ZHQ-22300-58770

3 vaccinations 13 coded responses 25 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 242 / VA
Registered: 2021-03-03

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Moderna
2021-03-03
Survey response — day 0, dose 1
MedDRA: Dizziness, Pre-existing disease — Feeling: Fair · Site: Pain

Free text: Mild light headed ness/dizziness. However I have an underlying vestibular disorder

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Abdominal pain

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Fever · Headache, Abdominal pain

Adult check-in
2021-03-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Survey response — day 14, dose 1
MedDRA: Cough, Dizziness, Dyspnoea, Headache, Nasal congestion — Feeling: Good

Free text: Increased nasal congestion, cough, mild SOB and headache with dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 21, dose 1
MedDRA: Vertigo — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Dose 2 — Moderna
2021-06-30
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Asthenia, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activities

Free text: Left arm/shoulder pain and weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-29
Survey response — 6 months, dose 2
MedDRA: Cough, Dyspnoea, Headache, Medical counselling, Myalgia, Sinus congestion — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Some SOB, headache for several weeks, sinus congestion, cough. Left deltoid pain since second vaccine 3/31/2021 · Healthcare visit (other): Drive up

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-13
Dose 3 — Moderna
2021-11-13
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-14
Survey response — days 1–6 daily, dose 3
MedDRA: Chest pain — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chest pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — days 1–6 daily, dose 3
MedDRA: Chest discomfort — Feeling: Fair · Site: Pain, Swelling · Headache

Free text: Chest discomfort

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness, runny nose, congestion

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-11-18
Survey response — days 1–6 daily, dose 3
MedDRA: Nasal congestion — Feeling: Good · Headache

Free text: Stuffy nose

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Survey response — days 1–6 daily, dose 3
MedDRA: Dysphagia, Nasal congestion — Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Free text: Nasal stuffiness, swallowing difficulty

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-11-27
Survey response — day 14, dose 3
MedDRA: Chest pain, Dyspnoea — Feeling: Fair

Free text: Some chest pain, shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Survey response — day 21, dose 3
MedDRA: Chest pain, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chest pain, headache

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Call 1 — Left Voicemail
2021-12-07
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-12-11
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-18
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-25
Survey response — day 42, dose 3
MedDRA: Chest pain, Cough, Dyspnoea, Epistaxis, Fatigue, Myalgia, Sinus congestion — Feeling: Poor · Be unable to do your normal daily activities

Free text: SOB, chest pain, fatigue, bloody nose, muscle pain, cough, sinus congestion

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2021-11-13	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-29	Successful 2021-12-07	Reported to VAERS voluntarily prior to GDIT contact

Free text

Release 5 — day 0, dose 1

2021-03-03

Systemic reaction (other): Mild light headed ness/dizziness. However I have an underlying vestibular disorder

Release 5 — day 14, dose 1

2021-03-17

Symptoms: Increased nasal congestion, cough, mild SOB and headache with dizziness

Release 6 — day 21, dose 1

2021-03-24

Symptoms: Vertigo

Release 9 — 3 months, dose 2

2021-06-30

Symptoms: Left arm/shoulder pain and weakness

Release 9 — 6 months, dose 2

2021-09-29

Symptoms: Some SOB, headache for several weeks, sinus congestion, cough. Left deltoid pain since second vaccine 3/31/2021

Healthcare visit (other): Drive up

Release 10 — days 1–6 daily, dose 3

2021-11-14

Systemic reaction (other): Chest pain

2021-11-15

Systemic reaction (other): Chest discomfort

2021-11-16

Systemic reaction (other): Dizziness, runny nose, congestion

2021-11-18

Systemic reaction (other): Stuffy nose

2021-11-19

Systemic reaction (other): Nasal stuffiness, swallowing difficulty

Release 10 — day 14, dose 3

2021-11-27

Symptoms: Some chest pain, shortness of breath

Release 10 — day 21, dose 3

2021-12-04

Symptoms: Chest pain, headache

Release 10 — day 42, dose 3

2021-12-25

Symptoms: SOB, chest pain, fatigue, bloody nose, muscle pain, cough, sinus congestion

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	Medical counselling	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Cough	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Epistaxis	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Sinus congestion	·	·	✓
SD	Vertigo	✓	✓	✓
SRO	Chest discomfort	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysphagia	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Rhinorrhoea	·	·	✓

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