Z7P-94434-35407

3 vaccinations 8 coded responses 33 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 297 / SC
Registered: 2021-02-10

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-02-10
Registered in v-safe
2021-02-10
Dose 1 — Moderna
2021-02-10
Survey response — day 0, dose 1
MedDRA: Respiratory tract congestion — Feeling: Fair · Fever · Chills, Fatigue or tiredness

Free text: Congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Chills, Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — day 7, dose 1
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-02-24
Survey response — day 14, dose 1
MedDRA: Asthenia, Blood pressure increased, Hypertension, Malaise — Feeling: Good · Be unable to do your normal daily activities

Free text: Yesterday I wasnt feeling well all day. I was weak and my blood pressure was up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-09
Dose 2 — Moderna
2021-03-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-06
Survey response — day 28, dose 2
MedDRA: Cough — Feeling: Good

Free text: I have a cough that I cant get rid of.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-20
Survey response — day 42, dose 2
MedDRA: Anxiety, Blood pressure increased — Feeling: Fair · Be unable to work

Free text: I have felt anxious and my blood pressure has been up. I started feeling sick around 3:00 pm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Survey response — 3 months, dose 2
MedDRA: Blood pressure fluctuation, Dizziness, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: My blood pressure has been out of control, an Ive been dizzy · Healthcare visit (other): In office health care

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
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)
2021-09-07
Dose 3 — Moderna
2021-09-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-07
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-09-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-09-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-09-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-09-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-09-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-09-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-09-14
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-09-21
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-09-28
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-05
Survey response — day 28, dose 3
MedDRA: Hypersensitivity, Pre-existing disease — Feeling: Good

Free text: My allergies are terrible

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-19
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-11-20
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-07
Survey response — 3 months, dose 3
MedDRA: Dyspepsia, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: I'm just. Dealing with Indigestion and congestion at night

MedDRA releases: 2024-11 · check-in free text available
2022-03-08
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-09-07
Survey response — 12 months, dose 3
MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: I have allergies

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-10	Moderna
2	2021-03-09	Moderna
3	2021-09-07	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-08	Successful 2021-11-20	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 4 — day 0, dose 1

2021-02-10

Systemic reaction (other): Congestion

Release 4 — day 14, dose 1

2021-02-24

Symptoms: Yesterday I wasnt feeling well all day. I was weak and my blood pressure was up.

Release 7 — day 28, dose 2

2021-04-06

Symptoms: I have a cough that I cant get rid of.

Release 7 — day 42, dose 2

2021-04-20

Symptoms: I have felt anxious and my blood pressure has been up. I started feeling sick around 3:00 pm

Release 8 — 3 months, dose 2

2021-06-08

Symptoms: My blood pressure has been out of control, an Ive been dizzy

Healthcare visit (other): In office health care

Release 10 — day 28, dose 3

2021-10-05

Symptoms: My allergies are terrible

Release 10 — 3 months, dose 3

2021-12-07

Symptoms: I'm just. Dealing with Indigestion and congestion at night

Release 12 — 12 months, dose 3

2022-09-07

Symptoms: I have allergies

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	Anxiety	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Blood pressure fluctuation	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspepsia	·	·	✓
SD	Hypersensitivity	·	·	✓
SD	Hypertension	○	✓	○
SD	Malaise	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Respiratory tract congestion	✓	✓	✓

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