Z4W-27530-52289

2 vaccinations 12 coded responses 26 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 774 / TX
Registered: 2021-03-28

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-28
Registered in v-safe
2021-03-28
Dose 1 — Moderna
2021-03-28
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-29
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Throat irritation — Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tiredness

Free text: Throat kind of itchy, with a cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Pyrexia, Rhinorrhoea — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cough and runny nose with feeling feverish

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Cough, Oropharyngeal pain, Sinus pain — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Severe sinus pain coughing sore throat and tightness in chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Oropharyngeal pain, Rhinorrhoea, Sinus pain — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Sinus pain cough runny nose sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Cough, Rhinorrhoea — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Coughing runny nose tightness in chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Cough, Rhinorrhoea, Scratch — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Runny nose cough scratchy throat tightness in chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — day 7, dose 1
MedDRA: Chest discomfort, Cough, Rhinorrhoea — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Runny nose coughing tightness in chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — day 14, dose 1
MedDRA: Rhinorrhoea, Sinus pain, Sinusitis — 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: Severe sinus pain green and yellow mucus from my nose. Which led to a sinus infection, now I have a cough

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

1 call case(s)
2021-04-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-25
Dose 2 — Moderna
2021-04-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Vision blurred — Feeling: Poor · Site: Pain, Swelling, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Vision is a little blurry

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Vision blurred — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Still having a little bit of blurred vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches

Adult check-in
2021-05-02
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches

Adult check-in
2021-05-09
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-16
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-23
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-30
Health check-in — day 35, dose 2
Feeling: Fair

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

Adult check-in
2021-07-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Survey response — 6 months, dose 2
MedDRA: Chest discomfort — Feeling: Good · Be unable to do your normal daily activities

Free text: Been having heavy ness in chest

MedDRA releases: 2024-11 · check-in free text available
2022-03-25
Call 1 — Left Voicemail
2022-04-25
Survey response — 12 months, dose 2
MedDRA: Diarrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Diarrhea

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-28	Moderna
2	2021-04-25	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-11	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-29

Systemic reaction (other): Throat kind of itchy, with a cough

2021-03-30

Systemic reaction (other): Cough and runny nose with feeling feverish

2021-03-31

Systemic reaction (other): Severe sinus pain coughing sore throat and tightness in chest

2021-04-01

Systemic reaction (other): Sinus pain cough runny nose sore throat

2021-04-02

Systemic reaction (other): Coughing runny nose tightness in chest

2021-04-03

Systemic reaction (other): Runny nose cough scratchy throat tightness in chest

Release 6 — day 7, dose 1

2021-04-04

Systemic reaction (other): Runny nose coughing tightness in chest

Release 7 — day 14, dose 1

2021-04-11

Symptoms: Severe sinus pain green and yellow mucus from my nose. Which led to a sinus infection, now I have a cough

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Vision is a little blurry

2021-04-27

Systemic reaction (other): Still having a little bit of blurred vision

Release 10 — 6 months, dose 2

2021-10-26

Symptoms: Been having heavy ness in chest

Release 11 — 12 months, dose 2

2022-04-25

Symptoms: Diarrhea

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	Chest discomfort	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sinus pain	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Scratch	✓	✓	✓
SRO	Sinus pain	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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