ZCQ-29020-86276

4 vaccinations 23 coded responses 56 check-ins 23 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 992 / WA
Registered: 2021-02-08

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
Registered in v-safe
2021-02-08
Dose 1 — Moderna
2021-02-08
Health check-in — day 0, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Feeling abnormal — Feeling: Fair · Site: Redness · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Feeling like every bit of energy is being sucked out of all my bones andcteeth. Like something isnt right

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Palpitations — Feeling: Fair · Chills, Fatigue or tiredness, Nausea

Free text: Heart palpitations and weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal, Palpitations — Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Free text: Some heart palpitations and brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-15
Survey response — day 7, dose 1
MedDRA: Palpitations — Feeling: Poor · Site: Pain, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Heart palpitations once in awhile

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — day 14, dose 1
MedDRA: Dyspnoea, Erythema, Nausea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Days 9 10 and 11 i was very nauseayed my arm was very red and i was short of breath

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
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-15
Survey response — day 35, dose 1
MedDRA: Asthenia, Dyspnoea, Headache, Myalgia, Nausea, Pain in extremity, Peripheral swelling — Feeling: Poor

Free text: My vaccine arm swelled up again this week and is painful i am also nauseated again. Weak and have a headache, muscle pain and short of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Dose 2 — Moderna
2021-03-22
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Palpitations — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Heart palpitations and shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 2
MedDRA: Palpitations — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Racing heart beat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Palpitations — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Heart racing and shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Self-medication — Feeling: Good · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Free text: The itching was so bad at thecsite as well as throughout my whole body i had to take a benedryl to stop the reaction

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Self-medication — Feeling: Good · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Free text: Had to take brnedryl again today to knock out the itching all over reaction

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-29
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Redness, Itching · None

Adult check-in
2021-04-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-19
Survey response — day 28, dose 2
MedDRA: Dyspnoea, Extrasystoles, Headache — Feeling: Fair

Free text: Bad headache for two days and skipped heart beats short breathed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — day 35, dose 2
MedDRA: Anxiety, Depression, Feeling abnormal — Feeling: Poor

Free text: Anxiety and depression that comes on suddenly. Feeling of gnawing in my bonex

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-21
Survey response — 3 months, dose 2
MedDRA: Pneumonia — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: I was diagnosed with pneumonia 14 days ago

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-21
Report sent to call center — 3 months, dose 2
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)
2021-06-28
Call 1 — Left Voicemail
2021-06-28
Call successful
Participant prefers to complete VAERS report online
2021-09-20
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-13
Dose 3 — Moderna
2021-12-13
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Nausea

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-12-17
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Dyspnoea — Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Shirt of breath and coughing

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache

Adult check-in
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Nausea, Rash, not including the immediate area around the injection site

Adult check-in
2021-12-20
Health check-in — day 7, dose 3
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-27
Survey response — day 14, dose 3
MedDRA: Headache, Nausea — Feeling: Fair · Be unable to work or attend school

Free text: Severe headache for 3 days with nausea

MedDRA releases: 2024-11 · check-in free text available
2022-01-03
Survey response — day 21, dose 3
MedDRA: Dizziness, Dyspnoea, Palpitations — Feeling: Fair · Be unable to do your normal daily activities

Free text: Heart palpitations and shortness of breath and dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-17
Survey response — day 35, dose 3
MedDRA: Chest discomfort, Cough — Feeling: Poor · 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: Tight chest coughing that wont stop. Have to do 3 to 4 breathing treatments a day.

MedDRA releases: 2024-11 · check-in free text available
2022-01-17
Report sent to call center — day 35, dose 3
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)
2022-01-18
Call 1 — Left Voicemail
2022-01-24
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-14
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-17
Dose 4 — Moderna
2022-05-17
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-18
Survey response — days 1–6 daily, dose 4
MedDRA: Salivary hypersecretion — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: I had exceeding saliva last night and was coming on it. This lasted for approx 6 hours.

