ZGB-32594-19612

2 vaccinations 6 coded responses 17 check-ins 6 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 082 / NJ
Registered: 2021-01-12

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

2021-01-04
Dose 1 — Moderna
2021-01-12
Registered in v-safe
2021-01-12
Survey response — day 7, dose 1
MedDRA: Erythema, Fatigue, Induration, Pain in extremity, Pruritus — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work

Free text: The first day of the shot I was tried a few hours later the second day tired and arm hurt the third day arm really hurt red itchy indurated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Report sent to call center — day 7, dose 1
Be unable to work

1 call case(s)
2021-01-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-01
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-06
Dose 2 — Moderna
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Joint pains

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-02-13
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Diarrhea

Adult check-in
2021-02-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-27
Survey response — day 21, dose 2
MedDRA: Diarrhoea, Muscle spasms — Feeling: Good · Be unable to work

Free text: Stomach spasms and diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-10
Survey response — 3 months, dose 2
MedDRA: Blood iron increased, Brain fog, Dizziness, Dyspnoea, Fatigue — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Short of breath high iron testsVery tired and Brain fog.. Dizziness sometimes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Report sent to call center — 3 months, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-10
Call successful
Participant prefers to complete VAERS report online
2021-08-07
Survey response — 6 months, dose 2
MedDRA: Dysstasia, Fatigue, Gastrointestinal hypermotility, Irritable bowel syndrome, Sjogren's syndrome — Feeling: Poor · Be unable to work or attend school, 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: I'm pending diagnosis for ankolosing spondylitis I also am pending Crohn's disease and have been diagnosed with shogrens syndrome I have parasteisis in my small Bowell and IBD I'm extremely fatigue and I can't stand being my feet past 10 min lower ba

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-07
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

1 call case(s)
2021-11-04
Call 1 — Left Voicemail
2022-02-08
Survey response — 12 months, dose 2
MedDRA: Disability, Dysstasia, Gait disturbance, Impaired work ability, Reaction to previous exposure to any vaccine — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Symptoms: Can't stand or walk long · Healthcare visit (other): On disability 3 months after my second vaccination last year.. been out of work for 9 months

MedDRA releases: 2024-11 · check-in free text available
2022-02-08
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-02-09
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-02-06	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-12	priority 2/3
2021-05-10	Successful 2021-06-10	Participant prefers to complete VAERS report online
2021-08-07	Unsuccessful
2022-02-08	Unsuccessful

Free text

Release 1 — day 7, dose 1

2021-01-12

Systemic reaction (other): The first day of the shot I was tried a few hours later the second day tired and arm hurt the third day arm really hurt red itchy indurated

Release 3 — days 1–6 daily, dose 2

2021-02-09

Systemic reaction (other): Dizziness

Release 4 — day 21, dose 2

2021-02-27

Symptoms: Stomach spasms and diarrhea

Release 8 — 3 months, dose 2

2021-05-10

Symptoms: Short of breath high iron testsVery tired and Brain fog.. Dizziness sometimes

Release 9 — 6 months, dose 2

2021-08-07

Symptoms: I'm pending diagnosis for ankolosing spondylitis I also am pending Crohn's disease and have been diagnosed with shogrens syndrome I have parasteisis in my small Bowell and IBD I'm extremely fatigue and I can't stand being my feet past 10 min lower ba cut off by CDC

Release 11 — 12 months, dose 2

2022-02-08

Symptoms: Can't stand or walk long

Healthcare visit (other): On disability 3 months after my second vaccination last year.. been out of work for 9 months

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	Disability	·	·	✓
HCVO	Impaired work ability	·	·	✓
HCVO	Reaction to previous exposure to any vaccine	·	·	✓
SD	Blood iron increased	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Dysstasia	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Gait disturbance	·	·	✓
SD	Gastrointestinal hypermotility	✓	·	✓
SD	Irritable bowel syndrome	✓	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Sjogren's syndrome	✓	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Induration	✓	✓	✓
SRO	Limb discomfort	○	○	○
SRO	Pain in extremity	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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