ZFX-69871-51894

2 vaccinations 10 coded responses 13 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 236 / VA
Registered: 2021-04-16

Relationship: Self
Race: American Indian or Alaska Native
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-04-15
Dose 1 — Moderna
2021-04-16
Registered in v-safe
2021-04-16
Survey response — days 1–6 daily, dose 1
MedDRA: Confusional state, Dizziness, Heart rate irregular, Oxygen saturation decreased — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Dizziness, confusion, low oxygen, erratic pulse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Fatigue, Oxygen saturation decreased — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Free text: Low oxygen, weak, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Oxygen consumption decreased — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Very low oxygen (especially in am or exertion) short of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 7, dose 1
MedDRA: Oxygen saturation decreased — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Low oxygen (not as low as previous days)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-06
Survey response — day 21, dose 1
MedDRA: Oxygen saturation decreased, Tinnitus — Feeling: Fair

Free text: Low oxygen levelsRinging in the ears?(prolonged)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Dose 2 — Moderna
2021-05-20
Survey response — days 1–6 daily, dose 2
MedDRA: Oxygen saturation decreased — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Low erratic oxygen levels

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Survey response — day 7, dose 2
MedDRA: Chest discomfort, Chest pain — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Low oxygen, tightness/pain in chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Survey response — day 14, dose 2
MedDRA: Arthralgia, Decreased appetite, Musculoskeletal pain, Nausea, Neck pain, Oxygen saturation decreased, Pneumonia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Pneumonia, low oxygen, erratic pulse? Very painful neck, shoulder in between shoulder blades, loss of appetite/nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-05
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-06-13
Survey response — day 28, dose 2
MedDRA: Arthralgia, Asthenia, Blood pressure fluctuation, Chest pain, Dizziness, Fatigue, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chest pain, fluttering?, Pr rate up & down, extreme weakness, fatigue, pain in legs and hips, dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-21
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-08-14
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Fatigue, Pneumonia, Pulse abnormal — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pneumonia won't go away with multiple antibiotics? Erratic pulse. Short of breath. Tiredness

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-04-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-15	Moderna
2	2021-05-15	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-05-31	Successful 2022-04-14	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-16

Systemic reaction (other): Dizziness, confusion, low oxygen, erratic pulse

2021-04-19

Systemic reaction (other): Low oxygen, weak, fatigue

2021-04-20

Systemic reaction (other): Very low oxygen (especially in am or exertion) short of breath

Release 7 — day 7, dose 1

2021-04-22

Systemic reaction (other): Low oxygen (not as low as previous days)

Release 8 — day 21, dose 1

2021-05-06

Symptoms: Low oxygen levelsRinging in the ears?(prolonged)

Release 8 — days 1–6 daily, dose 2

2021-05-20

Systemic reaction (other): Low erratic oxygen levels

Release 8 — day 7, dose 2

2021-05-22

Systemic reaction (other): Low oxygen, tightness/pain in chest

Release 8 — day 14, dose 2

2021-05-31

Symptoms: Pneumonia, low oxygen, erratic pulse? Very painful neck, shoulder in between shoulder blades, loss of appetite/nausea

Release 9 — day 28, dose 2

2021-06-13

Symptoms: Chest pain, fluttering?, Pr rate up & down, extreme weakness, fatigue, pain in legs and hips, dizziness

Release 9 — 3 months, dose 2

2021-08-14

Symptoms: Pneumonia won't go away with multiple antibiotics? Erratic pulse. Short of breath. Tiredness

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	Arthralgia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Blood pressure fluctuation	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Musculoskeletal pain	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Oxygen saturation decreased	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pneumonia	✓	✓	✓
SD	Pulse abnormal	✓	·	✓
SD	Tinnitus	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Heart rate irregular	✓	✓	✓
SRO	Oxygen consumption decreased	✓	✓	✓
SRO	Oxygen saturation decreased	✓	✓	✓

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