Z97-16385-46737

2 vaccinations 11 coded responses 15 check-ins 11 free-text entries 4 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 068 / CT
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

2021-03-10
Dose 1 — Moderna
2021-03-12
Registered in v-safe
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Balance disorder, Palpitations — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Palpitations, unsteadiness while standing

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: Dizziness, Palpitations — Feeling: Poor · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Pounding heart; severe dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Balance disorder — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · 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: A little wobbly on feet walking

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 1
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 — days 1–6 daily, dose 1
MedDRA: Office visit — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Cardiologist Doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
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)
2021-03-17
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Dose 2 — Moderna
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder, Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: wobbly on feet, foggy head (post-anesthesia) feeling, feel better lying down than up and about

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder, Dyspepsia, Feeling abnormal, Migraine — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Bad indigestion, continue to be off, foggy brain, footing not 100% headache is more of a migraine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder, Dyspepsia, Feeling abnormal, Nausea — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Continue to feel off at times unbalanced. Foggy brain, certainly not comfortable driving. Nausea comes in waves, at times want to vomit but, dont. Also, continue to have bad indigestion even thou I consistently take my daily Pantopazole.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspepsia, Malaise, Migraine — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Continue to have terrible indigestion! Another day of just not feeling well with another migraine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Survey response — day 7, dose 2
MedDRA: Dyspepsia, Headache, Migraine, Pre-existing disease — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I am a migraine sufferer...after my 2nd vaccine I continue to have migraines and/or headaches everyday. Also having bad indigestion although I take pantopazole everyday. Just not myself, pre vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
Survey response — 3 months, dose 2
MedDRA: Gastrointestinal disorder, Office visit, Pain, Pain in extremity, Paraesthesia, Pre-existing disease — Feeling: Poor · 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: Symptoms: GI symptoms have become more problematic requiring a doctor visit.More Tingling/pain of feet radiating up legs.More Tingling/pain of both hands/fingers requiring a doctors visit. · Healthcare visit (other): Saw podiatrist, seeing neurologist tomorrow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-08
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)
2021-07-13
Call 1 — Left Voicemail
2021-10-07
Survey response — 6 months, dose 2
MedDRA: Carpal tunnel syndrome, Office visit, Plantar fasciitis, Tarsal tunnel syndrome — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Bilateral plantar fasciitis Bilateral tarsal tunnel syndrome S&S of bilateral carpal tunnel syndrome Being worked up for small fiber neuropathy · Healthcare visit (other): In person visits with; podiatrist, gastrointestinal and neurologist

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-11
Call successful
Participant prefers to complete VAERS report online
2021-10-11
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-08	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-15	Successful	Participant prefers to complete VAERS report online
2021-03-16	Successful	Participant prefers to complete VAERS report online
2021-07-08	Successful 2021-10-11	Participant prefers to complete VAERS report online
2021-10-07	Successful 2021-10-11	Participant prefers to complete VAERS report online

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-12

Systemic reaction (other): Palpitations, unsteadiness while standing

2021-03-13

Systemic reaction (other): Pounding heart; severe dizziness

2021-03-15

Systemic reaction (other): A little wobbly on feet walking

2021-03-16

Healthcare visit (other): Cardiologist Doctor

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): wobbly on feet, foggy head (post-anesthesia) feeling, feel better lying down than up and about

2021-04-12

Systemic reaction (other): Bad indigestion, continue to be off, foggy brain, footing not 100% headache is more of a migraine

2021-04-13

Systemic reaction (other): Continue to feel off at times unbalanced. Foggy brain, certainly not comfortable driving. Nausea comes in waves, at times want to vomit but, dont. Also, continue to have bad indigestion even thou I consistently take my daily Pantopazole.

2021-04-14

Systemic reaction (other): Continue to have terrible indigestion! Another day of just not feeling well with another migraine.

Release 7 — day 7, dose 2

2021-04-18

Systemic reaction (other): I am a migraine sufferer...after my 2nd vaccine I continue to have migraines and/or headaches everyday. Also having bad indigestion although I take pantopazole everyday. Just not myself, pre vaccine.

Release 9 — 3 months, dose 2

2021-07-08

Symptoms: GI symptoms have become more problematic requiring a doctor visit.More Tingling/pain of feet radiating up legs.More Tingling/pain of both hands/fingers requiring a doctors visit.

Healthcare visit (other): Saw podiatrist, seeing neurologist tomorrow

Release 10 — 6 months, dose 2

2021-10-07

Symptoms: Bilateral plantar fasciitis Bilateral tarsal tunnel syndrome S&S of bilateral carpal tunnel syndrome Being worked up for small fiber neuropathy

Healthcare visit (other): In person visits with; podiatrist, gastrointestinal and neurologist

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	Carpal tunnel syndrome	·	·	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Plantar fasciitis	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Tarsal tunnel syndrome	·	·	✓
SRO	Balance disorder	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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