Z7J-29312-02082

4 vaccinations 14 coded responses 32 check-ins 13 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 180 / PA
Registered: 2021-03-24

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-19
Dose 1 — Moderna
2021-03-24
Registered in v-safe
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Glossodynia, Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Swollen glands under chin making tongue hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Glossodynia, Lymphadenopathy — Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Glands around neck still a little swollen. Making under tongue still sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — day 7, dose 1
MedDRA: Lymphadenopathy — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Nexk gland still swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 14, dose 1
MedDRA: Asthenia, Dizziness — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have been feeling weak and dizzy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 21, dose 1
MedDRA: Diarrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Dose 2 — Moderna
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-04-30
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-09
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-14
Survey response — day 28, dose 2
MedDRA: Asthenia, Dizziness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dizziness and weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — day 35, dose 2
MedDRA: Office visit, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Breathing · Healthcare visit (other): Doctors office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-30
Survey response — day 42, dose 2
MedDRA: Chest pain, Emergency care, Hypoaesthesia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: I had chest paibs,numbness in arm and face area. Went to hospital

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-15
Survey response — 6 months, dose 2
MedDRA: Fatigue, Headache — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Extreme exhaustion and headaches

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-19
Call 1 — Left Voicemail
2021-11-16
Dose 3 — Moderna
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Itching · Headache, Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-11-23
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-02
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-07
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-14
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-28
Survey response — day 42, dose 3
MedDRA: Asthenia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: More exhausted and drained

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Dose 4 — Moderna
2022-05-17
Survey response — 6 months, dose 3
MedDRA: Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Latest booster had made arm hurt

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-05-24
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-31
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-06-21
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-08-09
Survey response — 3 months, dose 4
MedDRA: Decreased appetite, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extremely tired and lost of appetite

MedDRA releases: 2024-11 · check-in free text available
2023-05-10
Survey response — 12 months, dose 4
MedDRA: Joint swelling — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna
2	2021-04-16	Moderna
3	2021-11-16	Moderna	No
4	2022-05-10	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-21	Unsuccessful
2021-05-30	Unsuccessful
2021-10-15	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-24

Systemic reaction (other): Swollen glands under chin making tongue hurt

2021-03-25

Systemic reaction (other): Glands around neck still a little swollen. Making under tongue still sore

Release 6 — day 7, dose 1

2021-03-27

Systemic reaction (other): Nexk gland still swollen

Release 6 — day 14, dose 1

2021-04-02

Symptoms: I have been feeling weak and dizzy.

Release 7 — day 21, dose 1

2021-04-09

Symptoms: Diarrhea

Release 7 — days 1–6 daily, dose 2

2021-04-17

Systemic reaction (other): Dizzy

Release 8 — day 28, dose 2

2021-05-14

Symptoms: Dizziness and weakness

Release 8 — day 35, dose 2

2021-05-21

Symptoms: Breathing

Healthcare visit (other): Doctors office

Release 8 — day 42, dose 2

2021-05-30

Symptoms: I had chest paibs,numbness in arm and face area. Went to hospital

Release 10 — 6 months, dose 2

2021-10-15

Symptoms: Extreme exhaustion and headaches

Release 10 — day 42, dose 3

2021-12-28

Symptoms: More exhausted and drained

Release 11 — 6 months, dose 3

2022-05-17

Symptoms: Latest booster had made arm hurt

Release 12 — 3 months, dose 4

2022-08-09

Symptoms: Extremely tired and lost of appetite

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	Asthenia	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Joint swelling	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Glossodynia	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓

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