ZD6-23020-38153

3 vaccinations 18 coded responses 31 check-ins 18 free-text entries 5 call cases

Sex: —
Age at first dose: 46-50
ZIP prefix: 908 / CA
Registered: 2021-03-17

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

2021-03-16
Dose 1 — Moderna
2021-03-17
Registered in v-safe
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Adult check-in
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Aphthous ulcer, Nasal congestion — Feeling: Fair · Site: Pain · 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

Free text: congestion, canker sore outbreak

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-30
Survey response — day 14, dose 1
MedDRA: Constipation, Ear pain, Fatigue, Headache, Irritable bowel syndrome, Pre-existing disease, Rectal tenesmus, Respiratory tract congestion, Sinusitis — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Headache, earache, congestion (though I believe this is likely due to a sinus infection at this time of year); Worsening constipation and frequent urge to defecate (history of IBS); Worsening fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 21, dose 1
MedDRA: Gastrointestinal disorder, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: GI issues, likely pre-existing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Dose 2 — Moderna
2021-04-13
Survey response — day 0, dose 2
MedDRA: Dyspepsia, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: I have preexisting conditions so these symptoms are pretty common for me - they do not seem different from what I often experience on a periodic basis, though I do have intense heartburn which is unusual.

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: Cough, Hyperhidrosis, Oropharyngeal pain, Peripheral coldness — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, 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

Free text: Profuse sweating, cough, sore throat, cold hands & feet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Aphthous ulcer, Cough, Night sweats — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, 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

Free text: Cough, canker sore outbreak, night sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Aphthous ulcer — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work

Free text: Canker sore outbreak

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-20
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work

Adult check-in
2021-04-27
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-04
Survey response — day 21, dose 2
MedDRA: Emergency care, Gastrointestinal disorder, Haematochezia — 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 · Emergency room or emergency department visit

Free text: GI issues including blood in stool. At ER now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Report sent to call center — day 21, dose 2
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)
2021-05-11
Survey response — day 28, dose 2
MedDRA: Condition aggravated, Myalgia, Pre-existing disease, Somnolence — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Worsening GI issues, somnolence, myalgia (I believe these are due to pre-existing conditions and not the vaccine).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — day 35, dose 2
MedDRA: Fatigue, Headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: GI issues, fatigue, headache (likely due to preexisting conditions).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Worsening GI issues (likely a result of a preexisting condition).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-12
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Irritable bowel syndrome, Myalgia, Pre-existing disease — Feeling: Fair · 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, Emergency room or emergency department visit

Free text: Worsening EDS and myalgia, worsening IBS.

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Report sent to call center — 6 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-10-13
Call 1 — Left Voicemail
2021-12-17
Dose 3 — Moderna
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-23
Survey response — days 1–6 daily, dose 3
MedDRA: Chest discomfort, Oropharyngeal pain, Palpitations — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Sore throat, chest discomfort, racing heart.

MedDRA releases: 2024-11 · check-in free text available
2021-12-26
Survey response — day 7, dose 3
MedDRA: Dizziness, Palpitations — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Racing heart, light headed,

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-01-07
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-01-14
Survey response — day 28, dose 3
MedDRA: Arthralgia, Back pain, Fatigue, Mobility decreased — Feeling: Poor · Be unable to do your normal daily activities

Free text: Exhaustion (unable to get out of bed), joint pain, lower back pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Survey response — day 35, dose 3
MedDRA: Back pain, Gastrointestinal pain, Muscle spasms, Somnolence — 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

Free text: Extreme somnolence, lower back pain, leg cramps, intestinal pain.

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-27
Call 1 — Left Voicemail
2022-01-28
Survey response — day 42, dose 3
MedDRA: Condition aggravated, Pre-existing disease, Somnolence — Feeling: Poor · 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: Worsening myalgia, extreme somnolence

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
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 · 1 call case(s)
2022-03-18
Survey response — 3 months, dose 3
MedDRA: Condition aggravated, Frequent bowel movements, General physical health deterioration, Pre-existing disease, Suicidal ideation — 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, Emergency room or emergency department visit

Free text: My whole body feels like it is falling apart. I'm sh|tting 15-20x/day, not that Kaiser (SoCal) cares. Finally have a consult with rheumatology re possible autoimmune. Vax def made all the symptoms worse. kcuF me. I want to die.

MedDRA releases: 2024-11 · check-in free text available
2022-03-18
Report sent to call center — 3 months, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-03-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Moderna
2	2021-04-13	Moderna
3	2021-12-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-04	Unsuccessful
2021-10-12	Unsuccessful
2022-01-24	Unsuccessful
2022-01-28	Unsuccessful
2022-03-18	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-21

Systemic reaction (other): congestion, canker sore outbreak

Release 6 — day 14, dose 1

2021-03-30

Symptoms: Headache, earache, congestion (though I believe this is likely due to a sinus infection at this time of year); Worsening constipation and frequent urge to defecate (history of IBS); Worsening fatigue

Release 7 — day 21, dose 1

2021-04-08

Symptoms: GI issues, likely pre-existing.

Release 7 — day 0, dose 2

2021-04-13

Systemic reaction (other): I have preexisting conditions so these symptoms are pretty common for me - they do not seem different from what I often experience on a periodic basis, though I do have intense heartburn which is unusual.

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): Profuse sweating, cough, sore throat, cold hands & feet

2021-04-15

Systemic reaction (other): Cough, canker sore outbreak, night sweats

2021-04-18

Systemic reaction (other): Canker sore outbreak

Release 8 — day 21, dose 2

2021-05-04

Symptoms: GI issues including blood in stool. At ER now.

Release 8 — day 28, dose 2

2021-05-11

Symptoms: Worsening GI issues, somnolence, myalgia (I believe these are due to pre-existing conditions and not the vaccine).

Release 8 — day 35, dose 2

2021-05-18

Symptoms: GI issues, fatigue, headache (likely due to preexisting conditions).

Release 8 — day 42, dose 2

2021-05-26

Symptoms: Worsening GI issues (likely a result of a preexisting condition).

Release 10 — 6 months, dose 2

2021-10-12

Symptoms: Worsening EDS and myalgia, worsening IBS.

Release 10 — days 1–6 daily, dose 3

2021-12-23

Systemic reaction (other): Sore throat, chest discomfort, racing heart.

Release 10 — day 7, dose 3

2021-12-26

Systemic reaction (other): Racing heart, light headed,

Release 10 — day 28, dose 3

2022-01-14

Symptoms: Exhaustion (unable to get out of bed), joint pain, lower back pain

Release 11 — day 35, dose 3

2022-01-24

Symptoms: Extreme somnolence, lower back pain, leg cramps, intestinal pain.

Release 11 — day 42, dose 3

2022-01-28

Symptoms: Worsening myalgia, extreme somnolence

Release 11 — 3 months, dose 3

2022-03-18

Symptoms: My whole body feels like it is falling apart. I'm sh|tting 15-20x/day, not that Kaiser (SoCal) cares. Finally have a consult with rheumatology re possible autoimmune. Vax def made all the symptoms worse. kcuF me. I want to die.

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	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Constipation	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Frequent bowel movements	·	·	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Gastrointestinal pain	·	·	✓
SD	General physical health deterioration	·	·	✓
SD	Haematochezia	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Irritable bowel syndrome	✓	✓	✓
SD	Mobility decreased	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rectal tenesmus	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Suicidal ideation	·	·	✓
SRO	Aphthous ulcer	✓	✓	✓
SRO	Chest discomfort	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Palpitations	·	·	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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