ZEL-29979-42693

2 vaccinations 7 coded responses 25 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 800 / CO
Registered: 2021-02-06

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-06
Registered in v-safe
2021-02-06
Dose 1 — Moderna
2021-02-06
Health check-in — day 0, dose 1
Feeling: Good · Abdominal pain

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Vertigo — Feeling: Good · Fatigue or tiredness

Free text: Moderate vertigo sea leg feeling since Sunday.as n

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea, Feeling abnormal, Vertigo — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Continued vertigo/sea leg feeling. Increased diarrhea (both the wobbly and foggy feel and diarrhea) feel like my mystery illness Feb 2020. Same feeling.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-27
Survey response — day 21, dose 1
MedDRA: Injection site pain, Pruritus, Scratch, Self-medication — Feeling: Good · Be unable to do your normal daily activities

Free text: Im on my 4th day of intense, acute body wide itching. 75 mg Benadryl works for 4-6 hrs then wake up scratching. No new clothes or detergents or food. Unknown cause. Coinciding with itching is re-emerging muscle pain from injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Dose 2 — Moderna
2021-03-06
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Affective disorder, Bipolar disorder, Feeling abnormal, Malaise, Pre-existing disease, Self-medication — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Rapid deterioration of mood disorder (Im diagnosed bi-polar2) last night lasting 8 hours approx. Rapid and intense onset that was frightening but mid morning dissipated to normal malaise with use of Advil. Crazy feeling but its gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-03-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-03
Survey response — day 28, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good

Free text: Bipolar2..experienced first mixed highly euphoric episode that Ive experienced in 15 years or more. Difficult to treat but manageable.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-17
Survey response — day 42, dose 2
MedDRA: Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sinus infection treated with antibiotics

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-04
Survey response — 6 months, dose 2
MedDRA: Fatigue, Nasal congestion, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Good · 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: My kids came in July with grandkids for 5 day visit. 2 days after they left i woke with worse sore throat, fatigue and nasal congestion. Kids tested positive for Covid when they got home. Illness lasted weeks &still tired but Covid tested negative.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-04
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

1 call case(s)
2021-09-09
Call 1 — Left Voicemail
2021-09-09
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-06
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-06	Moderna
2	2021-03-06	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-17	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-04	Successful 2021-09-09	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-09

Systemic reaction (other): Moderate vertigo sea leg feeling since Sunday.as n

Release 4 — days 1–6 daily, dose 1

2021-02-11

Systemic reaction (other): Continued vertigo/sea leg feeling. Increased diarrhea (both the wobbly and foggy feel and diarrhea) feel like my mystery illness Feb 2020. Same feeling.

Release 4 — day 21, dose 1

2021-02-27

Symptoms: Im on my 4th day of intense, acute body wide itching. 75 mg Benadryl works for 4-6 hrs then wake up scratching. No new clothes or detergents or food. Unknown cause. Coinciding with itching is re-emerging muscle pain from injection site.

Release 5 — days 1–6 daily, dose 2

2021-03-07

Systemic reaction (other): Rapid deterioration of mood disorder (Im diagnosed bi-polar2) last night lasting 8 hours approx. Rapid and intense onset that was frightening but mid morning dissipated to normal malaise with use of Advil. Crazy feeling but its gone.

Release 6 — day 28, dose 2

2021-04-03

Symptoms: Bipolar2..experienced first mixed highly euphoric episode that Ive experienced in 15 years or more. Difficult to treat but manageable.

Release 7 — day 42, dose 2

2021-04-17

Symptoms: Sinus infection treated with antibiotics

Release 9 — 6 months, dose 2

2021-09-04

Symptoms: My kids came in July with grandkids for 5 day visit. 2 days after they left i woke with worse sore throat, fatigue and nasal congestion. Kids tested positive for Covid when they got home. Illness lasted weeks &still tired but Covid tested negative. cut off by CDC

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	Condition aggravated	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Injection site pain	✓	✓	✓
SD	Nasal congestion	✓	·	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	·	✓
SD	Scratch	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SRO	Affective disorder	○	✓	○
SRO	Bipolar disorder	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Vertigo	✓	✓	✓

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