ZJU-19992-95270

2 vaccinations 5 coded responses 23 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 044 / ME
Registered: 2021-03-27

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

2021-03-27
Registered in v-safe
2021-03-27
Dose 1 — Moderna
2021-03-27
Survey response — day 0, dose 1
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Femur pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling, Itching · Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-05-03
Dose 2 — Moderna
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-05-10
Health check-in — day 7, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-05-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-07
Survey response — day 35, dose 2
MedDRA: Ageusia, Anosmia, Gastric disorder, Pyrexia, Respiratory symptom, SARS-CoV-2 test negative — 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: Fever, respiratory symptoms, stomach problems new loss of taste and smell. Negative COVID19 test.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-07
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-02
Survey response — 3 months, dose 2
MedDRA: Colitis ulcerative, Peptic ulcer, Respiratory tract infection viral, SARS-CoV-2 test negative — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Ulcerative colitis, peptic ulcer disease, respiratory illness(viral, Covid test negative)

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-02
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-13
Call 1 — Left Voicemail
2021-11-01
Survey response — 6 months, dose 2
MedDRA: Biopsy pancreas abnormal, Condition aggravated, Endoscopy abnormal, Pancreatic cyst, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

Free text: My pancreatic cyst which has been stable for 11 years has increased in size and I have another pancreatic cyst, which was detected during an endoscopy and needle biopsy in September.

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2021-11-02
Call successful
Participant prefers to complete VAERS report online
2022-05-03
Survey response — 12 months, dose 2
MedDRA: Gastrointestinal disorder, Pruritus, Rash, Weight increased — 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: Skin rashes and constant itching, unexplained weight gain, gastrointestinal issues

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-04
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Moderna
2	2021-05-03	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-06-07	Unsuccessful
2021-08-02	Unsuccessful
2021-11-01	Successful 2021-11-02	Participant prefers to complete VAERS report online
2022-05-03	Unsuccessful

Free text

Release 6 — day 0, dose 1

2021-03-27

Systemic reaction (other): Femur pain

Release 8 — day 35, dose 2

2021-06-07

Symptoms: Fever, respiratory symptoms, stomach problems new loss of taste and smell. Negative COVID19 test.

Release 9 — 3 months, dose 2

2021-08-02

Symptoms: Ulcerative colitis, peptic ulcer disease, respiratory illness(viral, Covid test negative)

Release 10 — 6 months, dose 2

2021-11-01

Symptoms: My pancreatic cyst which has been stable for 11 years has increased in size and I have another pancreatic cyst, which was detected during an endoscopy and needle biopsy in September.

Release 11 — 12 months, dose 2

2022-05-03

Symptoms: Skin rashes and constant itching, unexplained weight gain, gastrointestinal issues

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	Ageusia	✓	✓	✓
SD	Anosmia	✓	✓	✓
SD	Biopsy pancreas abnormal	·	·	✓
SD	Colitis ulcerative	✓	·	✓
SD	Condition aggravated	·	·	✓
SD	Endoscopy abnormal	·	·	✓
SD	Gastric disorder	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Pancreatic cyst	·	·	✓
SD	Peptic ulcer	✓	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	·	·	✓
SD	Respiratory symptom	✓	✓	✓
SD	Respiratory tract infection viral	✓	·	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Weight increased	·	·	✓
SRO	Pain in extremity	✓	✓	✓

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