ZJP-19463-25347

3 vaccinations 12 coded responses 21 check-ins 12 free-text entries 8 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 104 / NY
Registered: 2021-01-11

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

2021-01-11
Registered in v-safe
2021-01-11
Dose 1 — Moderna
2021-01-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-12
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-01-13
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Sinus disorder — Feeling: Fair · Site: Pain · Headache

Free text: Sinus issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Survey response — day 7, dose 1
MedDRA: Paranasal sinus discomfort, Sinus pain — Feeling: Fair · Site: Pain

Free text: Sinus pain and pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-09
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle discomfort, Restless legs syndrome — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Restless leg syndrome like sensations in all my muscles

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: Blood urine present, Medical counselling — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Bloody urine · Healthcare visit (other): Husband is a physician. He prescribed me medication

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Discomfort, Haematuria, Medical counselling, Pain, Paranasal sinus discomfort, Sinus congestion, Sleep disorder, Urinary tract infection — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to work, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Gross hematuria, pressure and stinging at urethra; sinus pressure and stuffiness, sleep issues · Healthcare visit (other): My husband is a physician. He prescribed meds for UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Acute sinusitis, Haematuria, Nephrolithiasis, Self-medication — Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Acute sinusitis; passed a kidney stone Thursday-Saturday, hematuria · Healthcare visit (other): My husband is a physician and prescribed medication

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Bedridden, Medical counselling — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Bedridden; extremely weak · Healthcare visit (other): Husband is a physician, overseeing my care

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-16
Survey response — day 7, dose 2
MedDRA: Medical counselling — Feeling: Poor · Headache, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: My husband is a physician, overseeing my care

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Report sent to call center — day 7, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-23
Survey response — day 14, dose 2
MedDRA: Abdominal pain, Gastrointestinal disorder, Nausea, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Continued GI issues: nausea, abdominal pain; and sinusitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-09
Survey response — day 28, dose 2
MedDRA: Abdominal pain, Fungal infection, Medical counselling, Nausea — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Abdominal pain, nausea, yeast infection · Healthcare visit (other): My husband is a physician, prescribed medication

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-16
Survey response — day 35, dose 2
MedDRA: Abdominal pain, Nausea, Sinusitis — Feeling: Fair

Free text: Ongoing abdominal pain, nausea, and sinusitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-19
Call 1 — Left Voicemail
2021-08-13
Survey response — 6 months, dose 2
MedDRA: Malaise, Mood altered — Feeling: Fair · Be unable to do your normal daily activities

Free text: Malaise, moodiness

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-25
Dose 3 — Moderna

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-11	Moderna
2	2021-02-09	Moderna
3	2021-12-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-12	priority 2/3
2021-01-13	priority 2/3
2021-02-11	Unsuccessful
2021-02-12	Unsuccessful
2021-02-14	Unsuccessful
2021-02-15	Unsuccessful
2021-02-16	Unsuccessful
2021-03-09	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Sinus issues

Release 2 — day 7, dose 1

2021-01-18

Systemic reaction (other): Sinus pain and pressure

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Restless leg syndrome like sensations in all my muscles

2021-02-11

Systemic reaction (other): Bloody urine

Healthcare visit (other): Husband is a physician. He prescribed me medication

2021-02-12

Systemic reaction (other): Gross hematuria, pressure and stinging at urethra; sinus pressure and stuffiness, sleep issues

Healthcare visit (other): My husband is a physician. He prescribed meds for UTI

2021-02-14

Systemic reaction (other): Acute sinusitis; passed a kidney stone Thursday-Saturday, hematuria

Healthcare visit (other): My husband is a physician and prescribed medication

2021-02-15

Systemic reaction (other): Bedridden; extremely weak

Healthcare visit (other): Husband is a physician, overseeing my care

Release 4 — day 7, dose 2

2021-02-16

Healthcare visit (other): My husband is a physician, overseeing my care

Release 4 — day 14, dose 2

2021-02-23

Symptoms: Continued GI issues: nausea, abdominal pain; and sinusitis

Release 5 — day 28, dose 2

2021-03-09

Symptoms: Abdominal pain, nausea, yeast infection

Healthcare visit (other): My husband is a physician, prescribed medication

Release 5 — day 35, dose 2

2021-03-16

Symptoms: Ongoing abdominal pain, nausea, and sinusitis

Release 9 — 6 months, dose 2

2021-08-13

Symptoms: Malaise, moodiness

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	✓	✓	✓
HCVO	Self-medication	✓	✓	✓
HCVO	Urinary tract infection	✓	✓	✓
SD	Abdominal pain	✓	✓	✓
SD	Fungal infection	✓	✓	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Malaise	✓	·	✓
SD	Mood altered	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SRO	Acute sinusitis	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Bedridden	✓	✓	✓
SRO	Blood urine	○	○	○
SRO	Blood urine present	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Haematuria	✓	✓	✓
SRO	Muscle discomfort	✓	✓	✓
SRO	Nephrolithiasis	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Paranasal sinus discomfort	✓	✓	✓
SRO	Restless legs syndrome	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓
SRO	Sinus pain	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓

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