ZDD-32114-91239

4 vaccinations 11 coded responses 22 check-ins 10 free-text entries 7 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 786 / TX
Registered: 2021-03-07

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

2021-02-26
Dose 1 — Moderna
2021-03-07
Registered in v-safe
2021-03-07
Health check-in — day 7, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-12
Survey response — day 14, dose 1
MedDRA: Arthralgia, Pain in extremity — Feeling: Fair

Free text: Pain in my right hip/thigh area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-27
Dose 2 — Moderna
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Diarrhoea, Pyrexia — Feeling: Good · Site: Pain, Itching · Be unable to do your normal daily activities

Free text: Had low-grade fever the following day ( all day). The following Monday I began having diarrhea ( that lasted 3 days).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-10
Survey response — day 14, dose 2
MedDRA: Back pain, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain in my right lower back · Healthcare visit (other): Office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-24
Survey response — day 28, dose 2
MedDRA: Office visit, Pain — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain on side. Had a CT scan which showed possible diverticulosis. · Healthcare visit (other): In person visit to doctors office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-26
Dose 3 — Moderna
2022-02-21
Call 1 — Left Voicemail
2022-03-29
Survey response — 12 months, dose 2
MedDRA: Alopecia, Arthritis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Joint inflammation, hair loss

MedDRA releases: 2024-11 · check-in free text available
2022-03-29
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)
2022-03-30
Call 1 — Could Not Reach Participant
2022-04-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-30
Dose 4 — Moderna
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2022-05-02
Survey response — days 1–6 daily, dose 4
MedDRA: Rash — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Rash on one side of my face and on hands.

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Survey response — days 1–6 daily, dose 4
MedDRA: Rash, Self-medication — Feeling: Good · Site: Redness, Swelling, Itching · Muscle or body aches · Be unable to do your normal daily activities

Free text: Took Benedryl last night for rash that began developing late Sunday night. The rash was on my hands, face, head, and back. Much better today. Rash is faint today.

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Survey response — days 1–6 daily, dose 4
MedDRA: Ear pain, Gait disturbance, Headache, Musculoskeletal stiffness, Neck pain, Pain, Pain in extremity, Unevaluable event — Feeling: Fair · Site: Redness, Swelling · Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Severe neck pain that extends behind my left ear and the back of my head. Can't turn my head. Hurts when I bend, walk and reach with my left arm · Healthcare visit (other): I see my doctor tomorrow. That is the earliest availability. I would rather see my own doc rather than go to the emergency room.

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Report sent to call center — days 1–6 daily, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-05
Survey response — days 1–6 daily, dose 4
MedDRA: Neck pain, Office visit — Feeling: Fair · Site: Swelling · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Neck pain. Went to doctor today and she prescribed steroid pills and a pain med. Will get them later when drugstore calls me, so don't know the names. · Healthcare visit (other): Internist

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Report sent to call center — days 1–6 daily, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-05
Call 1 — Left Voicemail
2022-05-06
Call 1 — Left Voicemail
2022-05-07
Survey response — day 7, dose 4
MedDRA: Office visit — Feeling: Fair · Joint pains, Muscle or body aches · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: My Regular physician, an internist

MedDRA releases: 2024-11 · check-in free text available
2022-05-07
Report sent to call center — day 7, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-10
Call successful
Participant prefers to complete VAERS report online
2022-05-10
Call successful
Participant prefers to complete VAERS report online
2022-05-10
Call successful
Participant prefers to complete VAERS report online
2022-08-01
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-29
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-30
Survey response — 12 months, dose 4
MedDRA: Sciatica — 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

MedDRA releases: 2024-11
2023-04-30
Report sent to call center — 12 months, dose 4
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)
2023-05-02
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-27	Moderna
3	2021-11-26	Moderna	No
4	2022-04-30	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-10	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-04-24	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-29	Successful 2022-04-04	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-04	Successful 2022-05-10	Participant prefers to complete VAERS report online
2022-05-05	Successful 2022-05-10	Participant prefers to complete VAERS report online
2022-05-07	Successful 2022-05-10	Participant prefers to complete VAERS report online
2023-04-30	Successful 2023-05-02	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5 — day 14, dose 1

2021-03-12

Symptoms: Pain in my right hip/thigh area

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): Had low-grade fever the following day ( all day). The following Monday I began having diarrhea ( that lasted 3 days).

Release 7 — day 14, dose 2

2021-04-10

Symptoms: Pain in my right lower back

Healthcare visit (other): Office visit

Release 7 — day 28, dose 2

2021-04-24

Symptoms: Pain on side. Had a CT scan which showed possible diverticulosis.

Healthcare visit (other): In person visit to doctors office

Release 11 — 12 months, dose 2

2022-03-29

Symptoms: Joint inflammation, hair loss

Release 11 — days 1–6 daily, dose 4

2022-05-02

Systemic reaction (other): Rash on one side of my face and on hands.

2022-05-03

Systemic reaction (other): Took Benedryl last night for rash that began developing late Sunday night. The rash was on my hands, face, head, and back. Much better today. Rash is faint today.

2022-05-04

Systemic reaction (other): Severe neck pain that extends behind my left ear and the back of my head. Can't turn my head. Hurts when I bend, walk and reach with my left arm

Healthcare visit (other): I see my doctor tomorrow. That is the earliest availability. I would rather see my own doc rather than go to the emergency room.

2022-05-05

Systemic reaction (other): Neck pain. Went to doctor today and she prescribed steroid pills and a pain med. Will get them later when drugstore calls me, so don't know the names.

Healthcare visit (other): Internist

Release 11 — day 7, dose 4

2022-05-07

Healthcare visit (other): My Regular physician, an internist

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
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Alopecia	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Arthritis	·	·	✓
SD	Back pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Sciatica	·	·	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Ear pain	·	·	✓
SRO	Gait disturbance	·	·	✓
SRO	Headache	·	·	✓
SRO	Musculoskeletal stiffness	·	·	✓
SRO	Neck pain	·	·	✓
SRO	Pain	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	·	·	✓
SRO	Self-medication	·	·	✓

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