ZER-31096-43361

2 vaccinations 14 coded responses 23 check-ins 14 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 109 / NY
Registered: 2021-03-23

Relationship: Self
Race: Multiracial
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-22
Dose 1 — Moderna
2021-03-23
Registered in v-safe
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Pyrexia — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to do your normal daily activities

Free text: Fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site warmth — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: The injection site since day one has felt hot and remains so.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site warmth — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: The site of the injection remains hot to the touch .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-04-05
Survey response — day 14, dose 1
MedDRA: Chest pain, Fatigue, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: I feel muscular pain all over, pain in the right side of my chest more so like a sprained muscle and fatigue like I didnt get any sleep.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-19
Dose 2 — Moderna
2021-04-19
Survey response — day 0, dose 2
MedDRA: Chest pain, Costochondritis, Eye inflammation, Office visit, Pre-existing disease, Vision blurred — Feeling: Fair · Site: Pain · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Had chest pain for 3 weeks now, EKG and PFMT both normal. diagnosed with costchrondritis of the chest wall and blurry vision, inflammation of the eyes. · Healthcare visit (other): In office visit with Internist and Optometrist.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Report sent to call center — day 0, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Costochondritis, Dizziness, Eye inflammation — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Dizzy, developed Costochrondritis of the chest wall on my right side and inflammation of my eyes since approximately 3 weeks ago.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder, Hypoaesthesia, Sensory disturbance — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: My head feels like someone is squeezing my brain, feeling of numbness and off balance.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Costochondritis, Musculoskeletal chest pain — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chest wall pain (costochrondritis)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Costochondritis — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Costochrondritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Good · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Costochrondritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — day 7, dose 2
MedDRA: Costochondritis — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Costochrondritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — day 14, dose 2
MedDRA: Costochondritis, Fatigue, Muscle tightness, Myalgia — Feeling: Good · Be unable to do your normal daily activities

Free text: Fatigue, Costochrondritis and muscle tightness and pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-17
Survey response — day 28, dose 2
MedDRA: Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headaches with fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-02
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-19
Survey response — 3 months, dose 2
MedDRA: Parosmia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I constantly have a sense of smelling something with an odd sweet smell and I cant describe it. It started after my 2nd dose of Moderna.

MedDRA releases: 2024-11 · check-in free text available
2021-07-19
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-24
Call 1 — Left Voicemail
2021-10-20
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-19	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-19	Unsuccessful
2021-07-19	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-23

Systemic reaction (other): Fever

2021-03-26

Systemic reaction (other): The injection site since day one has felt hot and remains so.

2021-03-27

Systemic reaction (other): The site of the injection remains hot to the touch .

Release 6 — day 14, dose 1

2021-04-05

Symptoms: I feel muscular pain all over, pain in the right side of my chest more so like a sprained muscle and fatigue like I didnt get any sleep.

Release 7 — day 0, dose 2

2021-04-19

Systemic reaction (other): Had chest pain for 3 weeks now, EKG and PFMT both normal. diagnosed with costchrondritis of the chest wall and blurry vision, inflammation of the eyes.

Healthcare visit (other): In office visit with Internist and Optometrist.

Release 7 — days 1–6 daily, dose 2

2021-04-21

Systemic reaction (other): Dizzy, developed Costochrondritis of the chest wall on my right side and inflammation of my eyes since approximately 3 weeks ago.

2021-04-22

Systemic reaction (other): My head feels like someone is squeezing my brain, feeling of numbness and off balance.

2021-04-23

Systemic reaction (other): Chest wall pain (costochrondritis)

2021-04-24

Systemic reaction (other): Costochrondritis

2021-04-25

Systemic reaction (other): Costochrondritis

Release 8 — day 7, dose 2

2021-04-26

Systemic reaction (other): Costochrondritis

Release 8 — day 14, dose 2

2021-05-03

Symptoms: Fatigue, Costochrondritis and muscle tightness and pain.

Release 8 — day 28, dose 2

2021-05-17

Symptoms: Headaches with fatigue

Release 9 — 3 months, dose 2

2021-07-19

Symptoms: I constantly have a sense of smelling something with an odd sweet smell and I cant describe it. It started after my 2nd dose of Moderna.

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	Chest pain	✓	✓	✓
SD	Costochondritis	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Muscle tightness	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Parosmia	·	·	✓
SRO	Balance disorder	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Costochondritis	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Eye inflammation	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Musculoskeletal chest pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Sensory disturbance	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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