ZAD-39184-18738

4 vaccinations 12 coded responses 46 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 067 / CT
Registered: 2021-02-12

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

2021-02-10
Dose 1 — Moderna
2021-02-12
Registered in v-safe
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle strain — Feeling: Fair · Muscle or body aches

Free text: Strained my neck this morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-03
Survey response — day 21, dose 1
MedDRA: Haemorrhoids, Pre-existing disease — Feeling: Fair

Free text: Hemmorhoid flare up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Dose 2 — Moderna
2021-03-10
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-24
Survey response — day 14, dose 2
MedDRA: Abdominal discomfort — Feeling: Good

Free text: A stomach upset on Monday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-07
Survey response — day 28, dose 2
MedDRA: Gastroenteritis viral — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Stomach flu

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-08
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Moderna
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Nasal congestion — Feeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Lacrimation increased — Feeling: Fair · Fatigue or tiredness

Free text: Eyes are tearing

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Haemorrhoids, Pre-existing disease — Feeling: Fair

Free text: Internal hemorrhoid flare up

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-11-11
Survey response — day 14, dose 3
MedDRA: Chills, Fatigue, Haemorrhoids, Pre-existing disease — Feeling: Fair

Free text: As happened after the 2nd Moderna shot, I've had a flare up of my internal hemorrhoids. Also, sporadically experiencing chills and feeling more tired than usual.

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-28
Survey response — 6 months, dose 3
MedDRA: Haematuria, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Blood in my urine · Healthcare visit (other): Visits to my PCP and a Urologist

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-29
Call 1 — Left Voicemail
2022-05-03
Call successful
Participant prefers to complete VAERS report online
2022-05-09
Dose 4 — Pfizer-BioNTech
2022-05-19
Survey response — day 7, dose 4
MedDRA: Intermenstrual bleeding — Feeling: Fair

Free text: Breakthrough bleeding on day 7. I've had this problem after receiving doses 3 & 4

MedDRA releases: 2024-11 · check-in free text available
2022-05-23
Survey response — day 14, dose 4
MedDRA: Pre-existing disease, Rectal haemorrhage — Feeling: Fair

Free text: Bleeding rectally began 5 days after receiving the second booster. I have internal hemorrhoids which reacted to each of the shots.

MedDRA releases: 2024-11 · check-in free text available
2022-05-30
Survey response — day 21, dose 4
MedDRA: Haemorrhoidal haemorrhage, Haemorrhoids, Pre-existing disease — Feeling: Fair

Free text: After the second Moderna, the Moderna booster and the Pfizer Booster, my internal hemorrhoids became inflamed. The episodes of bleeding occurred on and off for several weeks afterwards. Prior to that I had an episode ever few years.

MedDRA releases: 2024-11 · check-in free text available
2022-06-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-13
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-20
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-08-08
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-10
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-12
Health check-in — 12 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-10	Moderna
2	2021-03-10	Moderna
3	2021-10-28	Moderna	No
4	2022-05-09	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-04-28	Successful 2022-05-03	Participant prefers to complete VAERS report online

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-14

Systemic reaction (other): Strained my neck this morning

Release 5 — day 21, dose 1

2021-03-03

Symptoms: Hemmorhoid flare up

Release 6 — day 14, dose 2

2021-03-24

Symptoms: A stomach upset on Monday.

Release 7 — day 28, dose 2

2021-04-07

Symptoms: Stomach flu

Release 10 — days 1–6 daily, dose 3

2021-10-29

Systemic reaction (other): Nasal congestion

2021-10-31

Systemic reaction (other): Eyes are tearing

2021-11-03

Systemic reaction (other): Internal hemorrhoid flare up

Release 10 — day 14, dose 3

2021-11-11

Symptoms: As happened after the 2nd Moderna shot, I've had a flare up of my internal hemorrhoids. Also, sporadically experiencing chills and feeling more tired than usual.

Release 11 — 6 months, dose 3

2022-04-28

Symptoms: Blood in my urine

Healthcare visit (other): Visits to my PCP and a Urologist

Release 11 — day 7, dose 4

2022-05-19

Systemic reaction (other): Breakthrough bleeding on day 7. I've had this problem after receiving doses 3 & 4

Release 11 — day 14, dose 4

2022-05-23

Symptoms: Bleeding rectally began 5 days after receiving the second booster. I have internal hemorrhoids which reacted to each of the shots.

Release 11 — day 21, dose 4

2022-05-30

Symptoms: After the second Moderna, the Moderna booster and the Pfizer Booster, my internal hemorrhoids became inflamed. The episodes of bleeding occurred on and off for several weeks afterwards. Prior to that I had an episode ever few years.

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	Abdominal discomfort	✓	✓	✓
SD	Chills	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastroenteritis viral	✓	✓	✓
SD	Haematuria	·	·	✓
SD	Haemorrhoidal haemorrhage	·	·	✓
SD	Haemorrhoids	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rectal haemorrhage	·	·	✓
SRO	Haemorrhoids	·	·	✓
SRO	Intermenstrual bleeding	·	·	✓
SRO	Lacrimation increased	·	·	✓
SRO	Muscle strain	✓	✓	✓
SRO	Nasal congestion	·	·	✓
SRO	Pre-existing disease	·	·	✓

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