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia, Hypoaesthesia, Pain — Feeling: Poor · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I had shooting pains in the joints of my hand wrist and elbow that felt like i was being stabbed. My right foot and leg went totally numb for no reason them i had joint pain in them too

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia — Feeling: Good · Site: Pain · Headache

Free text: Some joint pain

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Joint pains

Adult check-in
2022-05-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-05-23
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache

Adult check-in
2022-05-24
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-31
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-07
Survey response — day 21, dose 4
MedDRA: Dizziness, Fall — Feeling: Poor · Be unable to work or attend school

Free text: Extreme diziness several days to where i was falling over

MedDRA releases: 2024-11 · check-in free text available
2022-06-14
Survey response — day 28, dose 4
MedDRA: Head discomfort, Migraine — Feeling: Fair · Be unable to work or attend school

Free text: Severe migraines for 7 days and pressure in my head

MedDRA releases: 2024-11 · check-in free text available
2022-06-21
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-28
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-16
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-05-17
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Moderna
2	2021-03-22	Moderna
3	2021-12-13	Moderna	No
4	2022-05-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-21	Successful 2021-06-28	Participant prefers to complete VAERS report online
2022-01-17	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Feeling like every bit of energy is being sucked out of all my bones andcteeth. Like something isnt right

Release 4 — days 1–6 daily, dose 1

2021-02-11

Systemic reaction (other): Heart palpitations and weakness

2021-02-12

Systemic reaction (other): Some heart palpitations and brain fog

Release 4 — day 7, dose 1

2021-02-15

Systemic reaction (other): Heart palpitations once in awhile

Release 4 — day 14, dose 1

2021-02-22

Symptoms: Days 9 10 and 11 i was very nauseayed my arm was very red and i was short of breath

Release 5 — day 35, dose 1

2021-03-15

Symptoms: My vaccine arm swelled up again this week and is painful i am also nauseated again. Weak and have a headache, muscle pain and short of breath

Release 6 — days 1–6 daily, dose 2

2021-03-23

Systemic reaction (other): Heart palpitations and shortness of breath

2021-03-24

Systemic reaction (other): Racing heart beat

2021-03-25

Systemic reaction (other): Heart racing and shortness of breath

2021-03-26

Systemic reaction (other): The itching was so bad at thecsite as well as throughout my whole body i had to take a benedryl to stop the reaction

2021-03-27

Systemic reaction (other): Had to take brnedryl again today to knock out the itching all over reaction

Release 7 — day 28, dose 2

2021-04-19

Symptoms: Bad headache for two days and skipped heart beats short breathed

Release 8 — day 35, dose 2

2021-04-26

Symptoms: Anxiety and depression that comes on suddenly. Feeling of gnawing in my bonex

Release 9 — 3 months, dose 2

2021-06-21

Symptoms: I was diagnosed with pneumonia 14 days ago

Release 10 — days 1–6 daily, dose 3

2021-12-17

Systemic reaction (other): Shirt of breath and coughing

Release 10 — day 14, dose 3

2021-12-27

Symptoms: Severe headache for 3 days with nausea

Release 10 — day 21, dose 3

2022-01-03

Symptoms: Heart palpitations and shortness of breath and dizziness

Release 10 — day 35, dose 3

2022-01-17

Symptoms: Tight chest coughing that wont stop. Have to do 3 to 4 breathing treatments a day.

Release 11 — days 1–6 daily, dose 4

2022-05-18

Systemic reaction (other): I had exceeding saliva last night and was coming on it. This lasted for approx 6 hours.

2022-05-19

Systemic reaction (other): I had shooting pains in the joints of my hand wrist and elbow that felt like i was being stabbed. My right foot and leg went totally numb for no reason them i had joint pain in them too

2022-05-20

Systemic reaction (other): Some joint pain

Release 11 — day 21, dose 4

2022-06-07

Symptoms: Extreme diziness several days to where i was falling over

Release 12 — day 28, dose 4

2022-06-14

Symptoms: Severe migraines for 7 days and pressure in my head

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	Anxiety	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Chest discomfort	·	·	✓
SD	Cough	·	·	✓
SD	Depression	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Extrasystoles	✓	✓	✓
SD	Fall	·	·	✓
SD	Feeling abnormal	✓	✓	✓
SD	Head discomfort	·	·	✓
SD	Headache	✓	✓	✓
SD	Migraine	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Palpitations	·	·	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pneumonia	✓	✓	✓
SRO	Arthralgia	·	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Pain	·	·	✓
SRO	Palpitations	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Salivary hypersecretion	·	·	✓
SRO	Self-medication	✓	✓	✓

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