Z65-24126-00521

2 vaccinations 10 coded responses 22 check-ins 10 free-text entries 4 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 150 / PA
Registered: 2021-03-19

Relationship: Self
Race: Multiracial
Ethnicity: N/A

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-18
Dose 1 — Moderna
2021-03-19
Registered in v-safe
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Survey response — day 14, dose 1
MedDRA: Dizziness, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nausea, light headed, and dizziness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 21, dose 1
MedDRA: Fatigue, Nasal congestion, Oropharyngeal pain, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Stuffy nose, sore throat, tiredness, body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 28, dose 1
MedDRA: Muscle twitching — Feeling: Fair

Free text: Muscle twitches on the left side of face and ear

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Dose 2 — Moderna
2021-04-20
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Breast pain, Chest pain — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: I have had odd pain on the right side of my chest/breast with both the first and second doses. The first time i thought i had just pulled a muscle but now having it again after the second dose i believe it has something to do with the shot..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2021-05-04
Survey response — day 14, dose 2
MedDRA: Diarrhoea, Dyspnoea, Painful respiration, Visual impairment — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea, visual disturbances, shortness of breath, pain when inhaling deeply

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-18
Survey response — day 28, dose 2
MedDRA: Menstrual disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I havent had a period since i received the second dose of the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-25
Survey response — day 35, dose 2
MedDRA: Amenorrhoea, Dyspnoea, Palpitations — Feeling: Fair · Be unable to do your normal daily activities

Free text: No period, heart palpatations, shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Survey response — day 42, dose 2
MedDRA: Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: No period since second shot, heart palpatations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-20
Survey response — 3 months, dose 2
MedDRA: Heavy menstrual bleeding, Hyperhidrosis, Intermenstrual bleeding, Menstruation delayed — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Missed periods, longer period, spotting in between periods, perfuse sweating

MedDRA releases: 2024-11 · check-in free text available
2021-07-20
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-24
Call 1 — Left Voicemail
2021-10-19
Survey response — 6 months, dose 2
MedDRA: Menstrual disorder, Nasopharyngitis — 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: Sporadic menstruation and a cold that will just not go away

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Report sent to call center — 6 months, dose 2
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)
2021-10-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-20	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-05-18	Unsuccessful
2021-06-01	Unsuccessful
2021-07-20	Unsuccessful
2021-10-19	Unsuccessful

Free text

Release 6 — day 14, dose 1

2021-04-01

Symptoms: Nausea, light headed, and dizziness.

Release 7 — day 21, dose 1

2021-04-08

Symptoms: Stuffy nose, sore throat, tiredness, body aches

Release 7 — day 28, dose 1

2021-04-15

Symptoms: Muscle twitches on the left side of face and ear

Release 7 — days 1–6 daily, dose 2

2021-04-25

Systemic reaction (other): I have had odd pain on the right side of my chest/breast with both the first and second doses. The first time i thought i had just pulled a muscle but now having it again after the second dose i believe it has something to do with the shot..

Release 8 — day 14, dose 2

2021-05-04

Symptoms: Diarrhea, visual disturbances, shortness of breath, pain when inhaling deeply

Release 8 — day 28, dose 2

2021-05-18

Symptoms: I havent had a period since i received the second dose of the vaccine.

Release 8 — day 35, dose 2

2021-05-25

Symptoms: No period, heart palpatations, shortness of breath

Release 8 — day 42, dose 2

2021-06-01

Symptoms: No period since second shot, heart palpatations

Release 9 — 3 months, dose 2

2021-07-20

Symptoms: Missed periods, longer period, spotting in between periods, perfuse sweating

Release 10 — 6 months, dose 2

2021-10-19

Symptoms: Sporadic menstruation and a cold that will just not go away

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	Amenorrhoea	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Heavy menstrual bleeding	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Intermenstrual bleeding	·	·	✓
SD	Menstrual disorder	✓	✓	✓
SD	Menstruation delayed	·	·	✓
SD	Muscle twitching	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Painful respiration	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Visual impairment	✓	✓	✓
SRO	Breast pain	✓	✓	✓
SRO	Chest pain	✓	✓	✓

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