ZEA-57353-48396

2 vaccinations 10 coded responses 25 check-ins 10 free-text entries 4 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 627 / IL
Registered: 2021-04-07

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

2021-04-07
Registered in v-safe
2021-04-07
Dose 1 — Moderna
2021-04-07
Health check-in — day 0, dose 1
Feeling: Fair · None

Adult check-in
2021-04-08
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain

Free text: Sore arm in shot arm .

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

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-06
Dose 2 — Moderna
2021-05-06
Survey response — day 0, dose 2
MedDRA: Bronchial disorder, Cough, Dysgeusia — Feeling: Fair · Site: Pain, Itching · Fever · Headache, Fatigue or tiredness

Free text: I have a cough and my bronchia feel inflamed . My cough has a foul taste .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — days 1–6 daily, dose 2
MedDRA: Rhinorrhoea, Sinus headache — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Sinus headache and mucus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Inflammation — Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness

Free text: Cough , bronchial inflammation ,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Bronchitis, Cough — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Cough and inflamed bronchia · Healthcare visit (other): I had to ask for pearls for cough and refill on my inhaler .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
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)
2021-05-10
Survey response — days 1–6 daily, dose 2
MedDRA: Bronchitis, Cough, Paranasal sinus hypersecretion, Unevaluable event — Feeling: Poor · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Bronchial , cough , sinus drainage · Healthcare visit (other): I requested pearls and an inhaler

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Bronchitis, Cough — Feeling: Poor · Fatigue or tiredness

Free text: Bronchia inflamed , cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — day 7, dose 2
MedDRA: Cough — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — day 21, dose 2
MedDRA: Fatigue, Hypersomnia, Medical counselling — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Since the vaccine I have had fatigue symptoms . It hasnt abated since I got it , it feels like Epstein bar or hypothyroid symptoms · Healthcare visit (other): I called today , I have been sleeping more than usual

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-04
Call 1 — Left Voicemail
2021-06-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-10
Survey response — day 35, dose 2
MedDRA: Fatigue, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue on and off . · Healthcare visit (other): I had Drs apt and bloodwork

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-17
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-17
Call 1 — Left Voicemail
2021-08-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-05-07
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-07	Moderna
2	2021-05-06	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-05-09	Unsuccessful
2021-05-10	Unsuccessful
2021-05-27	Unsuccessful
2021-06-10	Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-08

Systemic reaction (other): Sore arm in shot arm .

Release 8 — day 0, dose 2

2021-05-06

Systemic reaction (other): I have a cough and my bronchia feel inflamed . My cough has a foul taste .

Release 8 — days 1–6 daily, dose 2

2021-05-07

Systemic reaction (other): Sinus headache and mucus

2021-05-08

Systemic reaction (other): Cough , bronchial inflammation ,

2021-05-09

Systemic reaction (other): Cough and inflamed bronchia

Healthcare visit (other): I had to ask for pearls for cough and refill on my inhaler .

2021-05-10

Systemic reaction (other): Bronchial , cough , sinus drainage

Healthcare visit (other): I requested pearls and an inhaler

2021-05-12

Systemic reaction (other): Bronchia inflamed , cough

Release 8 — day 7, dose 2

2021-05-13

Systemic reaction (other): Cough

Release 8 — day 21, dose 2

2021-05-27

Symptoms: Since the vaccine I have had fatigue symptoms . It hasnt abated since I got it , it feels like Epstein bar or hypothyroid symptoms

Healthcare visit (other): I called today , I have been sleeping more than usual

Release 9 — day 35, dose 2

2021-06-10

Symptoms: Fatigue on and off .

Healthcare visit (other): I had Drs apt and bloodwork

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	Cough	✓	✓	✓
HCVO	Hypersomnia	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Fatigue	✓	✓	✓
SRO	Bronchial disorder	✓	✓	✓
SRO	Bronchitis	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Inflammation	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Paranasal sinus hypersecretion	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sinus headache	✓	✓	✓

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