Z73-32683-20770

2 vaccinations 7 coded responses 14 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 26-30
ZIP prefix: 372 / TN
Registered: 2021-01-27

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

2021-01-22
Dose 1 — Moderna
2021-01-27
Registered in v-safe
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Haematochezia — Feeling: Good

Free text: Blood clot in stool this morning. Not sure if related (this hasnt happened to me before)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain — Feeling: Good · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea

Free text: Ear pain (maybe infection) also pain level noted above was first 3-4 days after injection, but anymore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — day 7, dose 1
MedDRA: Ear infection — Feeling: Fair · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea

Free text: Right ear infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Dose 2 — Moderna
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms, Pain in extremity — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Muscle spasms in my legs (with stabbing pains)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Impaired work ability, Pyrexia, Rash, Self-medication — Feeling: Good · Site: Pain · Joint pains, Rash, not including the immediate area around the injection site

Free text: Im not sure if I was sent a day 2 check in. I missed two days of work, fever of 102.5 for about 18 hours intermittently, fluctuations assuming due to use of ibuprofen. Rash across sensitive skin areas on arms, neck, face, back, chest. Use of inhaler more frequently since shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-31
Survey response — day 35, dose 2
MedDRA: Acne, Dry skin, Fatigue, Insomnia, Myalgia, Pain of skin, Skin exfoliation — Feeling: Fair

Free text: Increased muscle ache/ fatigue. Increase scaly/dry/ painful skin, increase acne, decrease sleep each night

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

Adult check-in
2021-08-23
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-24
Survey response — 12 months, dose 2
MedDRA: Pregnancy, SARS-CoV-2 test negative, SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school, 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: Pregnancy, possible covid (positive at home test, negative PCR (they barely touched the inner membranes of my nose)

MedDRA releases: 2024-11 · check-in free text available
2022-02-24
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-28
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-22	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-02-24	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): Blood clot in stool this morning. Not sure if related (this hasnt happened to me before)

2021-01-28

Systemic reaction (other): Ear pain (maybe infection) also pain level noted above was first 3-4 days after injection, but anymore.

Release 3 — day 7, dose 1

2021-01-29

Systemic reaction (other): Right ear infection

Release 4 — days 1–6 daily, dose 2

2021-02-23

Systemic reaction (other): Muscle spasms in my legs (with stabbing pains)

2021-02-25

Systemic reaction (other): Im not sure if I was sent a day 2 check in. I missed two days of work, fever of 102.5 for about 18 hours intermittently, fluctuations assuming due to use of ibuprofen. Rash across sensitive skin areas on arms, neck, face, back, chest. Use of inhaler more frequently since shot.

Release 6 — day 35, dose 2

2021-03-31

Symptoms: Increased muscle ache/ fatigue. Increase scaly/dry/ painful skin, increase acne, decrease sleep each night

Release 11 — 12 months, dose 2

2022-02-24

Symptoms: Pregnancy, possible covid (positive at home test, negative PCR (they barely touched the inner membranes of my nose)

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	Acne	✓	✓	✓
SD	Dry skin	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain of skin	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Skin exfoliation	✓	✓	✓
SRO	Ear infection	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Haematochezia	✓	✓	✓
SRO	Impaired work ability	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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