Z97-74041-09831

2 vaccinations 15 coded responses 23 check-ins 15 free-text entries 5 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 785 / TX
Registered: 2021-01-04

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-04
Registered in v-safe
2021-01-04
Dose 1 — Moderna
2021-01-04
Survey response — day 0, dose 1
MedDRA: Muscle spasms — Feeling: Good · Site: Pain · Diarrhea

Free text: Mild toe cramp

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain, Swelling · Fever · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: No appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling, Itching · Headache, Muscle or body aches, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-06
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain — Feeling: Fair · Site: Pain, Swelling, Itching

Free text: Ear ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Earache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling, Itching · Fever · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Survey response — day 7, dose 1
MedDRA: Nasal pruritus — Feeling: Good

Free text: Very itchy nose. Mild pink before the shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Survey response — day 14, dose 1
MedDRA: Head discomfort, Headache, Productive cough, Pruritus — Feeling: Fair

Free text: I had a very itchy hand. I Had some phlegm. I had a pressure headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-02
Dose 2 — Moderna
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: My upper back hurts.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Conjunctivitis — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Nausea

Free text: I got very bad pink eye on one eye only.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Conjunctivitis — Feeling: Good · Site: Pain, Itching

Free text: Still have pink eye.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-02-09
Survey response — day 7, dose 2
MedDRA: Productive cough — Feeling: Good · Site: Pain

Free text: Mild phlegm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Call 1 — Could Not Reach Participant
2021-02-17
Call 2 — Could Not Reach Participant
2021-02-18
Survey response — day 14, dose 2
MedDRA: Diarrhoea, Musculoskeletal pain, Pain, Sluggishness — Feeling: Poor · Be unable to do your normal daily activities

Free text: I HAVE EXPERIENCED A VERY BAD PAIN NEAR MY LEFT SHOULDER BLADE SINCE MONDAY YESTERDAY WAS THE WORST I HAD DIARRHEA YESTERDAY AND AM FEELING ACHY AND SLUGGISH

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Call 3 — Left Voicemail
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Survey response — day 35, dose 2
MedDRA: Conjunctivitis, Dry eye — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: The pink eye on my right side keeps coming back. When I use the antibiotics on my eye it makes my right eye dry during the night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — 3 months, dose 2
MedDRA: Anxiety, Asthma, Back pain, Cystitis, Muscle spasms — Feeling: Fair · Be unable to work, 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: Bladder infection Very mild asthma or anxiety Severe cramps Backache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-16
Call 1 — Left Voicemail
2021-08-06
Survey response — 6 months, dose 2
MedDRA: Dry eye, Office visit, Photopsia, Vision blurred — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: My left eye has a new symptom or condition like I see lightning on and off. About a month I first saw glossy and blurry on the same left eye. · Healthcare visit (other): Walk in.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-06
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

no matching call case
2021-12-12
Call 2 — Could Not Reach Participant
2021-12-23
Call 3 — Could Not Reach Participant
2022-02-02
Survey response — 12 months, dose 2
MedDRA: Anxiety, Back pain, Emergency care, Hypertension — Feeling: Fair · Be unable to do your normal daily activities

Free text: Blood pressure was high and anxiety got me to the hospital. Have upper and lower back pain.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-02-02	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-05	Unsuccessful
2021-01-06	Unsuccessful
2021-01-08	Unsuccessful
2021-03-11	Unsuccessful
2021-05-07	Unsuccessful

1 report(s) with no call case — see the timeline.

Free text

Release 1 — day 0, dose 1

2021-01-04

Systemic reaction (other): Mild toe cramp

Release 1 — days 1–6 daily, dose 1

2021-01-05

Systemic reaction (other): No appetite

2021-01-07

Systemic reaction (other): Ear ache

2021-01-08

Systemic reaction (other): Earache

Release 1 — day 7, dose 1

2021-01-11

Systemic reaction (other): Very itchy nose. Mild pink before the shot.

Release 2 — day 14, dose 1

2021-01-18

Symptoms: I had a very itchy hand. I Had some phlegm. I had a pressure headache.

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): My upper back hurts.

2021-02-04

Systemic reaction (other): I got very bad pink eye on one eye only.

2021-02-05

Systemic reaction (other): Still have pink eye.

Release 3 — day 7, dose 2

2021-02-09

Systemic reaction (other): Mild phlegm.

Release 4 — day 14, dose 2

2021-02-18

Symptoms: I HAVE EXPERIENCED A VERY BAD PAIN NEAR MY LEFT SHOULDER BLADE SINCE MONDAY YESTERDAY WAS THE WORST I HAD DIARRHEA YESTERDAY AND AM FEELING ACHY AND SLUGGISH

Release 5 — day 35, dose 2

2021-03-11

Symptoms: The pink eye on my right side keeps coming back. When I use the antibiotics on my eye it makes my right eye dry during the night.

Release 8 — 3 months, dose 2

2021-05-07

Symptoms: Bladder infection Very mild asthma or anxiety Severe cramps Backache

Release 9 — 6 months, dose 2

2021-08-06

Symptoms: My left eye has a new symptom or condition like I see lightning on and off. About a month I first saw glossy and blurry on the same left eye.

Healthcare visit (other): Walk in.

Release 11 — 12 months, dose 2

2022-02-02

Symptoms: Blood pressure was high and anxiety got me to the hospital. Have upper and lower back pain.

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	Asthma	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Conjunctivitis	✓	✓	✓
SD	Cystitis	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dry eye	✓	✓	✓
SD	Emergency care	·	·	✓
SD	Head discomfort	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypertension	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Musculoskeletal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Photopsia	✓	·	✓
SD	Productive cough	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Sluggishness	✓	✓	✓
SD	Vision blurred	✓	·	✓
SRO	Back pain	✓	✓	✓
SRO	Conjunctivitis	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Nasal pruritus	✓	✓	✓
SRO	Productive cough	✓	✓	✓

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