Z6M-31818-67732

2 vaccinations 6 coded responses 20 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 787 / TX
Registered: 2021-03-07

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

2021-03-07
Registered in v-safe
2021-03-07
Dose 1 — Moderna
2021-03-07
Survey response — day 0, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: Arm pain on side of injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-14
Survey response — day 7, dose 1
MedDRA: Dental restoration failure, Headache, Procedural pain — Feeling: Good · Headache

Free text: But the headache early this morning may be about my failing root canal!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-11
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-04-18
Health check-in — day 42, dose 1
Feeling: Good

Adult check-in
2021-04-19
Dose 2 — Moderna
2021-04-26
Survey response — day 7, dose 2
MedDRA: No adverse event — Feeling: Good · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Im just now filling out. My vaccine was last week. So Im reporting symptoms from last week. I am now without symptoms a week out.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-24
Survey response — day 35, dose 2
MedDRA: Musculoskeletal stiffness, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Ive been having a stiff neck. Waking with it and throughout the day. I will be following up with a chiropractor later next week after Im done with end of school duties. · Healthcare visit (other): Will be scheduling a office visit with chiropractor to work on my neck.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-20
Survey response — 6 months, dose 2
MedDRA: Cough, Laryngitis, Nasopharyngitis, Office visit, Oropharyngeal pain, Pre-existing disease, Rhinorrhoea, SARS-CoV-2 test negative, Self-medication, Sneezing — Feeling: Fair · 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: Sore throat, runny nose, sneezy, cough, laryngitis. Virus cold + allergies. Got cough meds and inhaler. Did a covid test - was negative. Went to doctor-got inhaler and cough meds. Currently going on 2 weeks of symptoms · Healthcare visit (other): Also did a covid test/neg.

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
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)
2021-10-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-19
Survey response — 12 months, dose 2
MedDRA: Diarrhoea, Gastroenteritis viral, Impaired work ability — Feeling: Good · Be unable to work or attend school

Free text: Had a stomach bug 3 weeks ago- Diahrea. Missed 2 days of work

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-07	Moderna
2	2021-04-19	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-05-24	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-20	Successful 2021-10-22	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 5 — day 0, dose 1

2021-03-07

Systemic reaction (other): Arm pain on side of injection

Release 5 — day 7, dose 1

2021-03-14

Systemic reaction (other): But the headache early this morning may be about my failing root canal!

Release 8 — day 7, dose 2

2021-04-26

Systemic reaction (other): Im just now filling out. My vaccine was last week. So Im reporting symptoms from last week. I am now without symptoms a week out.

Release 8 — day 35, dose 2

2021-05-24

Symptoms: Ive been having a stiff neck. Waking with it and throughout the day. I will be following up with a chiropractor later next week after Im done with end of school duties.

Healthcare visit (other): Will be scheduling a office visit with chiropractor to work on my neck.

Release 10 — 6 months, dose 2

2021-10-20

Symptoms: Sore throat, runny nose, sneezy, cough, laryngitis. Virus cold + allergies. Got cough meds and inhaler. Did a covid test - was negative. Went to doctor-got inhaler and cough meds. Currently going on 2 weeks of symptoms

Healthcare visit (other): Also did a covid test/neg.

Release 11 — 12 months, dose 2

2022-04-19

Symptoms: Had a stomach bug 3 weeks ago- Diahrea. Missed 2 days of work

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	SARS-CoV-2 test negative	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Gastroenteritis viral	·	·	✓
SD	Impaired work ability	·	·	✓
SD	Laryngitis	·	·	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Office visit	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Self-medication	·	·	✓
SD	Sneezing	·	·	✓
SRO	Dental restoration failure	✓	·	✓
SRO	Headache	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Procedural pain	○	✓	○

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