Z7K-13196-45397

4 vaccinations 10 coded responses 36 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 537 / WI
Registered: 2021-03-12

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

2021-03-12
Registered in v-safe
2021-03-12
Dose 1 — Moderna
2021-03-12
Survey response — day 0, dose 1
MedDRA: Dizziness exertional, Rhinorrhoea — Feeling: Good

Free text: Had a runny nose for the first hour; a little dizzy when I went out for walk

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Musculoskeletal stiffness — Feeling: Good · Headache, Muscle or body aches

Free text: It too bad but had a stiff neck for about an hour followed by a headache for an hour. Headaches are rare for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Pain in the arm where I received my shot. About. 1/2 hour.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in jaw, Salivary gland pain — Feeling: Good · Site: Pain

Free text: Jaw sore around left parotid gland. About 2 hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-14
Dose 2 — Moderna
2021-04-14
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-05-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-19
Survey response — day 35, dose 2
MedDRA: Abdominal pain upper — Feeling: Good · Be unable to do your normal daily activities

Free text: Very painful stomach cramping

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-14
Survey response — 3 months, dose 2
MedDRA: Urinary tract infection — 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

Free text: urinary track infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-14
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-23
Call 1 — Left Voicemail
2021-10-13
Survey response — 6 months, dose 2
MedDRA: Parotitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Parotitus

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-11
Dose 3 — Moderna
2021-11-11
Call 1 — Could Not Reach Participant
2021-11-16
Call 2 — Left Voicemail
2022-04-15
Survey response — 12 months, dose 2
MedDRA: Parotid gland enlargement — Feeling: Good · 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: Swollen parotid gland

MedDRA releases: 2024-11 · check-in free text available
2022-04-15
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 · 1 call case(s)
2022-04-19
Call 1 — Left Voicemail
2022-04-26
Dose 4 — Pfizer-BioNTech
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-05
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-17
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-24
Survey response — day 28, dose 4
MedDRA: Diarrhoea — Feeling: Good

Free text: loose bowels

MedDRA releases: 2024-11 · check-in free text available
2022-05-31
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-07
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-26
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-25
Survey response — 6 months, dose 4
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school

Free text: Had COVID

MedDRA releases: 2024-11 · check-in free text available
2023-04-26
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Moderna
2	2021-04-14	Moderna
3	2021-11-11	Moderna	No
4	2022-04-26	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-14	Unsuccessful
2021-10-13	Unsuccessful
2022-04-15	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-12

Systemic reaction (other): Had a runny nose for the first hour; a little dizzy when I went out for walk

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): It too bad but had a stiff neck for about an hour followed by a headache for an hour. Headaches are rare for me.

2021-03-14

Systemic reaction (other): Pain in the arm where I received my shot. About. 1/2 hour.

2021-03-17

Systemic reaction (other): Jaw sore around left parotid gland. About 2 hours.

Release 8 — day 35, dose 2

2021-05-19

Symptoms: Very painful stomach cramping

Release 9 — 3 months, dose 2

2021-07-14

Symptoms: urinary track infection

Release 10 — 6 months, dose 2

2021-10-13

Symptoms: Parotitus

Release 11 — 12 months, dose 2

2022-04-15

Symptoms: Swollen parotid gland

Release 11 — day 28, dose 4

2022-05-24

Symptoms: loose bowels

Release 12 — 6 months, dose 4

2022-10-25

Symptoms: Had COVID

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	Abdominal pain upper	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Parotid gland enlargement	·	·	✓
SD	Parotitis	·	·	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Dizziness exertional	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Salivary gland pain	✓	✓	✓

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