ZCC-16703-15169

3 vaccinations 13 coded responses 15 check-ins 13 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 799 / TX
Registered: 2021-03-03

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-19
Dose 1 — Moderna
2021-02-28
Dose 2 — Moderna
2021-03-03
Registered in v-safe
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Dizziness, Oropharyngeal pain, Productive cough — Feeling: Poor · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Dizziness, sore throat, chest tightness and phlegm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Chest pain, Dizziness, Ear discomfort, Ear pain — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness, chest pain and tightness, ears clogged and pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Dizziness, Ear congestion, Productive cough — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness, chest congestion and phlegm, ear congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — day 7, dose 2
MedDRA: Chest pain, Dizziness, Ear discomfort, Respiratory tract congestion — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Dizziness, chest pain and congestion, ears clogged

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — day 14, dose 2
MedDRA: Chest pain, Chills, Diarrhoea, Fatigue, Headache, Palpitations, Vomiting — Feeling: Poor · Be unable to do your normal daily activities

Free text: Diarrhea and vomit, chills, headache, heart palpitations, chest pains, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — day 21, dose 2
MedDRA: Arthralgia, Chest discomfort, Dyspnoea exertional, Fatigue, Headache, Productive cough — Feeling: Fair · Be unable to do your normal daily activities

Free text: Phlegm, joint pain, fatigue, persistent headache, chest tightness, shortness of breath with activity

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — day 28, dose 2
MedDRA: Arthralgia, Chest pain, Neck pain, Palpitations, Renal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Heart palpitations, chest pain that goes to shoulder and neck, kidney pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — day 35, dose 2
MedDRA: Dizziness, Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: Extreme fatigue and dizzy spells

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-29
Survey response — 6 months, dose 2
MedDRA: Abdominal pain upper, Diarrhoea, Hepatic lesion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea and stomach pains, liver lesion

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-27
Dose 3 — Moderna
2021-10-26
Health check-in — day 28, dose 3
Feeling: Poor

Adult check-in
2021-11-01
Survey response — day 35, dose 3
MedDRA: Bronchitis, Chest pain, Dysphonia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Reoccurring bronchitis, voice hoarseness, chest pains

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Report sent to call center — day 35, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-02
Call 1 — Could Not Reach Participant
2021-11-02
Call 1 — Could Not Reach Participant
2021-11-05
Call 2 — Could Not Reach Participant
2021-11-05
Call 2 — Could Not Reach Participant
2021-11-10
Survey response — day 42, dose 3
MedDRA: Bronchitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Bronquitis on and off

MedDRA releases: 2024-11 · check-in free text available
2021-11-10
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · no matching call case
2021-12-27
Survey response — 3 months, dose 3
MedDRA: Arthralgia, Headache, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headaches and joint pains as well as mialgias

MedDRA releases: 2024-11 · check-in free text available
2022-03-29
Survey response — 6 months, dose 3
MedDRA: Hepatic lesion, Hypertension, Renal cyst — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Liver lesion and cyst on kidney. As well as high blood pressure

MedDRA releases: 2024-11 · check-in free text available
2022-03-29
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-30
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-19	Moderna
2	2021-02-28	Moderna
3	2021-09-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-04	Unsuccessful
2021-11-01	Unsuccessful
2022-03-29	Unsuccessful

1 report(s) with no call case — see the timeline.

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Dizziness, sore throat, chest tightness and phlegm

2021-03-05

Systemic reaction (other): Dizziness, chest pain and tightness, ears clogged and pain

2021-03-06

Systemic reaction (other): Dizziness, chest congestion and phlegm, ear congestion

Release 5 — day 7, dose 2

2021-03-07

Systemic reaction (other): Dizziness, chest pain and congestion, ears clogged

Release 5 — day 14, dose 2

2021-03-14

Symptoms: Diarrhea and vomit, chills, headache, heart palpitations, chest pains, fatigue

Release 6 — day 21, dose 2

2021-03-21

Symptoms: Phlegm, joint pain, fatigue, persistent headache, chest tightness, shortness of breath with activity

Release 6 — day 28, dose 2

2021-03-28

Symptoms: Heart palpitations, chest pain that goes to shoulder and neck, kidney pain

Release 7 — day 35, dose 2

2021-04-06

Symptoms: Extreme fatigue and dizzy spells

Release 9 — 6 months, dose 2

2021-08-29

Symptoms: Diarrhea and stomach pains, liver lesion

Release 10 — day 35, dose 3

2021-11-01

Symptoms: Reoccurring bronchitis, voice hoarseness, chest pains

Release 10 — day 42, dose 3

2021-11-10

Symptoms: Bronquitis on and off

Release 10 — 3 months, dose 3

2021-12-27

Symptoms: Headaches and joint pains as well as mialgias

Release 11 — 6 months, dose 3

2022-03-29

Symptoms: Liver lesion and cyst on kidney. As well as high blood pressure

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	Arthralgia	✓	✓	✓
SD	Bronchitis	·	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dysphonia	·	·	✓
SD	Dyspnoea exertional	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hepatic lesion	✓	·	✓
SD	Hypertension	·	·	✓
SD	Myalgia	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Productive cough	✓	✓	✓
SD	Renal cyst	·	·	✓
SD	Renal pain	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear congestion	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Productive cough	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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