Z4Z-33136-25146

2 vaccinations 7 coded responses 25 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 430 / OH
Registered: 2021-03-06

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

2021-03-06
Registered in v-safe
2021-03-06
Dose 1 — Moderna
2021-03-06
Survey response — day 0, dose 1
MedDRA: Dizziness, Malaise — Feeling: Fair · Chills, Fatigue or tiredness, Nausea

Free text: Feeling sick, like I might pass out

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Nausea

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-01
Dose 2 — Moderna
2021-04-01
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Rash erythematous, Rash papular, Rash pruritic, Urticaria — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Red, itchy, Welty raise rash all over the body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Nausea, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness, Nausea, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling, Rash, Rash erythematous, Rash pruritic, Urticaria — Feeling: Poor · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Red, Welty itchy rash all over entire body. · Healthcare visit (other): Messaging with Rheumatologist, in person visit with primary care who prescribed steroids.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Office visit, Pruritus, Rash, Rash pruritic, Urticaria — Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Red, Welty, itchy rash all over my body. · Healthcare visit (other): Dr visit, put me on prednisone

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-08
Survey response — day 7, dose 2
MedDRA: Erythema, Office visit, Pruritus, Rash, Urticaria — Feeling: Fair · Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Red, Welty, itchy rash all over the body · Healthcare visit (other): 2nd follow-up visit at dr visit for covid reaction been taking prednisone since Monday, added vistaril for the itching today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — day 7, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-16
Call 1 — Left Voicemail
2021-07-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-01
Survey response — 12 months, dose 2
MedDRA: Patella fracture, Upper limb fracture, Vertigo — Feeling: Good · Be unable to do your normal daily activities

Free text: Broken arm and knee cap. Vertigo

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-06	Moderna
2	2021-04-01	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-05	Unsuccessful
2021-04-07	Unsuccessful
2021-04-08	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-06

Systemic reaction (other): Feeling sick, like I might pass out

Release 5 — days 1–6 daily, dose 1

2021-03-07

Systemic reaction (other): Dizzy

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): Red, itchy, Welty raise rash all over the body

2021-04-05

Systemic reaction (other): Red, Welty itchy rash all over entire body.

Healthcare visit (other): Messaging with Rheumatologist, in person visit with primary care who prescribed steroids.

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Red, Welty, itchy rash all over my body.

Healthcare visit (other): Dr visit, put me on prednisone

Release 7 — day 7, dose 2

2021-04-08

Systemic reaction (other): Red, Welty, itchy rash all over the body

Healthcare visit (other): 2nd follow-up visit at dr visit for covid reaction been taking prednisone since Monday, added vistaril for the itching today.

Release 11 — 12 months, dose 2

2022-04-01

Symptoms: Broken arm and knee cap. Vertigo

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Pruritus	✓	✓	✓
SD	Patella fracture	·	·	✓
SD	Upper limb fracture	·	·	✓
SD	Vertigo	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Rash papular	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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