Z7V-32614-95439

4 vaccinations 12 coded responses 39 check-ins 11 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 195 / PA
Registered: 2021-03-28

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

2021-03-27
Dose 1 — Moderna
2021-03-28
Registered in v-safe
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-03-29
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Good · Site: Pain, Swelling · Headache

Free text: Headache this am

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-24
Dose 2 — Moderna
2021-04-24
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Hypersensitivity — Feeling: Good

Free text: Only allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-15
Survey response — day 21, dose 2
MedDRA: Arthralgia, Carpal tunnel syndrome, Fatigue, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Carpel tunnel pain right wrist. Tired and some muscle aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Survey response — day 28, dose 2
MedDRA: Arthralgia, Joint swelling, Memory impairment — Feeling: Fair · Be unable to do your normal daily activities

Free text: Swollen ankles said could be from varicose veins, wrist pain, forgetfulness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Survey response — day 35, dose 2
MedDRA: Feeling abnormal, Joint swelling, Muscle disorder, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscle problems in back, ankle swollen, hands sore, spacey

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Survey response — day 42, dose 2
MedDRA: Memory impairment, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Forgetful · Healthcare visit (other): Vascular Dr appt.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
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)
2021-07-24
Survey response — 3 months, dose 2
MedDRA: Back disorder, Exostosis, Inflammation, Muscle disorder, Nerve compression, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Pinched nerve between metarsals in foot got inflamed carpel tunnel symptoms on hand with bony growth. Back low back and muscle problems in mid back · Healthcare visit (other): Dont know how to answer last question. I dont know Saw Foot Dr. Hand Dr. Chiropractor

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-24
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)
2021-07-28
Call 1 — Left Voicemail
2021-07-28
Call 1 — Left Voicemail
2021-07-29
Call 1 — Left Voicemail
2021-10-07
Call successful
Participant prefers to complete VAERS report online
2021-10-23
Survey response — 6 months, dose 2
MedDRA: Computerised tomogram abnormal, Pneumonia, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Had a CT and they said I had an infection in my right lung. Subpleural ill defined opificAtion in the lingual, may be infectious or inflammatory etiology. · Healthcare visit (other): Need to see lung dr

MedDRA releases: 2024-11 · check-in free text available
2021-10-23
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-27
Call 2 — Left Voicemail
2021-10-27
Call 2 — Left Voicemail
2021-10-27
Call 2 — Left Voicemail
2021-10-27
Call successful
Participant prefers to complete VAERS report online
2021-10-27
Call successful
Participant prefers to complete VAERS report online
2021-12-02
Dose 3 — Moderna
Co-administered: Flu
2022-04-24
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-09-23
Dose 4 — Moderna
2022-09-24
Survey response — days 1–6 daily, dose 4
MedDRA: Medical counselling — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: My son-in-law is a Dr.

MedDRA releases: 2024-11 · check-in free text available
2022-09-24
Report sent to call center — days 1–6 daily, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-09-25
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-09-26
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-09-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-28
Survey response — days 1–6 daily, dose 4
MedDRA: Abdominal discomfort, Lymphadenopathy — Feeling: Fair · Muscle or body aches, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Swollen glands, think the taste from meds is what's upsetting stomach

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-09-30
Health check-in — day 7, dose 4
Feeling: Good · Nausea

Adult check-in
2022-10-07
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-10-14
Survey response — day 21, dose 4
MedDRA: Medical counselling — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Couldn't get Keflex script for 5 days CVS screwup. They said Dr called in and said I was dec'd. Disabled acct. needs all new scripts. took 4+ calls daily to get Dr to get script in cVS didn't answer phone. Started Lyme setback.Not good w Covid issue · Healthcare visit (other): Numerous Phone call to Dr

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Report sent to call center — day 21, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-18
Call 1 — Left Voicemail
2022-10-21
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-28
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-04
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-23
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-24
Survey response — 6 months, dose 4
MedDRA: Constipation, Haemorrhoids, Medical counselling — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-03-24
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2023-03-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Moderna
2	2021-04-24	Moderna
3	2021-12-02	Moderna	Flu
4	2022-09-23	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-05	Successful 2021-10-07	Participant prefers to complete VAERS report online
2021-07-24	Successful 2021-10-27	Participant prefers to complete VAERS report online
2021-10-23	Successful 2021-10-27	Participant prefers to complete VAERS report online
2022-09-24	Successful 2022-09-26	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-14	Successful 2023-03-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-24	Successful 2023-03-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-29

Systemic reaction (other): Headache this am

Release 8 — days 1–6 daily, dose 2

2021-04-29

Systemic reaction (other): Only allergies

Release 8 — day 21, dose 2

2021-05-15

Symptoms: Carpel tunnel pain right wrist. Tired and some muscle aches

Release 8 — day 28, dose 2

2021-05-22

Symptoms: Swollen ankles said could be from varicose veins, wrist pain, forgetfulness

Release 8 — day 35, dose 2

2021-05-29

Symptoms: Muscle problems in back, ankle swollen, hands sore, spacey

Release 8 — day 42, dose 2

2021-06-05

Symptoms: Forgetful

Healthcare visit (other): Vascular Dr appt.

Release 9 — 3 months, dose 2

2021-07-24

Symptoms: Pinched nerve between metarsals in foot got inflamed carpel tunnel symptoms on hand with bony growth. Back low back and muscle problems in mid back

Healthcare visit (other): Dont know how to answer last question. I dont know Saw Foot Dr. Hand Dr. Chiropractor

Release 10 — 6 months, dose 2

2021-10-23

Symptoms: Had a CT and they said I had an infection in my right lung. Subpleural ill defined opificAtion in the lingual, may be infectious or inflammatory etiology.

Healthcare visit (other): Need to see lung dr

Release 12 — days 1–6 daily, dose 4

2022-09-24

Healthcare visit (other): My son-in-law is a Dr.

2022-09-28

Systemic reaction (other): Swollen glands, think the taste from meds is what's upsetting stomach

Release 12 — day 21, dose 4

2022-10-14

Symptoms: Couldn't get Keflex script for 5 days CVS screwup. They said Dr called in and said I was dec'd. Disabled acct. needs all new scripts. took 4+ calls daily to get Dr to get script in cVS didn't answer phone. Started Lyme setback.Not good w Covid issue cut off by CDC

Healthcare visit (other): Numerous Phone call to Dr

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	Office visit	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Back disorder	✓	·	✓
SD	Carpal tunnel syndrome	✓	✓	✓
SD	Computerised tomogram abnormal	·	·	✓
SD	Constipation	·	·	✓
SD	Exostosis	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Haemorrhoids	·	·	✓
SD	Inflammation	✓	·	✓
SD	Joint swelling	✓	✓	✓
SD	Medical counselling	·	·	✓
SD	Memory impairment	✓	✓	✓
SD	Muscle disorder	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nerve compression	✓	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pneumonia	·	·	✓
SRO	Abdominal discomfort	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓

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