ZBZ-27487-44512

2 vaccinations 12 coded responses 20 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 300 / GA
Registered: 2021-02-09

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

2021-02-08
Dose 1 — Moderna
2021-02-09
Registered in v-safe
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Lymph node pain — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Possible cervical lymph node tenderness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Survey response — day 14, dose 1
MedDRA: Injection site pain — Feeling: Fair

Free text: I seem to have some injection site tenderness that I do not remember noting last week. It is fairly significant, especially if i have to press on the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-08
Dose 2 — Moderna
2021-03-08
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Pain of skin, Toothache — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Skin hurts, teeth hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Oral pain — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dental pain (generalized throughout mouth)- significant enough to keep me awake last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Oral pain — Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dental pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Oral pain — Feeling: Good · Site: Pain · Headache, Rash, not including the immediate area around the injection site

Free text: Dental pain (generalized)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Toothache — Feeling: Good · Site: Pain · Headache

Free text: Generalized dental pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — day 7, dose 2
MedDRA: Dental discomfort — Feeling: Good

Free text: Generalized dental discomfort, possibly decreasing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-12
Survey response — day 35, dose 2
MedDRA: Mobility decreased — Feeling: Good · Be unable to do your normal daily activities

Free text: I have more difficulties getting up (e.g., from chair or floor) and with some upper arm movements than i remember prior to vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — day 42, dose 2
MedDRA: Loss of personal independence in daily activities, Muscular weakness, Pre-existing disease, Self-medication, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

Free text: My proximal muscles in arms and legs seem weaker than baseline prior to vaccination (i.e., more trouble with walking even slight inclines, getting up from floor, raising arms.) Also have some intermittent tinnitus, but might partly relate to NSAIDS.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-06
Survey response — 6 months, dose 2
MedDRA: Asthenia, Chorioretinal folds — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Bilateral choroidal folds, generalized weakness

MedDRA releases: 2024-11 · check-in free text available
2021-09-06
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-10
Call 1 — Requested Callback
2021-09-17
Callback requested for
01:00PM ET
2022-03-08
Survey response — 12 months, dose 2
MedDRA: Visual impairment — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: My vision seems to be worsening progressively. I received a Moderna booster dose on 12/17/21.

MedDRA releases: 2024-11 · check-in free text available
2022-03-08
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-09
Call 1 — Requested Callback
2022-03-17
Callback requested for
10:00AM ET
2022-03-17
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Moderna
2	2021-03-08	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-09-06	Successful	Participant prefers to complete VAERS report online
2022-03-08	Successful 2022-03-17	Participant prefers to complete VAERS report online

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-09

Systemic reaction (other): Possible cervical lymph node tenderness

Release 4 — day 14, dose 1

2021-02-22

Symptoms: I seem to have some injection site tenderness that I do not remember noting last week. It is fairly significant, especially if i have to press on the injection site.

Release 5 — days 1–6 daily, dose 2

2021-03-09

Systemic reaction (other): Skin hurts, teeth hurt

2021-03-10

Systemic reaction (other): Dental pain (generalized throughout mouth)- significant enough to keep me awake last night

2021-03-11

Systemic reaction (other): Dental pain

2021-03-13

Systemic reaction (other): Dental pain (generalized)

2021-03-14

Systemic reaction (other): Generalized dental pain

Release 5 — day 7, dose 2

2021-03-15

Systemic reaction (other): Generalized dental discomfort, possibly decreasing

Release 7 — day 35, dose 2

2021-04-12

Symptoms: I have more difficulties getting up (e.g., from chair or floor) and with some upper arm movements than i remember prior to vaccination.

Release 7 — day 42, dose 2

2021-04-20

Symptoms: My proximal muscles in arms and legs seem weaker than baseline prior to vaccination (i.e., more trouble with walking even slight inclines, getting up from floor, raising arms.) Also have some intermittent tinnitus, but might partly relate to NSAIDS. cut off by CDC

Release 9 — 6 months, dose 2

2021-09-06

Symptoms: Bilateral choroidal folds, generalized weakness

Release 11 — 12 months, dose 2

2022-03-08

Symptoms: My vision seems to be worsening progressively. I received a Moderna booster dose on 12/17/21.

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	Asthenia	·	·	✓
SD	Chorioretinal folds	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Mobility decreased	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SD	Visual impairment	·	·	✓
SRO	Dental discomfort	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Oral pain	✓	✓	✓
SRO	Pain of skin	✓	✓	✓
SRO	Toothache	✓	✓	✓

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