ZF4-85360-60147

4 vaccinations 9 coded responses 32 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 598 / MT
Registered: 2021-01-29

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

GPY-81192-33795 Adult relative or friend · Male · 2022-11-21

Timeline

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

2021-01-29
Registered in v-safe
2021-01-29
Dose 1 — Moderna
2021-01-29
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Chills, Headache, Pyrexia, Self-medication — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My hands were extremely painful at all the joints. My left knee felt like someone hit it with a hammer. Constant headache even with extra strength tylenol. Chills last night into this afternoon then a fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Sensitive skin, Tenderness — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: The headache that has been with me since about 5 hours after my second shot seems to remain at the base of my skull. It is very tender and sensitive. I have been using Extra Strength Tylenol about every 12 hrs. It dulls it but doesnt get rid of it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine, Self-medication — Feeling: Good · Site: Pain · Headache

Free text: After eating and taking an Excedrine Migraine single tablet this morning it eased the shoulder to neck to base of skull headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 28, dose 2
Feeling: Good

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

Adult check-in
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-04
Dose 3 — Moderna
2022-02-28
Survey response — 12 months, dose 2
MedDRA: Disturbance in attention, Feeling abnormal, Headache, Paranasal sinus discomfort, SARS-CoV-2 test positive, Sinus pain, Visual impairment — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have been experiencing sinus pain and pressure as well as headaches and problems with my vision. When I first tested positive for Covid January 21st I felt like my brain was scrambled. I still have trouble focusing on computer work.

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Dose 4 — Moderna
2022-11-22
Survey response — days 1–6 daily, dose 4
MedDRA: Rhinorrhoea, Visual impairment — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: My vision has been affected by the 4th Booster and my nose seems to run continuously

MedDRA releases: 2024-11 · check-in free text available
2022-11-23
Survey response — days 1–6 daily, dose 4
MedDRA: Headache, Irritability — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Annoying headache

MedDRA releases: 2024-11 · check-in free text available
2022-11-24
Survey response — days 1–6 daily, dose 4
MedDRA: Headache — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Annoying headache about the same time every day

MedDRA releases: 2024-11 · check-in free text available
2022-11-25
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-12-04
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-12-09
Survey response — day 21, dose 4
MedDRA: Paranasal sinus discomfort, Paranasal sinus hypersecretion, Sinus pain, Sinusitis, Sputum discoloured — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sinus pressure and pain and sinus infection. Blowing out yellow to green from both nostrils

MedDRA releases: 2024-11 · check-in free text available
2022-12-16
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-23
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-02-17
Survey response — 3 months, dose 4
MedDRA: Eye disorder, Eye irritation, Lacrimation increased, Medical counselling, Ocular hyperaemia, Office visit, Self-medication — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-02-17
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2023-02-20
Call 1 — Requested Callback
2023-02-20
Callback requested for
06:30PM ET
2023-02-20
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-11-04	Moderna	No
4	2022-11-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2023-02-17	Successful 2023-02-20	Not applicable - Accidental Reporting

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): My hands were extremely painful at all the joints. My left knee felt like someone hit it with a hammer. Constant headache even with extra strength tylenol. Chills last night into this afternoon then a fever.

2021-03-01

Systemic reaction (other): The headache that has been with me since about 5 hours after my second shot seems to remain at the base of my skull. It is very tender and sensitive. I have been using Extra Strength Tylenol about every 12 hrs. It dulls it but doesnt get rid of it.

2021-03-02

Systemic reaction (other): After eating and taking an Excedrine Migraine single tablet this morning it eased the shoulder to neck to base of skull headache

Release 11 — 12 months, dose 2

2022-02-28

Symptoms: I have been experiencing sinus pain and pressure as well as headaches and problems with my vision. When I first tested positive for Covid January 21st I felt like my brain was scrambled. I still have trouble focusing on computer work.

Release 12 — days 1–6 daily, dose 4

2022-11-22

Systemic reaction (other): My vision has been affected by the 4th Booster and my nose seems to run continuously

2022-11-23

Systemic reaction (other): Annoying headache

2022-11-24

Systemic reaction (other): Annoying headache about the same time every day

Release 12 — day 21, dose 4

2022-12-09

Symptoms: Sinus pressure and pain and sinus infection. Blowing out yellow to green from both nostrils

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	Disturbance in attention	·	·	✓
SD	Eye disorder	·	·	✓
SD	Eye irritation	·	·	✓
SD	Feeling abnormal	·	·	✓
SD	Headache	·	·	✓
SD	Lacrimation increased	·	·	✓
SD	Medical counselling	·	·	✓
SD	Ocular hyperaemia	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Self-medication	·	·	✓
SD	Sinus pain	·	·	✓
SD	Sinusitis	·	·	✓
SD	Sputum discoloured	·	·	✓
SD	Visual impairment	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Irritability	·	·	✓
SRO	Migraine	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Self-medication	✓	✓	✓
SRO	Sensitive skin	✓	✓	✓
SRO	Tenderness	✓	✓	✓
SRO	Visual impairment	·	·	✓

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