Z75-55619-75762

2 vaccinations 8 coded responses 24 check-ins 8 free-text entries 5 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 890 / NV
Registered: 2021-03-19

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

2021-03-19
Registered in v-safe
2021-03-19
Dose 1 — Moderna
2021-03-19
Survey response — day 0, dose 1
MedDRA: Musculoskeletal stiffness, Rhinorrhoea, Vision blurred — Feeling: Fair · Site: Swelling · Fever · Headache, Joint pains, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Runny nose stiff neck blurred vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Eye pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness I pain in the sockets of my eyeballs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pain, Medical counselling, Migraine, Musculoskeletal stiffness, Telemedicine, Vision blurred — Feeling: Poor · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Blurred vision, massive migraine massive eyesocket pain, stiff neck still · Healthcare visit (other): Telephone call To get migraine medication

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Report sent to call center — days 1–6 daily, dose 1
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)
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-03-22
Report sent to call center — days 1–6 daily, dose 1
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)
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · 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
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-26
Health check-in — day 7, dose 1
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-16
Dose 2 — Moderna
2021-04-16
Survey response — day 0, dose 2
MedDRA: Vision blurred — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Blurred vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-04-17
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · 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, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-23
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-30
Survey response — day 14, dose 2
MedDRA: Pain in extremity — Feeling: Good

Free text: My arm where I received the vaccine started hurting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-21
Survey response — day 35, dose 2
MedDRA: Fatigue, Somnolence — Feeling: Fair · Be unable to do your normal daily activities

Free text: So tired just sleepy all the time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-16
Survey response — 3 months, dose 2
MedDRA: Alopecia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: My hair is falling out a lot.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-16
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-23
Call 1 — Left Voicemail
2021-10-15
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-16
Survey response — 12 months, dose 2
MedDRA: Alopecia, COVID-19 — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Still losing a lot of hair. Therefore I'm not excited to have the booster shot I've had zero so far. Also I had a second Covid, so now I've had Covid twice

MedDRA releases: 2024-11 · check-in free text available
2022-04-16
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-19
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna
2	2021-04-16	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-21	Unsuccessful
2021-03-22	Unsuccessful
2021-04-17	Unsuccessful
2021-07-16	Unsuccessful
2022-04-16	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-19

Systemic reaction (other): Runny nose stiff neck blurred vision

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Dizziness I pain in the sockets of my eyeballs

2021-03-21

Systemic reaction (other): Blurred vision, massive migraine massive eyesocket pain, stiff neck still

Healthcare visit (other): Telephone call To get migraine medication

Release 7 — day 0, dose 2

2021-04-16

Systemic reaction (other): Blurred vision

Release 8 — day 14, dose 2

2021-04-30

Symptoms: My arm where I received the vaccine started hurting

Release 8 — day 35, dose 2

2021-05-21

Symptoms: So tired just sleepy all the time

Release 9 — 3 months, dose 2

2021-07-16

Symptoms: My hair is falling out a lot.

Release 11 — 12 months, dose 2

2022-04-16

Symptoms: Still losing a lot of hair. Therefore I'm not excited to have the booster shot I've had zero so far. Also I had a second Covid, so now I've had Covid twice

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	Medical counselling	·	·	✓
HCVO	Migraine	·	·	✓
HCVO	Telemedicine	✓	✓	○
SD	Alopecia	✓	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Somnolence	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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