Z5Z-18272-86509

5 vaccinations 8 coded responses 36 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 790 / TX
Registered: 2021-03-04

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

2021-03-04
Registered in v-safe
2021-03-04
Dose 1 — Moderna
2021-03-04
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fever · Chills

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Anaemia, Medical observation, Musculoskeletal discomfort, Petechiae, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): 1) shoulder of injected arm popping at times 2) petechia over both arms, back, torso and a few on neck. I do get a few of these from time to time but never this many. Call and had my platelets checked by my nurse practitioner today. They were normal. Labs showed mild anemia. · Healthcare visit (other): Saw nurse practitioner in office today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle twitching — Feeling: Good

Free text: Muscle that was injected twitched several times today. A few minutes at a time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Swelling

Free text: Invention shoulder popped a few times today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-12
Health check-in — day 7, dose 1
Feeling: Good

Free text: Shoulder popped a few times on injection arm

Adult check-in · check-in free text available
2021-03-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 21, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: Had some dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Dose 2 — Moderna
2021-04-01
Survey response — day 0, dose 2
MedDRA: Immediate post-injection reaction, Paraesthesia, Parosmia, Pruritus — Feeling: Fair · Site: Pain, Swelling · Headache, Diarrhea

Free text: 1) had tingling and itching from knees to toes starting 5 min after injection lasting for 5 min 2) have had a weird metallic odor that Im smelling off and on for last 30 min

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Abdominal pain

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Joint pains, Muscle or body aches

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Survey response — day 14, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Thigh muscles seem to tire quickly.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — day 21, dose 2
MedDRA: Anaemia, Fatigue, Muscular weakness, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Weak muscles and tires easily. Lab results anemia. · Healthcare visit (other): Office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-16
Survey response — day 42, dose 2
MedDRA: Abdominal pain, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Have had recurrent utis , pelvic and abdominal pain. But this started last year long before my Covid shots. Went to urologist going to have CT on June 1st for the abdominal pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-12-14
Call successful
Participant prefers to complete VAERS report online
2021-12-30
Dose 3 — Moderna
2022-04-03
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-08-19
Dose 4 — Moderna
2022-11-01
Dose 5 — Moderna
2022-11-01
Health check-in — day 0, dose 5
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-02
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-03
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Swelling · Headache

Adult check-in
2022-11-05
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-06
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Headache

Adult check-in
2022-11-08
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-11-20
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-22
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-12-01
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-07
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-14
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-31
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna
3	2021-12-30	Moderna	No
4	2022-08-19	Moderna	No
5	2022-11-01	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-05	Successful	Participant prefers to complete VAERS report online
2021-04-24	Successful	Participant prefers to complete VAERS report online
2021-05-16	Successful 2021-12-14	Participant prefers to complete VAERS report online

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-05

Systemic reaction (other): 1) shoulder of injected arm popping at times 2) petechia over both arms, back, torso and a few on neck. I do get a few of these from time to time but never this many. Call and had my platelets checked by my nurse practitioner today. They were normal. Labs showed mild anemia.

Healthcare visit (other): Saw nurse practitioner in office today.

2021-03-08

Systemic reaction (other): Muscle that was injected twitched several times today. A few minutes at a time.

2021-03-09

Systemic reaction (other): Invention shoulder popped a few times today

Release 6 — day 21, dose 1

2021-03-26

Symptoms: Had some dizziness

Release 6 — day 0, dose 2

2021-04-01

Systemic reaction (other): 1) had tingling and itching from knees to toes starting 5 min after injection lasting for 5 min 2) have had a weird metallic odor that Im smelling off and on for last 30 min

Release 7 — day 14, dose 2

2021-04-15

Symptoms: Thigh muscles seem to tire quickly.

Release 7 — day 21, dose 2

2021-04-24

Symptoms: Weak muscles and tires easily. Lab results anemia.

Healthcare visit (other): Office visit

Release 8 — day 42, dose 2

2021-05-16

Symptoms: Have had recurrent utis , pelvic and abdominal pain. But this started last year long before my Covid shots. Went to urologist going to have CT on June 1st for the abdominal pain.

Release 12 — day 7, dose 1

2021-03-12

Systemic reaction (other): Shoulder popped a few times on injection arm

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 observation	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Abdominal pain	✓	✓	✓
SD	Anaemia	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Anaemia	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Muscle twitching	✓	✓	✓
SRO	Musculoskeletal discomfort	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Parosmia	✓	✓	✓
SRO	Petechiae	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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