Z6Y-11561-28696

4 vaccinations 15 coded responses 53 check-ins 15 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 787 / TX
Registered: 2021-03-06

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

2021-03-05
Dose 1 — Moderna
2021-03-06
Registered in v-safe
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness, Nausea

Free text: Itchy upper body but no visible rash

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Throat irritation — Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Scratchy throat

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: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 7, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-03
Dose 2 — Moderna
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Itching all over, but no visible rash

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder, Dizziness, Muscular weakness, Pruritus, Thinking abnormal — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness, wobbliness, weakness in legs; still some itching all over, but no rash; unclear thinking, probably related to dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Muscular weakness, Restless legs syndrome — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness, weakness (especially in legs), tension/restlessness in legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Dizziness — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Weakness, dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Dizziness — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness, weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-24
Survey response — day 21, dose 2
MedDRA: Hyperventilation, Muscular weakness — Feeling: Poor · Be unable to do your normal daily activities

Free text: My legs have gotten weaker again and Im having to lie down more. Sometimes I find myself involuntarily taking extra deep breaths.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-08
Survey response — day 35, dose 2
MedDRA: Arthralgia, Disturbance in attention, Fatigue, Muscular weakness, Musculoskeletal discomfort — Feeling: Fair · Be unable to do your normal daily activities

Free text: Legs weaker, knee joints more uncomfortable, hard to concentrate, tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-02
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-03
Dose 3 — Pfizer-BioNTech
2021-12-03
Survey response — day 0, dose 3
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Chills

Free text: Starting to feel a little off. It's only been about 4 hours.

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-10
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-17
Survey response — day 14, dose 3
MedDRA: Injection site pruritus — Feeling: Good

Free text: Arm was mildly itchy at injection site starting on Day 8 after booster. Haven't felt anything today.

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Survey response — day 21, dose 3
MedDRA: Discomfort, Reaction to previous exposure to any vaccine — Feeling: Fair

Free text: The discomfort I felt in both knees after my second shot of Moderna had returned, though in milder form.

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-07
Survey response — day 35, dose 3
MedDRA: Fatigue, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Mild sore throat, slight congestion, mild fatigue · Healthcare visit (other): mobile COVID test (negative)

MedDRA releases: 2024-11 · check-in free text available
2022-01-07
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-14
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-04
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-07-21
Dose 4 — Pfizer-BioNTech
2022-07-21
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-07-22
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-07-23
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-07-24
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-07-25
Survey response — days 1–6 daily, dose 4
MedDRA: Discomfort — Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Discomfort in knees

MedDRA releases: 2024-11 · check-in free text available
2022-07-26
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-07-27
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mild congestion and sore throatI think I've come down with a cold!

MedDRA releases: 2024-11 · check-in free text available
2022-07-28
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-08-04
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-08-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-08-18
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-08-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-09-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-10-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-01-22
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-03	Moderna
3	2021-12-03	Pfizer-BioNTech	No
4	2022-07-21	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-07	Successful 2022-01-10	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-06

Systemic reaction (other): Itchy upper body but no visible rash

2021-03-07

Systemic reaction (other): Scratchy throat

Release 6 — days 1–6 daily, dose 2

2021-04-05

Systemic reaction (other): Itching all over, but no visible rash

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Dizziness, wobbliness, weakness in legs; still some itching all over, but no rash; unclear thinking, probably related to dizziness

2021-04-07

Systemic reaction (other): Dizziness, weakness (especially in legs), tension/restlessness in legs

2021-04-08

Systemic reaction (other): Weakness, dizziness

2021-04-09

Systemic reaction (other): Dizziness, weakness

Release 7 — day 21, dose 2

2021-04-24

Symptoms: My legs have gotten weaker again and Im having to lie down more. Sometimes I find myself involuntarily taking extra deep breaths.

Release 8 — day 35, dose 2

2021-05-08

Symptoms: Legs weaker, knee joints more uncomfortable, hard to concentrate, tired

Release 10 — day 0, dose 3

2021-12-03

Systemic reaction (other): Starting to feel a little off. It's only been about 4 hours.

Release 10 — day 14, dose 3

2021-12-17

Symptoms: Arm was mildly itchy at injection site starting on Day 8 after booster. Haven't felt anything today.

Release 10 — day 21, dose 3

2021-12-24

Symptoms: The discomfort I felt in both knees after my second shot of Moderna had returned, though in milder form.

Release 10 — day 35, dose 3

2022-01-07

Symptoms: Mild sore throat, slight congestion, mild fatigue

Healthcare visit (other): mobile COVID test (negative)

Release 12 — days 1–6 daily, dose 4

2022-07-25

Systemic reaction (other): Discomfort in knees

2022-07-27

Systemic reaction (other): Mild congestion and sore throatI think I've come down with a cold!

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	·	·	✓
SD	Arthralgia	✓	✓	○
SD	Discomfort	·	·	✓
SD	Disturbance in attention	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hyperventilation	✓	✓	✓
SD	Injection site pruritus	·	·	✓
SD	Muscular weakness	✓	✓	✓
SD	Musculoskeletal discomfort	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Discomfort	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	·	·	✓
SRO	Muscular weakness	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pruritus	✓	✓	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Restless legs syndrome	✓	✓	✓
SRO	Thinking abnormal	✓	✓	✓
SRO	Throat irritation	✓	✓	✓

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