ZBN-12989-91717

4 vaccinations 7 coded responses 49 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 787 / TX
Registered: 2021-03-04

Relationship: Self
Race: Asian
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-04
Registered in v-safe
2021-03-04
Dose 1 — Moderna
2021-03-04
Survey response — day 0, dose 1
MedDRA: Parosmia — Feeling: Good

Free text: 5-10 minutes after the shot, I smelled a chemical scent for a few minutes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Diarrhea

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Diarrhea

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-11
Health check-in — day 7, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-03-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-25
Survey response — day 21, dose 1
MedDRA: Back pain, Diarrhoea — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Pain around my kidney area and diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Dose 2 — Moderna
2021-04-01
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Difficulty sleeping

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Good

Free text: Still not able to sleep through the night. Ive been waking up around 3:30am and not really able to sleep after that.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 7, dose 2
MedDRA: Insomnia — Feeling: Good

Free text: Still not able to sleep through the night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-16
Dose 3 — Moderna
2021-12-17
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-12-20
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good · Site: Pain

Free text: Forgot to report previously, since injection, painful swollen lymph node in underarm.

MedDRA releases: 2024-11 · check-in free text available
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-23
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Nausea

Adult check-in
2021-12-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-06
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-13
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-20
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-19
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-16
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-11
Dose 4 — Moderna
Co-administered: Flu
2022-09-11
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-12
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-09-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-18
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-09-25
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-02
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-09
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-16
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-23
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-12
Survey response — 3 months, dose 4
MedDRA: COVID-19, Cough, Pyrexia — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Cough and fever during Covid (6 days), persistent aggressive cough in small bouts still.

MedDRA releases: 2024-11 · check-in free text available
2022-12-12
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-12-13
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna
3	2021-12-16	Moderna	No
4	2022-09-11	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-12-12	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-04

Systemic reaction (other): 5-10 minutes after the shot, I smelled a chemical scent for a few minutes

Release 6 — day 21, dose 1

2021-03-25

Symptoms: Pain around my kidney area and diarrhea

Release 6 — days 1–6 daily, dose 2

2021-04-05

Systemic reaction (other): Difficulty sleeping

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Still not able to sleep through the night. Ive been waking up around 3:30am and not really able to sleep after that.

Release 7 — day 7, dose 2

2021-04-08

Systemic reaction (other): Still not able to sleep through the night.

Release 10 — days 1–6 daily, dose 3

2021-12-20

Systemic reaction (other): Forgot to report previously, since injection, painful swollen lymph node in underarm.

Release 12 — 3 months, dose 4

2022-12-12

Symptoms: Cough and fever during Covid (6 days), persistent aggressive cough in small bouts still.

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	Back pain	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Pyrexia	·	·	✓
SRO	Insomnia	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Parosmia	✓	✓	✓

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