ZED-31007-31243

4 vaccinations 11 coded responses 32 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 983 / WA
Registered: 2021-02-12

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

2021-02-12
Registered in v-safe
2021-02-12
Dose 1 — Moderna
2021-02-12
Survey response — day 0, dose 1
MedDRA: Immediate post-injection reaction, Lip swelling, Oropharyngeal discomfort, Pharyngeal swelling, Swelling of eyelid — Feeling: Fair · Site: Pain

Free text: Throat a little swollen, mildly uncomfortable. Swollen lips, eye lids puffy This most noticeable after first 30 mins. Throat persists through the evening

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Respiratory tract congestion — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy, mild congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Middle ear effusion, Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Mildly congested, mildly dizzy on waking probably due to fluid in ears, mild sore throat. Mostly gone by evening.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work

Free text: I was great yesterday, surprised headache returned for several hours today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-26
Survey response — day 14, dose 1
MedDRA: Headache — Feeling: Good

Free text: Still getting headaches that are unusual for me and dont feel like my headaches usually do. Not every day, may be there upon waking or come on during the day. Last about an hour

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-12
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain, Oropharyngeal pain — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Free text: Sore throat, ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Middle ear effusion — Feeling: Fair

Free text: Dizzy, fluid in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — day 7, dose 2
Feeling: Fair · Headache

Adult check-in
2021-03-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-04
Survey response — day 21, dose 2
MedDRA: Headache — Feeling: Good

Free text: Mild headache above or behind eyes. Recurs every few days. Annoying

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-12
Survey response — 6 months, dose 2
MedDRA: Headache, Pain in extremity — Feeling: Good

Free text: Had a couple days of headache and about an hour of very sore arm.

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Dose 3 — Moderna
Co-administered: Flu
2022-03-13
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-13
Dose 4 — Moderna
2022-05-20
Survey response — day 7, dose 4
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-04
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-11
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-17
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-13
Survey response — 6 months, dose 4
MedDRA: Aphasia — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Had episode of aphasia, possibly TIA or migraine aura

MedDRA releases: 2024-11 · check-in free text available
2022-11-13
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-11-14
Call successful
Not applicable - Accidental Reporting
2023-05-16
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2021-11-19	Moderna	Flu
4	2022-05-13	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-11-13	Successful 2022-11-14	Not applicable - Accidental Reporting

Free text

Release 4 — day 0, dose 1

2021-02-12

Systemic reaction (other): Throat a little swollen, mildly uncomfortable. Swollen lips, eye lids puffy This most noticeable after first 30 mins. Throat persists through the evening

Release 4 — days 1–6 daily, dose 1

2021-02-13

Systemic reaction (other): Dizzy, mild congestion

2021-02-14

Systemic reaction (other): Mildly congested, mildly dizzy on waking probably due to fluid in ears, mild sore throat. Mostly gone by evening.

2021-02-18

Systemic reaction (other): I was great yesterday, surprised headache returned for several hours today

Release 4 — day 14, dose 1

2021-02-26

Symptoms: Still getting headaches that are unusual for me and dont feel like my headaches usually do. Not every day, may be there upon waking or come on during the day. Last about an hour

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): Sore throat, ears

2021-03-18

Systemic reaction (other): Dizzy, fluid in ears

Release 6 — day 21, dose 2

2021-04-04

Symptoms: Mild headache above or behind eyes. Recurs every few days. Annoying

Release 9 — 6 months, dose 2

2021-09-12

Symptoms: Had a couple days of headache and about an hour of very sore arm.

Release 11 — day 7, dose 4

2022-05-20

Systemic reaction (other): No

Release 12 — 6 months, dose 4

2022-11-13

Symptoms: Had episode of aphasia, possibly TIA or migraine aura

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	Aphasia	·	·	✓
SD	Headache	✓	✓	✓
SD	Pain in extremity	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dizziness exertional	○	○	○
SRO	Ear pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Lip swelling	✓	✓	✓
SRO	Middle ear effusion	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Oropharyngeal discomfort	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pharyngeal swelling	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Swelling of eyelid	✓	✓	✓

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