Z5P-22220-53668

4 vaccinations 11 coded responses 28 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 326 / FL
Registered: 2021-03-12

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

2021-03-10
Dose 1 — Moderna
2021-03-12
Registered in v-safe
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good · Site: Pain, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: DAY 1: stystemic itching Severe 13 hours after shot. (can't go backwards?).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Hypersensitivity, Wheezing — Feeling: Good · Joint pains

Free text: Allergic reaction first day. Still a little wheezy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-17
Survey response — day 7, dose 1
MedDRA: Seasonal allergy — Feeling: Good · Fatigue or tiredness

Free text: Pollen is especially bad today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Survey response — day 21, dose 1
MedDRA: Asthenia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pollen allergies? No energy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-08
Dose 2 — Moderna
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Fever · Chills

Free text: I felt better than usual for 2-3 days after this shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 7, dose 2
Feeling: Good · Fever · Chills

Adult check-in
2021-04-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-06
Survey response — day 28, dose 2
MedDRA: Hypersensitivity — Feeling: Good · Be unable to work

Free text: Allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Pyrexia — Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fever 102 day after shot. Fine after 30 hours.

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Survey response — day 21, dose 3
MedDRA: Hypersensitivity, Pre-existing disease — Feeling: Good

Free text: Mold allergies acting up.

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Survey response — day 35, dose 3
MedDRA: Mast cell activation syndrome, Unevaluable event — Feeling: Poor · 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: Mast cell overreaction. · Healthcare visit (other): Glutathione iv.

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Survey response — 3 months, dose 3
MedDRA: Oropharyngeal pain, Sinus disorder, Upper-airway cough syndrome — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sore throat, sinus issues. Post nasal drip.

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-25
Survey response — 6 months, dose 3
MedDRA: Office visit, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: It's allergy season here in Florida. I'm pretty certain I have MCAS, and we've started testing to prove it. · Healthcare visit (other): PCP

MedDRA releases: 2024-11 · check-in free text available
2022-04-25
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

1 call case(s)
2022-04-26
Dose 4 — Moderna
2022-04-26
Call 1 — Left Voicemail
2022-04-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-08	Moderna
3	2021-10-25	Moderna	No
4	2022-04-26	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-29	Successful	Reported to VAERS voluntarily prior to GDIT contact
2022-01-24	Successful	Reported to VAERS voluntarily prior to GDIT contact
2022-04-25	Successful 2022-04-26	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): DAY 1: stystemic itching Severe 13 hours after shot. (can't go backwards?).

2021-03-15

Systemic reaction (other): Allergic reaction first day. Still a little wheezy

Release 5 — day 7, dose 1

2021-03-17

Systemic reaction (other): Pollen is especially bad today

Release 6 — day 21, dose 1

2021-03-31

Symptoms: Pollen allergies? No energy.

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): I felt better than usual for 2-3 days after this shot.

Release 8 — day 28, dose 2

2021-05-06

Symptoms: Allergies

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): Fever 102 day after shot. Fine after 30 hours.

Release 10 — day 21, dose 3

2021-11-15

Symptoms: Mold allergies acting up.

Release 10 — day 35, dose 3

2021-11-29

Symptoms: Mast cell overreaction.

Healthcare visit (other): Glutathione iv.

Release 11 — 3 months, dose 3

2022-01-24

Symptoms: Sore throat, sinus issues. Post nasal drip.

Release 11 — 6 months, dose 3

2022-04-25

Symptoms: It's allergy season here in Florida. I'm pretty certain I have MCAS, and we've started testing to prove it.

Healthcare visit (other): PCP

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	Unevaluable event	·	·	✓
SD	Asthenia	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Mast cell activation syndrome	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Sinus disorder	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	·	·	✓
SRO	Seasonal allergy	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Wheezing	✓	✓	✓

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