
2022-12-29
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-30
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-25	Moderna
2	2021-02-24	Moderna
3	2021-08-24	Moderna	No
4	2022-02-22	Pfizer-BioNTech	No
5	2022-09-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-24	Unsuccessful
2022-08-24	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Sinus drainage, cough, sneezing and loss of taste.

Release 5 — day 21, dose 2

2021-03-17

Symptoms: Nauseated, headache, low grade fever, dizzy, fatigued, sore throat and earache.

Release 9 — 6 months, dose 2

2021-08-25

Symptoms: Very confused and out of it- difficulty driving and making decisions. Impacted my ability to work at my job effectively. m swollen twice its size.

Release 9 — days 1–6 daily, dose 3

2021-08-25

Systemic reaction (other): Confusion, difficulty driving.

2021-08-26

Systemic reaction (other): Facial and arm swelling

Release 9 — day 14, dose 3

2021-09-07

Symptoms: A breakout of tiny bright red spots across my torso and limbs. No itching or pain, though.

Release 9 — day 28, dose 3

2021-09-23

Symptoms: Ache all over. Sore throat. Congestion.

Release 10 — 3 months, dose 3

2021-11-23

Symptoms: Coughing

Release 11 — 6 months, dose 3

2022-02-24

Symptoms: Vertigo.

Release 12 — 12 months, dose 3

2022-08-24

Symptoms: Sore throat, cough and sneezing, runny nose, mental confusion, muscle aches, vomiting

Release 12 — day 21, dose 5

2022-10-20

Symptoms: Hives

Release 12 — day 42, dose 5

2022-11-10

Symptoms: Increased migraines, urticaria.

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	Confusional state	✓	·	✓
SD	Cough	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Erythema	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	·	✓
SD	Headache	✓	✓	✓
SD	Impaired driving ability	✓	·	✓
SD	Impaired work ability	✓	·	✓
SD	Mental impairment	✓	·	✓
SD	Migraine	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sneezing	·	·	✓
SD	Unevaluable event	✓	·	✓
SD	Urticaria	·	·	✓
SD	Vertigo	·	·	✓
SD	Vomiting	·	·	✓
SRO	Ageusia	✓	✓	✓
SRO	Confusional state	✓	·	✓
SRO	Cough	✓	✓	✓
SRO	Impaired driving ability	✓	·	✓
SRO	Peripheral swelling	✓	·	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Swelling face	✓	·	✓

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