ZBV-24458-10845

1 vaccination 7 coded responses 14 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 600 / IL
Registered: 2021-02-03

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

2021-02-03
Registered in v-safe
2021-02-03
Dose 1 — Moderna
2021-02-03
Survey response — day 0, dose 1
MedDRA: Anaphylactic reaction, Hypersensitivity — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: I had an allergic reaction causing anaphylaxis and had to receive an Epi injection, benadryl and steroids

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Report sent to call center — day 0, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-02-04
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Kidney infection — Feeling: Good · Site: Redness · Abdominal pain · Be unable to do your normal daily activities

Free text: Kidney infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — day 7, dose 1
Feeling: Good · Site: Redness, Itching · Fatigue or tiredness

Adult check-in
2021-02-17
Survey response — day 14, dose 1
MedDRA: Injection site vesicles, Lymphadenopathy, Migraine, Night sweats — Feeling: Fair

Free text: Injection arm has swollen lymph nodes just on that side. Small blisters appeared around injection site and then dried and flaked off. Night sweats and migraine twice.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — day 28, dose 1
MedDRA: Hypoaesthesia, Lymphadenopathy, Nephrolithiasis — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Had kidney stones, swollen lymph nodes, loss of feeling in right leg from hip to toes for three days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 35, dose 1
MedDRA: Muscular weakness, Myalgia, SARS-CoV-2 test negative — Feeling: Good · Be unable to work, 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: Muscle pain and weakness, Covid symptoms but tested negative.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 35, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Health check-in — day 42, dose 1
Feeling: Good

Adult check-in
2021-05-05
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-06-22
Call 1 — Left Voicemail
2021-08-04
Survey response — 6 months, dose 1
MedDRA: Brain fog, Nasopharyngitis, Sinusitis — Feeling: Good · Be unable to work or attend school, 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: Brain fog a great deal and i catch colds or sinus infections very easily.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-04
Report sent to call center — 6 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-14
Call 1 — Left Voicemail
2022-02-03
Survey response — 12 months, dose 1
MedDRA: Alopecia, Mobility decreased, Tinnitus — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Ringing in ears, hair loss, complete loss of use of right side to include limbs lasting 3 weeks, and homebound due to inability to be vaccinated and fear of contracting the virus.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-03	Unsuccessful
2021-02-04	Unsuccessful
2021-03-12	Unsuccessful
2021-08-04	Unsuccessful

Free text

Release 3 — day 0, dose 1

2021-02-03

Systemic reaction (other): I had an allergic reaction causing anaphylaxis and had to receive an Epi injection, benadryl and steroids

Release 3 — days 1–6 daily, dose 1

2021-02-08

Systemic reaction (other): Kidney infection

Release 4 — day 14, dose 1

2021-02-17

Symptoms: Injection arm has swollen lymph nodes just on that side. Small blisters appeared around injection site and then dried and flaked off. Night sweats and migraine twice.

Release 5 — day 28, dose 1

2021-03-03

Symptoms: Had kidney stones, swollen lymph nodes, loss of feeling in right leg from hip to toes for three days.

Release 5 — day 35, dose 1

2021-03-12

Symptoms: Muscle pain and weakness, Covid symptoms but tested negative.

Release 9 — 6 months, dose 1

2021-08-04

Symptoms: Brain fog a great deal and i catch colds or sinus infections very easily.

Release 11 — 12 months, dose 1

2022-02-03

Symptoms: Ringing in ears, hair loss, complete loss of use of right side to include limbs lasting 3 weeks, and homebound due to inability to be vaccinated and fear of contracting the virus.

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	Alopecia	·	·	✓
SD	Brain fog	✓	·	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Injection site vesicles	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Mobility decreased	·	·	✓
SD	Muscular weakness	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nasopharyngitis	✓	·	✓
SD	Nephrolithiasis	✓	✓	✓
SD	Night sweats	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Sinusitis	✓	·	✓
SD	Tinnitus	·	·	✓
SRO	Anaphylactic reaction	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Kidney infection	✓	✓	✓

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