Z5N-16879-68930

5 vaccinations 7 coded responses 33 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 320 / FL
Registered: 2021-04-22

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

2021-03-23
Dose 1 — Moderna
2021-04-20
Dose 2 — Moderna
2021-04-22
Registered in v-safe
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-27
Health check-in — day 7, dose 2
Feeling: Fair · Fever · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-05-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-25
Survey response — day 35, dose 2
MedDRA: Abdominal pain, Abdominal pain lower, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Lower abdomen pain after every meal. Deciding today to rest digestion and just eat broth and a few saltines as tolerated. And I will call my GI doc tomorrow. · Healthcare visit (other): I will see my Gastroenterologist asap.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-19
Survey response — 6 months, dose 2
MedDRA: Abdominal pain upper, Diarrhoea, Fatigue, Headache, Nausea — Feeling: Fair

Free text: Experienced stomach pain, diarrhea, severe headache and nausea at 4am today. Still have the headache and fatigued.

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Dose 3 — Moderna
2021-11-02
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — day 7, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-14
Survey response — day 42, dose 3
MedDRA: Asthenia, Body temperature increased, Paranasal sinus hypersecretion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Low grade temp, sinus drainage, body weak.

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-03
Survey response — 6 months, dose 3
MedDRA: Office visit, Pneumonia, Sinusitis, Telemedicine — Feeling: Poor · 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: Symptoms: sinus infection, pneumonia · Healthcare visit (other): One virtual visit, obe in office visit with my pcp, one chest xray, another scheduled pcp visit this week

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-04
Call 1 — Left Voicemail
2022-05-04
Call 1 — Left Voicemail
2022-06-16
Dose 4 — Moderna
2022-06-24
Survey response — day 7, dose 4
MedDRA: Arthralgia, Body temperature increased, Fatigue, Injection site erythema, Injection site swelling, Injection site warmth, Joint swelling, Pain, Pain in extremity — Feeling: Good

Free text: I did run a low grade temp for 2 days, was really fatigued for 2 days, with body aches. On the 3rd day, injection site was red and raised anout the size of my palm. On the 4th day the redness and swelling had spread down to my elbow, painful and hot.

MedDRA releases: 2024-11 · check-in free text available
2022-06-30
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-07
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-14
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-21
Survey response — day 35, dose 4
MedDRA: Abdominal distension, Back pain, Headache, Malaise, Nausea, Pain, Urinary tract infection — Feeling: Fair · 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: Uti causing all over pain and specific lower back pain and fullness. Also, having nausea, headache, and general malaise.

MedDRA releases: 2024-11 · check-in free text available
2022-07-21
Report sent to call center — day 35, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-22
Call 2 — Left Voicemail
2022-07-22
Call 2 — Left Voicemail
2022-07-22
Call 1 — Left Voicemail
2022-07-28
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-17
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-12-18
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-01-25
Dose 5 — Moderna
2023-04-26
Survey response — 3 months, dose 5
MedDRA: COVID-19, Malaise — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-23	Moderna
2	2021-04-20	Moderna
3	2021-11-02	Moderna	No
4	2022-06-16	Moderna	No
5	2023-01-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-25	Unsuccessful
2022-05-03	Unsuccessful
2022-07-21	Unsuccessful

Free text

Release 8 — day 35, dose 2

2021-05-25

Symptoms: Lower abdomen pain after every meal. Deciding today to rest digestion and just eat broth and a few saltines as tolerated. And I will call my GI doc tomorrow.

Healthcare visit (other): I will see my Gastroenterologist asap.

Release 10 — 6 months, dose 2

2021-10-19

Symptoms: Experienced stomach pain, diarrhea, severe headache and nausea at 4am today. Still have the headache and fatigued.

Release 10 — day 42, dose 3

2021-12-14

Symptoms: Low grade temp, sinus drainage, body weak.

Release 11 — 6 months, dose 3

2022-05-03

Symptoms: sinus infection, pneumonia

Healthcare visit (other): One virtual visit, obe in office visit with my pcp, one chest xray, another scheduled pcp visit this week

Release 12 — day 7, dose 4

2022-06-24

Systemic reaction (other): I did run a low grade temp for 2 days, was really fatigued for 2 days, with body aches. On the 3rd day, injection site was red and raised anout the size of my palm. On the 4th day the redness and swelling had spread down to my elbow, painful and hot. cut off by CDC

Release 12 — day 35, dose 4

2022-07-21

Symptoms: Uti causing all over pain and specific lower back pain and fullness. Also, having nausea, headache, and general malaise.

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	Office visit	·	·	✓
HCVO	Telemedicine	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Abdominal distension	·	·	✓
SD	Abdominal pain	✓	✓	✓
SD	Abdominal pain lower	✓	✓	✓
SD	Abdominal pain upper	·	·	✓
SD	Asthenia	·	·	✓
SD	Back pain	·	·	✓
SD	Body temperature increased	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Malaise	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	Pneumonia	·	·	✓
SD	Sinusitis	·	·	✓
SD	Urinary tract infection	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Body temperature increased	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Injection site erythema	·	·	✓
SRO	Injection site swelling	·	·	✓
SRO	Injection site warmth	·	·	✓
SRO	Joint swelling	·	·	✓
SRO	Pain	·	·	✓
SRO	Pain in extremity	·	·	✓

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