ZEQ-28890-52386

2 vaccinations 14 coded responses 19 check-ins 14 free-text entries 8 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 445 / OH
Registered: 2021-03-17

Relationship: Self
Race: White
Ethnicity: N/A

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
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy, Swelling face — Feeling: Fair · Site: Pain · Muscle or body aches · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Yeasterday right face swelling. Today right lymph node swelling in neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pruritus, Lymphadenopathy, Swelling face — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · 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

Free text: Swollen lymph node and swollen check right side and ichy eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Flushing, Hypertension — Feeling: Fair · Site: Redness, Swelling, Itching · Chills, Muscle or body aches, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site

Free text: Flushing and high bo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Lymphadenopathy — Feeling: Fair · Muscle or body aches, Nausea, Diarrhea, Abdominal pain

Free text: Swollen lymph nods

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Office visit — Feeling: Good · Chills, Muscle or body aches, Nausea, Diarrhea, Abdominal pain · Get care from a doctor or other healthcare professional

Free text: Dr office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-23
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches, Nausea, Abdominal pain

Adult check-in
2021-04-05
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-06
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-13
Survey response — day 28, dose 1
MedDRA: Abdominal pain upper, Gastritis, Office visit, Rash — Feeling: Fair · 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: Symptoms: Rash on arm and chest. Not doing so good. Stomach is still inflamed and very achy. Scared to death of 2nd shot. Drs are advising not to take it untill rash goes away. Not surevi will ever get another. To many bad side effects. Just greatful to still · Healthcare visit (other): In office visit also. Calls to 8 specialist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Report sent to call center — day 28, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-14
Dose 2 — Moderna
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Gastrooesophageal reflux disease, Neuralgia, Pain — Feeling: Good · Site: Pain · Nausea, Abdominal pain

Free text: Acid reflex and shsrp shooting pains all over like nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Adnexa uteri pain, Gastrooesophageal reflux disease — Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Muscle or body aches, Nausea, Vomiting, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Overies hurt and acid reflex bad

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Oxygen consumption decreased — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Low oxegen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Oxygen consumption decreased — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Low oxegen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 7, dose 2
MedDRA: Oxygen saturation decreased — Feeling: Fair · Site: Pain, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · 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: Low O2 that comes and goes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Report sent to call center — day 7, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Survey response — day 14, dose 2
MedDRA: Haemoptysis, Pain in extremity — Feeling: Fair · 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: Couphing up blood bad pain in legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-05
Survey response — day 21, dose 2
MedDRA: Dyspnoea, Pulmonary haemorrhage, Thrombosis — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Lung hemorrhage and very bad paun shortness of breath bloodclot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
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)
2021-05-21
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-10-15
Survey response — 6 months, dose 2
MedDRA: Myocardial infarction, Unevaluable event — 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 · Emergency room or emergency department visit, Hospitalization

Free text: Heart attack and stents

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-10-19
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Moderna
2	2021-04-14	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-17	Unsuccessful
2021-03-18	Unsuccessful
2021-03-22	Unsuccessful
2021-04-13	Unsuccessful
2021-04-21	Unsuccessful
2021-04-29	Unsuccessful
2021-05-05	Unsuccessful
2021-10-15	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Yeasterday right face swelling. Today right lymph node swelling in neck

2021-03-18

Systemic reaction (other): Swollen lymph node and swollen check right side and ichy eyes

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Flushing and high bo

2021-03-21

Systemic reaction (other): Swollen lymph nods

2021-03-22

Healthcare visit (other): Dr office

Release 7 — day 28, dose 1

2021-04-13

Symptoms: Rash on arm and chest. Not doing so good. Stomach is still inflamed and very achy. Scared to death of 2nd shot. Drs are advising not to take it untill rash goes away. Not surevi will ever get another. To many bad side effects. Just greatful to still cut off by CDC

Healthcare visit (other): In office visit also. Calls to 8 specialist

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Acid reflex and shsrp shooting pains all over like nerve pain

2021-04-16

Systemic reaction (other): Overies hurt and acid reflex bad

2021-04-19

Systemic reaction (other): Low oxegen

2021-04-20

Systemic reaction (other): Low oxegen

Release 7 — day 7, dose 2

2021-04-21

Systemic reaction (other): Low O2 that comes and goes

Release 8 — day 14, dose 2

2021-04-29

Symptoms: Couphing up blood bad pain in legs

Release 8 — day 21, dose 2

2021-05-05

Symptoms: Lung hemorrhage and very bad paun shortness of breath bloodclot

Release 10 — 6 months, dose 2

2021-10-15

Symptoms: Heart attack and stents

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	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Gastritis	✓	✓	✓
SD	Haemoptysis	✓	✓	✓
SD	Myocardial infarction	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pulmonary haemorrhage	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Thrombosis	✓	✓	✓
SD	Unevaluable event	·	·	✓
SRO	Adnexa uteri pain	✓	✓	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Gastrooesophageal reflux disease	✓	✓	✓
SRO	Hypertension	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	Oxygen consumption decreased	✓	✓	✓
SRO	Oxygen saturation decreased	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Swelling face	✓	✓	✓

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