ZEY-29638-47804

5 vaccinations 9 coded responses 22 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 303 / GA
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-13
Survey response — day 0, dose 1
MedDRA: Burning sensation, Flushing, Immediate post-injection reaction — Feeling: Fair · Site: Pain

Free text: Burning and flushed face 20 mins after injection lasted an hour

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Survey response — day 14, dose 1
MedDRA: Balance disorder, Dizziness, Feeling abnormal — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dizzy, foggy, unsteady

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Dose 2 — Moderna
2021-02-10
Survey response — day 0, dose 2
MedDRA: Balance disorder, Erythema, Feeling hot, Headache, Immediate post-injection reaction, Nausea, Tinnitus, Vaccine positive rechallenge — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Free text: Immediate red and hot face upon injection as first dose but second one more severe and lasting longer. Bad headache, buzzing in ears, unsteady and queasy within 30 to 60 mins. 2 hours and still have allsymptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Malaise — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Feel sick

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Injection site erythema — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Red area 4 inches below injection site, weakness,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Weak

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-19
Survey response — day 35, dose 2
MedDRA: Eczema, Office visit, Pruritus — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Developed an exzema like area on my neck about a month ago which is still there and itches. Never have had any kind of skin issues and I am now 65. · Healthcare visit (other): In person doctor visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-17
Survey response — 6 months, dose 2
MedDRA: Eye disorder — 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: Problem with eye and surrounding tissues since june

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-17
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-19
Call 1 — Left Voicemail
2021-12-17
Dose 3 — Moderna
2022-05-07
Dose 4 — Moderna
2022-11-17
Dose 5 — Moderna
2022-12-16
Survey response — day 28, dose 5
MedDRA: Injection site erythema, Injection site pain, Injection site swelling — Feeling: Fair

Free text: On 3rd day after bivalent moderna on 11.17.2022 I developed a very large red area about 3 inches below where the injection was given. It was very painful, swollen, burning and took 6 days to calm down. It still gets pink in that area after shower.

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna
3	2021-12-17	Moderna	No
4	2022-05-07	Moderna	No
5	2022-11-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-19	Unsuccessful
2021-08-17	Unsuccessful

Free text

Release 1 — day 0, dose 1

2021-01-13

Systemic reaction (other): Burning and flushed face 20 mins after injection lasted an hour

Release 2 — day 14, dose 1

2021-01-27

Symptoms: Dizzy, foggy, unsteady

Release 4 — day 0, dose 2

2021-02-10

Systemic reaction (other): Immediate red and hot face upon injection as first dose but second one more severe and lasting longer. Bad headache, buzzing in ears, unsteady and queasy within 30 to 60 mins. 2 hours and still have allsymptoms

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Feel sick

2021-02-14

Systemic reaction (other): Red area 4 inches below injection site, weakness,

2021-02-15

Systemic reaction (other): Weak

Release 5 — day 35, dose 2

2021-03-19

Symptoms: Developed an exzema like area on my neck about a month ago which is still there and itches. Never have had any kind of skin issues and I am now 65.

Healthcare visit (other): In person doctor visit

Release 9 — 6 months, dose 2

2021-08-17

Symptoms: Problem with eye and surrounding tissues since june

Release 12 — day 28, dose 5

2022-12-16

Symptoms: On 3rd day after bivalent moderna on 11.17.2022 I developed a very large red area about 3 inches below where the injection was given. It was very painful, swollen, burning and took 6 days to calm down. It still gets pink in that area after shower. 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
HCVO	Office visit	✓	✓	✓
SD	Balance disorder	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Eczema	✓	✓	✓
SD	Eye disorder	✓	·	✓
SD	Feeling abnormal	✓	✓	✓
SD	Injection site erythema	·	·	✓
SD	Injection site pain	·	·	✓
SD	Injection site swelling	·	·	✓
SD	Pruritus	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Flushing	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Tinnitus	✓	✓	✓
SRO	Vaccine positive rechallenge	✓	✓	✓

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