ZBJ-23560-08307

1 vaccination 5 coded responses 9 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 856 / AZ
Registered: 2021-08-30

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

Timeline

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

2021-08-27
Dose 1 — Moderna
2021-08-30
Registered in v-safe
2021-08-30
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain, Decreased appetite, Dyspepsia, Heart rate increased — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Fast heart rate 4x since 28 Aug latest 4:30 am 30 Aug 118bpm. Burning sensation chest to stomach no appetite .

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-01
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Fatigue, Rash, Somnolence — Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Yesterday was as bad as Sunday slept the entire day extremely fatigue I had a rash on both palms of my hands the cough that started Sunday has gotten worse . This is why I missed yesterdays check in.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-03
Health check-in — day 7, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-09-10
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-09-18
Survey response — day 21, dose 1
MedDRA: Cough, Dyspepsia, Fatigue, Nausea, Productive cough — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Cough, phlegm, constant indigestion, nausea, tiredness

MedDRA releases: 2024-11 · check-in free text available
2021-09-18
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-22
Call 1 — Left Voicemail
2021-09-26
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-10-01
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2022-02-25
Survey response — 6 months, dose 1
MedDRA: Abdominal pain upper, Diarrhoea, Dyspepsia, Heart rate increased, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Rapid heart rate doctor put me on medication. Terrible rash on both arms beginning one week after the vaccine finally cleared up completely a week and a half ago Developed heartburn which I've never had Also stomach pains w/ loose stools Up to six

MedDRA releases: 2024-11 · check-in free text available
2022-02-25
Report sent to call center — 6 months, dose 1
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-28
Call 1 — Left Voicemail
2022-03-03
Call successful
Participant prefers to complete VAERS report online
2022-08-27
Survey response — 12 months, dose 1
MedDRA: Abdominal pain upper, Asthenia, Dizziness, Dyspepsia, Dyspnoea, Fatigue, Gastrointestinal disorder, Rash, Rash pruritic, Skin burning sensation — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: A never ending rash on both my arms itches and burns It has become unbearable Gastro intestinal problems stomach pain, heartburn, bowel issues. Dizzy Tired No Energy at times. Feeling out of breath. I will have an ablation cardio on September 8

MedDRA releases: 2024-11 · check-in free text available
2022-08-27
Report sent to call center — 12 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-29
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-08-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-18	Successful	Participant prefers to complete VAERS report online
2022-02-25	Successful 2022-03-03	Participant prefers to complete VAERS report online
2022-08-27	Unsuccessful

Free text

Release 9 — days 1–6 daily, dose 1

2021-08-30

Systemic reaction (other): Fast heart rate 4x since 28 Aug latest 4:30 am 30 Aug 118bpm. Burning sensation chest to stomach no appetite .

2021-09-01

Systemic reaction (other): Yesterday was as bad as Sunday slept the entire day extremely fatigue I had a rash on both palms of my hands the cough that started Sunday has gotten worse . This is why I missed yesterdays check in.

Release 9 — day 21, dose 1

2021-09-18

Symptoms: Cough, phlegm, constant indigestion, nausea, tiredness

Release 11 — 6 months, dose 1

2022-02-25

Symptoms: Rapid heart rate doctor put me on medication. Terrible rash on both arms beginning one week after the vaccine finally cleared up completely a week and a half ago Developed heartburn which I've never had Also stomach pains w/ loose stools Up to six

Release 12 — 12 months, dose 1

2022-08-27

Symptoms: A never ending rash on both my arms itches and burns It has become unbearable Gastro intestinal problems stomach pain, heartburn, bowel issues. Dizzy Tired No Energy at times. Feeling out of breath. I will have an ablation cardio on September 8

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	Abdominal pain upper	·	·	✓
SD	Asthenia	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspepsia	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Nausea	·	·	✓
SD	Productive cough	·	·	✓
SD	Rash	·	·	✓
SD	Rash pruritic	·	·	✓
SD	Skin burning sensation	·	·	✓
SRO	Chest pain	✓	·	✓
SRO	Cough	✓	·	✓
SRO	Decreased appetite	✓	·	✓
SRO	Dyspepsia	✓	·	✓
SRO	Fatigue	✓	·	✓
SRO	Heart rate increased	✓	·	✓
SRO	Rash	✓	·	✓
SRO	Somnolence	✓	·	✓

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