ZAE-47123-72442

3 vaccinations 11 coded responses 28 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 891 / NV
Registered: 2021-01-05

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Health check-in — day 0, dose 1
Feeling: Fair · None

Adult check-in
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Dry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Feeling abnormal — Feeling: Fair · Site: Itching · Fever · Fatigue or tiredness

Free text: Dry cough, some brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Good · Fever · Chills, Fatigue or tiredness

Free text: Dry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Survey response — day 7, dose 1
MedDRA: Cough, Feeling abnormal — Feeling: Good · Fever · Chills

Free text: Brain fog, dry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-26
Survey response — day 21, dose 1
MedDRA: Cough — Feeling: Fair

Free text: More of a cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Dose 2 — Moderna
2021-02-02
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain — Feeling: Good · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Occasional Ear pain seems to originate from gland

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain — Feeling: Fair · Site: Pain, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Pain going from gland into ear

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 · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — day 7, dose 2
Feeling: Good · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-23
Survey response — day 21, dose 2
MedDRA: Acne, Body temperature increased, Furuncle, Nodule, Skin mass — Feeling: Fair

Free text: Fever came back, 100 F for 2 days. Developed a small boil on tail bone and acne breakout. Small nodule in armpit,same side as injection site. Nodule now gone. Boil area is getting better as is acne after 5 days. These things are atypical for me

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-10
Survey response — day 35, dose 2
MedDRA: Axillary pain, Diarrhoea — Feeling: Fair

Free text: Diarrhea for two days. Infrequent Pain under arm, thinking it is glandular

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 42, dose 2
MedDRA: Pain in extremity — Feeling: Fair

Free text: Pain in right foot inner heel, like a possible bone spur? Came on out of the blue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-21
Dose 3 — Moderna
2021-10-23
Survey response — day 28, dose 3
MedDRA: Urinary tract infection, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Had a UTI, was treated with a antibiotic after 4 days broke out in Hives. Never have been allergic previously. Hives still come and go. Treat hives with antihistamine whenever it occurs.

MedDRA releases: 2024-11 · check-in free text available
2021-10-23
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-26
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-10-27
Call 1 — Could Not Reach Participant
2021-11-01
Call 2 — Could Not Reach Participant
2021-11-01
Callback requested for
2021-11-02
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2021-12-21
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-03-24
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-09-23
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-02	Moderna
3	2021-09-21	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-23	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-08

Systemic reaction (other): Dry cough

2021-01-09

Systemic reaction (other): Dry cough, some brain fog

2021-01-11

Systemic reaction (other): Dry cough

Release 1 — day 7, dose 1

2021-01-12

Systemic reaction (other): Brain fog, dry cough

Release 2 — day 21, dose 1

2021-01-26

Symptoms: More of a cough.

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): Occasional Ear pain seems to originate from gland

2021-02-06

Systemic reaction (other): Pain going from gland into ear

Release 4 — day 21, dose 2

2021-02-23

Symptoms: Fever came back, 100 F for 2 days. Developed a small boil on tail bone and acne breakout. Small nodule in armpit,same side as injection site. Nodule now gone. Boil area is getting better as is acne after 5 days. These things are atypical for me

Release 5 — day 35, dose 2

2021-03-10

Symptoms: Diarrhea for two days. Infrequent Pain under arm, thinking it is glandular

Release 5 — day 42, dose 2

2021-03-17

Symptoms: Pain in right foot inner heel, like a possible bone spur? Came on out of the blue.

Release 10 — day 28, dose 3

2021-10-23

Symptoms: Had a UTI, was treated with a antibiotic after 4 days broke out in Hives. Never have been allergic previously. Hives still come and go. Treat hives with antihistamine whenever it occurs.

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	Acne	✓	·	✓
SD	Axillary pain	✓	✓	✓
SD	Body temperature increased	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Furuncle	✓	✓	✓
SD	Nodule	✓	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Skin mass	○	✓	○
SD	Urinary tract infection	·	·	✓
SD	Urticaria	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓

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