Z6V-28470-16836

2 vaccinations 5 coded responses 17 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 852 / AZ
Registered: 2021-02-11

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

2021-02-09
Dose 1 — Moderna
2021-02-11
Registered in v-safe
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — day 14, dose 1
Feeling: Good

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

Adult check-in
2021-03-09
Dose 2 — Moderna
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain upper, Gastrointestinal pain, Pain, Pre-existing disease — Feeling: Poor · Site: Pain · Chills, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Have had more pain than before from surgery i had few wks b4 2nd shot and my prescription pain meds have not workedand stomach and bowel pain bad

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: This is day6 and has been so awful dont think i could ever go thru it again

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-17
Survey response — day 7, dose 2
MedDRA: Malaise, Office visit, Spinal operation — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to work, 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: Systemic reaction (other): Heart dr said i have a very bad reacyion to vaccine due to having it close to back surgery overwhelmed my body and now do not have covid bug mimic covid and will take very long time tocrecover · Healthcare visit (other): Nextcare plus my heart doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 7, dose 2
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)
2021-03-24
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-30
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-20
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-09-10
Survey response — 6 months, dose 2
MedDRA: Herpes zoster, Pain, Parosmia, Taste disorder — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Still having issurs w tadte and smell and now have a bad case of shingles. And having major side effects to the medications that help w shingles pain.

MedDRA releases: 2024-11 · check-in free text available
2021-09-10
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

1 call case(s)
2021-09-13
Call 1 — Left Voicemail
2022-03-09
Survey response — 12 months, dose 2
MedDRA: Medical procedure, Office visit — 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, Emergency room or emergency department visit

Free text: During epidural dr put needle into spinal cord

MedDRA releases: 2024-11 · check-in free text available
2022-03-09
Report sent to call center — 12 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 · Emergency room or emergency department visit · 1 call case(s)
2022-03-10
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-09	Moderna
2	2021-03-09	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-17	Unsuccessful
2021-09-10	Unsuccessful
2022-03-09	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): Have had more pain than before from surgery i had few wks b4 2nd shot and my prescription pain meds have not workedand stomach and bowel pain bad

2021-03-14

Systemic reaction (other): This is day6 and has been so awful dont think i could ever go thru it again

Release 5 — day 7, dose 2

2021-03-17

Systemic reaction (other): Heart dr said i have a very bad reacyion to vaccine due to having it close to back surgery overwhelmed my body and now do not have covid bug mimic covid and will take very long time tocrecover

Healthcare visit (other): Nextcare plus my heart doctor

Release 9 — 6 months, dose 2

2021-09-10

Symptoms: Still having issurs w tadte and smell and now have a bad case of shingles. And having major side effects to the medications that help w shingles pain.

Release 11 — 12 months, dose 2

2022-03-09

Symptoms: During epidural dr put needle into spinal cord

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	Office visit	✓	✓	✓
SD	Herpes zoster	·	·	✓
SD	Medical procedure	·	·	✓
SD	Office visit	·	·	✓
SD	Pain	·	·	✓
SD	Parosmia	·	·	✓
SD	Taste disorder	·	·	✓
SRO	Abdominal pain upper	·	·	✓
SRO	Gastrointestinal pain	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Spinal operation	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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