Z62-84070-46753

2 vaccinations 8 coded responses 15 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 497 / MI
Registered: 2021-04-03

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

2021-04-01
Dose 1 — Moderna
2021-04-03
Registered in v-safe
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Hypoaesthesia oral, Intranasal hypoaesthesia, Paranasal sinus hypersecretion, Sinus congestion — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: i had a numb face, nose and mouth the second day and today i had sinus drainage so bad it felt like it was closing my nasal passages up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspepsia, Fatigue, Sinus disorder, Throat irritation — Feeling: Good · Fatigue or tiredness

Free text: Still having sinus problems and throat irritation like an allergic reaction and general body fatigue but doing alright. Also still having heartburn.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia — Feeling: Good · Fatigue or tiredness

Free text: Feeling good today but i did wake up with numbness in my nose again and a little fatigue today but other thsn that I'm feeling good.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-04-16
Survey response — day 14, dose 1
MedDRA: Abdominal distension, Abdominal pain, Chills, Headache, Movement disorder, Oropharyngeal pain — Feeling: Poor · Be unable to work, 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: I've had chills and severe bloating and pain in my abdomen and i couldn't get out of bed, a headache and slight sore throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 14, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-22
Survey response — day 21, dose 1
MedDRA: Liver disorder, Sinus operation — Feeling: Good · Be unable to work

Free text: I have liver disease now along with sinus drainage

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 28, dose 1
MedDRA: Discomfort, Heart rate increased, Malaise — Feeling: Poor · Be unable to work

Free text: I have pressure under my left breast and fast heartbeat not feeling well at all

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Dose 2 — Moderna
2021-06-01
Health check-in — day 0, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-06-03
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Diarrhea · Be unable to work

Free text: I was unable to sleep at all last night and that is a side effect a couple other people i know had as well with the Moderna vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-06-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-06-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-17
Survey response — day 14, dose 2
MedDRA: Abdominal distension, Abdominal pain upper — Feeling: Poor · Be unable to work or attend school

Free text: Severe stomach bloat and pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2022-04-01
Call successful
Does not wish to fill out VAERS report

Vaccinations

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

Call center

Reported	Outcome	VAERS-related outcome
2021-04-16	Successful 2022-04-01	Does not wish to fill out VAERS report

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-03

Systemic reaction (other): i had a numb face, nose and mouth the second day and today i had sinus drainage so bad it felt like it was closing my nasal passages up.

2021-04-05

Systemic reaction (other): Still having sinus problems and throat irritation like an allergic reaction and general body fatigue but doing alright. Also still having heartburn.

Release 7 — days 1–6 daily, dose 1

2021-04-06

Systemic reaction (other): Feeling good today but i did wake up with numbness in my nose again and a little fatigue today but other thsn that I'm feeling good.

Release 7 — day 14, dose 1

2021-04-16

Symptoms: I've had chills and severe bloating and pain in my abdomen and i couldn't get out of bed, a headache and slight sore throat.

Release 7 — day 21, dose 1

2021-04-22

Symptoms: I have liver disease now along with sinus drainage

Release 8 — day 28, dose 1

2021-04-29

Symptoms: I have pressure under my left breast and fast heartbeat not feeling well at all

Release 8 — days 1–6 daily, dose 2

2021-06-03

Systemic reaction (other): I was unable to sleep at all last night and that is a side effect a couple other people i know had as well with the Moderna vaccine

Release 9 — day 14, dose 2

2021-06-17

Symptoms: Severe stomach bloat and pain

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
SD	Abdominal distension	✓	✓	✓
SD	Abdominal pain	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Discomfort	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Heart rate increased	✓	✓	✓
SD	Liver disorder	·	·	✓
SD	Malaise	✓	✓	✓
SD	Movement disorder	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Sinus operation	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Intranasal hypoaesthesia	✓	✓	✓
SRO	Paranasal sinus hypersecretion	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓
SRO	Throat irritation	✓	✓	✓

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