ZA9-90342-78588

4 vaccinations 5 coded responses 40 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 937 / CA
Registered: 2021-01-30

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

2021-01-30
Registered in v-safe
2021-01-30
Dose 1 — Moderna
2021-01-30
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea, Frequent bowel movements — Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Having a lot of Bowel movement come out some diarrhea some normal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

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

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

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Survey response — day 0, dose 2
MedDRA: Bell's palsy, Headache, Pre-existing disease — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pain on the left side of my head where I previously had Bells palsy about 10 years ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
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 · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-25
Survey response — day 28, dose 2
MedDRA: Headache, Pain of skin — Feeling: Fair · Be unable to do your normal daily activities

Free text: Woke up with the back of my head/scalp hurting ... and on the back left side of my head too... in pain...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Headache, Pre-existing disease — Feeling: Good · Site: Pain · Headache

Free text: I've had Bell's palsy before so I'm correlating the headache to that but today I feel better, not 100% but better

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-07
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-13
Survey response — day 21, dose 3
MedDRA: Pain in jaw — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: My upper right jaw has been hurting and I don't know why.

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-16
Call 1 — Left Voicemail
2021-11-20
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-29
Dose 4 — Moderna
2022-04-23
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-29
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna
2	2021-02-25	Moderna
3	2021-10-23	Moderna	No
4	2022-03-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-13	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-31

Systemic reaction (other): Having a lot of Bowel movement come out some diarrhea some normal

Release 4 — day 0, dose 2

2021-02-25

Systemic reaction (other): Pain on the left side of my head where I previously had Bells palsy about 10 years ago

Release 6 — day 28, dose 2

2021-03-25

Symptoms: Woke up with the back of my head/scalp hurting ... and on the back left side of my head too... in pain...

Release 10 — days 1–6 daily, dose 3

2021-10-26

Systemic reaction (other): I've had Bell's palsy before so I'm correlating the headache to that but today I feel better, not 100% but better

Release 10 — day 21, dose 3

2021-11-13

Symptoms: My upper right jaw has been hurting and I don't know why.

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
SD	Headache	✓	✓	✓
SD	Pain in jaw	·	·	✓
SD	Pain of skin	✓	✓	✓
SRO	Bell's palsy	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Frequent bowel movements	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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