Z8K-23003-59784

2 vaccinations 19 coded responses 25 check-ins 19 free-text entries 13 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 800 / CO
Registered: 2021-02-09

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

2021-02-09
Registered in v-safe
2021-02-09
Dose 1 — Moderna
2021-02-09
Health check-in — day 0, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Tooth infection — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: I started an antibiotic yesterday for an infected tooth. It will be treated 2/15/21

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: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 1
MedDRA: Tooth infection — Feeling: Good · Site: Pain · Diarrhea

Free text: Still taking antibiotics for tooth infection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Fibromyalgia, Pre-existing disease — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: I do have fibromyalgia.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Emergency care, Malaise, Office visit, Tooth extraction — Feeling: Poor · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): I had a root extraction this afternoon. Not feeling too well. Better tomorrow. · Healthcare visit (other): ER Dental visit.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-16
Survey response — day 7, dose 1
MedDRA: Hyperhidrosis — Feeling: Fair · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Very sweaty...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-02
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-09
Dose 2 — Moderna
2021-03-09
Survey response — day 0, dose 2
MedDRA: Arthralgia, Office visit — Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): Fell yesterday no fracture but very sore · Healthcare visit (other): Home Heath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Report sent to call center — day 0, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Fall — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · 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: Recent fall on Monday...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-12
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Ligament sprain, Medical counselling — Feeling: Good · Joint pains, Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Sprain in ankle up side leg and bruised hip. · Healthcare visit (other): Home visit by PT & Home Health

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Fall, Unevaluable event — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Healing from recent fall. · Healthcare visit (other): Hone Heath Assistant this morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Ligament sprain, Medical counselling — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Recovering from sprains · Healthcare visit (other): Home Health

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Fall, Medical counselling — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Nausea, Rash, not including the immediate area around the injection site · 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: Systemic reaction (other): Recovering from a Fall 1 week ago · Healthcare visit (other): Phone calls

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-16
Survey response — day 7, dose 2
MedDRA: Fall, Medical counselling — Feeling: Fair · Joint pains, Muscle or body aches, Nausea, Rash, not including the immediate area around the injection site · 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: Systemic reaction (other): Recovering from recent fall · Healthcare visit (other): Home Health Aide

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Report sent to call center — day 7, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-23
Survey response — day 14, dose 2
MedDRA: Cough, Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Cough sore throat congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-30
Survey response — day 21, dose 2
MedDRA: Mucosal discolouration, Oropharyngeal pain, Productive cough, Respiratory tract congestion — Feeling: Fair · 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: Sore throat congestion colored mucus coughed up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-06
Health check-in — day 28, dose 2
Feeling: Poor

Adult check-in
2021-04-13
Survey response — day 35, dose 2
MedDRA: Fatigue, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fun to pain and fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — day 42, dose 2
MedDRA: Upper respiratory tract irritation — Feeling: Fair

Free text: Upper respiratory irritation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Survey response — 3 months, dose 2
MedDRA: Ageusia, Anosmia, Disturbance in attention, Fatigue, Pain — Feeling: Fair · 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: Fatigue loss of smell taste continues.. body pain loose stools hard to focus.

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)
2021-08-01
Call 1 — Left Voicemail
2021-09-09
Survey response — 6 months, dose 2
MedDRA: Diabetes mellitus, Office visit, Thyroid disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Diagnosed w/ diabetes and some type of thyroid issue. · Healthcare visit (other): Doctors office

MedDRA releases: 2024-11 · check-in free text available
2021-09-09
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-10
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-09
Survey response — 12 months, dose 2
MedDRA: Blood pressure increased — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Higher blood pressure

MedDRA releases: 2024-11 · check-in free text available
2022-03-09
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-11
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-09	Moderna
2	2021-03-09	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-15	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-09	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-10	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-12	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-13	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-14	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-15	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-16	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-23	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-03-30	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-06-08	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-09	Successful 2021-09-10	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-09	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): I started an antibiotic yesterday for an infected tooth. It will be treated 2/15/21

Release 4 — days 1–6 daily, dose 1

2021-02-12

Systemic reaction (other): Still taking antibiotics for tooth infection.

2021-02-14

Systemic reaction (other): I do have fibromyalgia.

2021-02-15

Systemic reaction (other): I had a root extraction this afternoon. Not feeling too well. Better tomorrow.

Healthcare visit (other): ER Dental visit.

Release 4 — day 7, dose 1

2021-02-16

Systemic reaction (other): Very sweaty...

Release 5 — day 0, dose 2

2021-03-09

Systemic reaction (other): Fell yesterday no fracture but very sore

Healthcare visit (other): Home Heath

Release 5 — days 1–6 daily, dose 2

2021-03-10

Systemic reaction (other): Recent fall on Monday...

2021-03-12

Systemic reaction (other): Sprain in ankle up side leg and bruised hip.

Healthcare visit (other): Home visit by PT & Home Health

2021-03-13

Systemic reaction (other): Healing from recent fall.

Healthcare visit (other): Hone Heath Assistant this morning.

2021-03-14

Systemic reaction (other): Recovering from sprains

Healthcare visit (other): Home Health

2021-03-15

Systemic reaction (other): Recovering from a Fall 1 week ago

Healthcare visit (other): Phone calls

Release 5 — day 7, dose 2

2021-03-16

Systemic reaction (other): Recovering from recent fall

Healthcare visit (other): Home Health Aide

Release 6 — day 14, dose 2

2021-03-23

Symptoms: Cough sore throat congestion

Release 6 — day 21, dose 2

2021-03-30

Symptoms: Sore throat congestion colored mucus coughed up

Release 7 — day 35, dose 2

2021-04-13

Symptoms: Fun to pain and fatigue

Release 7 — day 42, dose 2

2021-04-20

Symptoms: Upper respiratory irritation

Release 8 — 3 months, dose 2

2021-06-08

Symptoms: Fatigue loss of smell taste continues.. body pain loose stools hard to focus.

Release 9 — 6 months, dose 2

2021-09-09

Symptoms: Diagnosed w/ diabetes and some type of thyroid issue.

Healthcare visit (other): Doctors office

Release 11 — 12 months, dose 2

2022-03-09

Symptoms: Higher blood pressure

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	Emergency care	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Ageusia	✓	✓	✓
SD	Anosmia	✓	✓	✓
SD	Blood pressure increased	·	·	✓
SD	Cough	✓	✓	✓
SD	Diabetes mellitus	·	·	✓
SD	Disturbance in attention	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Mucosal discolouration	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Productive cough	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Thyroid disorder	·	·	✓
SD	Upper respiratory tract irritation	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Fall	✓	✓	✓
SRO	Fibromyalgia	○	✓	○
SRO	Hyperhidrosis	✓	✓	✓
SRO	Ligament sprain	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Tooth extraction	✓	✓	✓
SRO	Tooth infection	✓	✓	✓
SRO	Unevaluable event	○	○	○

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