Z5W-30926-51079

2 vaccinations 10 coded responses 19 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 130 / NY
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Rhinorrhoea — Feeling: Good · Site: Swelling · Fatigue or tiredness

Free text: Runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Survey response — day 7, dose 1
MedDRA: Hyperhidrosis — Feeling: Good

Free text: periods of body sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-10
Dose 2 — Moderna
2021-02-10
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Photophobia — Feeling: Poor · Site: Pain · Nausea · Be unable to do your normal daily activities

Free text: Light sensitivity

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Photophobia, Unevaluable event — Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Light sensitivity using eye drops · Healthcare visit (other): Appointment with eye doctor on 2/16

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Photophobia — Feeling: Fair · Site: Pain, Swelling · Fever · Be unable to do your normal daily activities

Free text: Light sensitivity has reduced but present

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Photophobia — Feeling: Fair · Site: Pain · Joint pains

Free text: Light sensitivity

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-05
Survey response — day 21, dose 2
MedDRA: Fatigue, Respiratory tract congestion — Feeling: Fair · Be unable to work

Free text: Congestion and fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-21
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme exhaustion sudden onset needing to sleep occurred on the weekend

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Difficulty with breathing using inhaler more frequently

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-16
Call successful
Participant prefers to complete VAERS report online
2021-08-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-12
Survey response — 12 months, dose 2
MedDRA: Dyspnoea, Laryngitis, Pre-existing disease, Quarantine, Respiratory symptom, Unevaluable event — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: Placed on five day quarantine mid January. Upper respiratory illness not COVID laryngitis and breathing difficulty. Never has my asthma been like this. Struggled going up stairs at work Chest X-ray negative. Placed on prednisone for the next mi th · Healthcare visit (other): Took four days saw my internist who listened to my lungs. Breathing 96%

MedDRA releases: 2024-11 · check-in free text available
2022-02-12
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-02-18
Call 1 — Left Voicemail
2022-03-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-13	Successful	Participant prefers to complete VAERS report online
2021-05-14	Successful 2021-06-16	Participant prefers to complete VAERS report online
2022-02-12	Successful 2022-03-01	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Runny nose

Release 2 — day 7, dose 1

2021-01-21

Systemic reaction (other): periods of body sweats

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Light sensitivity

2021-02-13

Systemic reaction (other): Light sensitivity using eye drops

Healthcare visit (other): Appointment with eye doctor on 2/16

2021-02-14

Systemic reaction (other): Light sensitivity has reduced but present

2021-02-15

Systemic reaction (other): Light sensitivity

Release 5 — day 21, dose 2

2021-03-05

Symptoms: Congestion and fatigue

Release 6 — day 35, dose 2

2021-03-21

Symptoms: Extreme exhaustion sudden onset needing to sleep occurred on the weekend

Release 8 — 3 months, dose 2

2021-05-14

Symptoms: Difficulty with breathing using inhaler more frequently

Release 11 — 12 months, dose 2

2022-02-12

Symptoms: Placed on five day quarantine mid January. Upper respiratory illness not COVID laryngitis and breathing difficulty. Never has my asthma been like this. Struggled going up stairs at work Chest X-ray negative. Placed on prednisone for the next mi th cut off by CDC

Healthcare visit (other): Took four days saw my internist who listened to my lungs. Breathing 96%

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	Unevaluable event	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Laryngitis	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Quarantine	·	·	✓
SD	Respiratory symptom	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Photophobia	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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