ZBQ-21269-33564

4 vaccinations 17 coded responses 38 check-ins 17 free-text entries 5 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 956 / CA
Registered: 2021-04-08

Relationship: Self
Race: Multiracial
Ethnicity: Hispanic or Latino

Registered dependents

HR2-24649-76344 Child or adolescent in my care · Female · 2021-11-08

Timeline

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

2021-03-11
Dose 1 — Moderna
2021-04-08
Registered in v-safe
2021-04-08
Dose 2 — Moderna
2021-04-08
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Headache

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Eczema, Muscle spasms, Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches

Free text: Eczema Flare Up, Muscles Cramps in Leg

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Itching · Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 7, dose 2
MedDRA: Dizziness — Feeling: Good · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Dizziness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-29
Survey response — day 21, dose 2
MedDRA: Heavy menstrual bleeding, Menstrual disorder, Thrombosis — Feeling: Good · Be unable to do your normal daily activities

Free text: Heavy menstrual Bleeding (Blood Clots), not like normal cycle. Resolved in 3 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-20
Survey response — day 42, dose 2
MedDRA: Gastrooesophageal reflux disease — 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

Free text: Extreme Acid Reflux that started about 7 days after the vaccine and got progressively worse over time.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-07
Survey response — 6 months, dose 2
MedDRA: Ageusia, Anosmia, Gastrointestinal disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Loss of Taste and Smell, Stomach Issues

MedDRA releases: 2024-11 · check-in free text available
2021-10-07
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-10
Call 1 — Left Voicemail
2021-10-11
Call successful
Reported to VAERS during previous contact from GDIT
2021-11-01
Dose 3 — Moderna
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: Dizzy, Lightheaded

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness

Free text: Dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Good · Site: Redness

Free text: Dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Good · Site: Redness, Swelling · Joint pains, Fatigue or tiredness

Free text: Dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Good · Site: Redness, Swelling

Free text: Dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-15
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-22
Survey response — day 21, dose 3
MedDRA: Rash — Feeling: Good

Free text: Rash (random places on body), comes and goes.

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Survey response — day 28, dose 3
MedDRA: Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Hives

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
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)
2021-11-30
Call 1 — Left Voicemail
2021-11-30
Call successful
Reported to VAERS during previous contact from GDIT
2021-12-06
Survey response — day 35, dose 3
MedDRA: Office visit, Self-medication, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Hives Appointment with allergist. Believed to be immune reaction from booster. Taking medication advised by allergist (increased Zyrtec, Pepcid, Benedryl) for several weeks to try to get rid immune system of reacting and causing the hives.

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-07
Call successful
Reported to VAERS during previous contact from GDIT
2021-12-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-31
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-02
Survey response — 6 months, dose 3
MedDRA: Ageusia, Chest discomfort, Dizziness, Dyspnoea, Fatigue, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Currently being evaluated for Covid. Shortness of breath, tightness in chest, fever, fatigue. Loss of taste and dizzy. All rapid tests negative over 5 days.

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-04
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-14
Dose 4 — Moderna
2022-09-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-09-21
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-09-28
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-05
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-19
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-26
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-15
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-08	Moderna
3	2021-11-01	Moderna	No
4	2022-09-14	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-20	Successful	Reported to VAERS during previous contact from GDIT
2021-10-07	Successful 2021-10-11	Reported to VAERS during previous contact from GDIT
2021-11-29	Successful 2021-11-30	Reported to VAERS during previous contact from GDIT
2021-12-06	Successful 2021-12-07	Reported to VAERS during previous contact from GDIT
2022-05-02	Successful 2022-05-04	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): Eczema Flare Up, Muscles Cramps in Leg

2021-04-12

Systemic reaction (other): Lightheaded

2021-04-13

Systemic reaction (other): Dizziness

2021-04-14

Systemic reaction (other): Dizziness

Release 7 — day 7, dose 2

2021-04-15

Systemic reaction (other): Dizziness.

Release 8 — day 21, dose 2

2021-04-29

Symptoms: Heavy menstrual Bleeding (Blood Clots), not like normal cycle. Resolved in 3 days.

Release 8 — day 42, dose 2

2021-05-20

Symptoms: Extreme Acid Reflux that started about 7 days after the vaccine and got progressively worse over time.

Release 10 — 6 months, dose 2

2021-10-07

Symptoms: Loss of Taste and Smell, Stomach Issues

Release 10 — days 1–6 daily, dose 3

2021-11-02

Systemic reaction (other): Dizzy, Lightheaded

2021-11-04

Systemic reaction (other): Dizzy

2021-11-05

Systemic reaction (other): Dizzy

2021-11-06

Systemic reaction (other): Dizzy

2021-11-07

Systemic reaction (other): Dizzy

Release 10 — day 21, dose 3

2021-11-22

Symptoms: Rash (random places on body), comes and goes.

Release 10 — day 28, dose 3

2021-11-29

Symptoms: Hives

Release 10 — day 35, dose 3

2021-12-06

Symptoms: Hives Appointment with allergist. Believed to be immune reaction from booster. Taking medication advised by allergist (increased Zyrtec, Pepcid, Benedryl) for several weeks to try to get rid immune system of reacting and causing the hives.

Release 11 — 6 months, dose 3

2022-05-02

Symptoms: Currently being evaluated for Covid. Shortness of breath, tightness in chest, fever, fatigue. Loss of taste and dizzy. All rapid tests negative over 5 days.

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	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Heavy menstrual bleeding	✓	✓	✓
SD	Menstrual disorder	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rash	·	·	✓
SD	Self-medication	·	·	✓
SD	Thrombosis	✓	✓	✓
SD	Urticaria	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Eczema	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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