Z9H-28141-09215

2 vaccinations 8 coded responses 25 check-ins 8 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 360 / AL
Registered: 2021-02-26

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

2021-02-26
Registered in v-safe
2021-02-26
Dose 1 — Moderna
2021-02-26
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-26
Dose 2 — Moderna
2021-03-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — day 7, dose 2
Feeling: Fair · Fever · Fatigue or tiredness

Adult check-in
2021-04-09
Survey response — day 14, dose 2
MedDRA: Fall, Muscular weakness — Feeling: Good · Be unable to do your normal daily activities

Free text: Weakness vausing fall

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — day 21, dose 2
MedDRA: Asthenia, Emergency care, Fall, Gait disturbance, Tremor — Feeling: Poor · 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: Unable walk without assistance. Weakness and shaking 2 bad falls one emergency visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
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)
2021-04-23
Survey response — day 28, dose 2
MedDRA: Asthenia, Fall, Muscular weakness, Physiotherapy, Tremor — Feeling: Poor · 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, Emergency room or emergency department visit

Free text: Symptoms: 2 werks aho i could ealk without addistance. Cannot today took baf fall leg gave out a few dayz after vacinne yhen snother onr s few days later ledd and less control ovef legs. Shaking throughouy body with wsknesd · Healthcare visit (other): Physical therspy started

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Report sent to call center — day 28, 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)
2021-04-30
Survey response — day 35, dose 2
MedDRA: General physical health deterioration, Physiotherapy — Feeling: Poor · Be unable to work, 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: Symptoms: Went from heslthy ealking person yo unable co tt kehs zm on wlker · Healthcare visit (other): Pt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — day 35, 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)
2021-05-07
Survey response — day 42, dose 2
MedDRA: Myalgia, Office visit — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Muscle pain unable wal without assistance · Healthcare visit (other): Appt with nuerologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — day 42, 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)
2021-06-25
Survey response — 3 months, dose 2
MedDRA: Gait disturbance — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Nuro prob still. Limited control of legs difficulity walking. Definetly told it was reaction to vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Report sent to call center — 3 months, dose 2
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)
2021-06-28
Call 1 — Left Voicemail
2021-09-24
Survey response — 6 months, dose 2
MedDRA: Gait disturbance, Walking aid user — Feeling: Good · Be unable to do your normal daily activities

Free text: Limited use of legs difficulty walking use of walker necessary at times

MedDRA releases: 2024-11 · check-in free text available
2022-03-26
Survey response — 12 months, dose 2
MedDRA: COVID-19 — Feeling: Good · Be unable to do your normal daily activities

Free text: Had covid. Omiconthey think. Wnd round with covid

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-26	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-17	Unsuccessful
2021-04-23	Unsuccessful
2021-04-30	Unsuccessful
2021-05-07	Unsuccessful
2021-06-25	Unsuccessful

Free text

Release 7 — day 14, dose 2

2021-04-09

Symptoms: Weakness vausing fall

Release 7 — day 21, dose 2

2021-04-17

Symptoms: Unable walk without assistance. Weakness and shaking 2 bad falls one emergency visit

Release 7 — day 28, dose 2

2021-04-23

Symptoms: 2 werks aho i could ealk without addistance. Cannot today took baf fall leg gave out a few dayz after vacinne yhen snother onr s few days later ledd and less control ovef legs. Shaking throughouy body with wsknesd

Healthcare visit (other): Physical therspy started

Release 8 — day 35, dose 2

2021-04-30

Symptoms: Went from heslthy ealking person yo unable co tt kehs zm on wlker

Healthcare visit (other): Pt

Release 8 — day 42, dose 2

2021-05-07

Symptoms: Muscle pain unable wal without assistance

Healthcare visit (other): Appt with nuerologist

Release 9 — 3 months, dose 2

2021-06-25

Symptoms: Nuro prob still. Limited control of legs difficulity walking. Definetly told it was reaction to vaccine

Release 9 — 6 months, dose 2

2021-09-24

Symptoms: Limited use of legs difficulty walking use of walker necessary at times

Release 11 — 12 months, dose 2

2022-03-26

Symptoms: Had covid. Omiconthey think. Wnd round with covid

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	✓	✓	✓
HCVO	Physiotherapy	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Emergency care	✓	✓	✓
SD	Fall	✓	✓	✓
SD	Gait disturbance	✓	✓	✓
SD	General physical health deterioration	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Tremor	✓	✓	✓
SD	Walking aid user	·	·	✓

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