ZK6-20211-16518

4 vaccinations 10 coded responses 45 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 505 / IA
Registered: 2021-02-14

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

2021-02-06
Dose 1 — Moderna
2021-02-14
Registered in v-safe
2021-02-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-20
Survey response — day 14, dose 1
MedDRA: Diplopia, Dizziness — Feeling: Fair

Free text: Occasional light headed feeling. Occasional double vision in right eye.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-06
Dose 2 — Moderna
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Survey response — day 14, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-04
Survey response — day 28, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue all day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-17
Survey response — day 42, dose 2
MedDRA: Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-04
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-28
Dose 3 — Moderna
2021-10-28
Health check-in — day 0, dose 3
Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Urinary hesitation — Feeling: Good

Free text: Urinary hesitancy for past 3 days

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Survey response — day 7, dose 3
MedDRA: Urinary hesitation — Feeling: Good

Free text: Urinary hesitancy

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Survey response — day 21, dose 3
MedDRA: Corneal disorder, Dizziness, Office visit, Vertigo — 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: For past 2 weeks, left eye has progressively developed serious dry cornea requiring on going medical treatment. 2 unusual dizzy spells (room spinning) lasting 10 -15 seconds. Never happened to me before. Did not seek medical care for dizzy spells.

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Report sent to call center — day 21, dose 3
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)
2021-11-23
Call 1 — Left Voicemail
2021-11-25
Survey response — day 28, dose 3
MedDRA: Corneal disorder, Office visit — Feeling: Fair · Be unable to do your normal daily activities

Free text: Demes of cornea continues. Still seeing doctor for care.

MedDRA releases: 2024-11 · check-in free text available
2021-12-02
Survey response — day 35, dose 3
MedDRA: Dizziness, Dry eye — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Random dizziness lasting 5-7 minutes. One day episode was around 4 hours requiring me to sit for 10 minutes then lingering light headed ness for remainder of time. Previously reported dry cornea has improved by about 90%.

MedDRA releases: 2024-11 · check-in free text available
2021-12-02
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-06
Call successful
Participant prefers to complete VAERS report online
2021-12-14
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-22
Dose 4 — Moderna
2022-04-23
Survey response — days 1–6 daily, dose 4
MedDRA: Tremor — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Trembling arms and hands, but is lessening over past few hours.

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-04-26
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-30
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-22
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-22
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-04-22
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-06	Moderna
2	2021-03-06	Moderna
3	2021-10-28	Moderna	No
4	2022-04-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-19	Successful	Participant prefers to complete VAERS report online
2021-12-02	Successful 2021-12-06	Participant prefers to complete VAERS report online

Free text

Release 4 — day 14, dose 1

2021-02-20

Symptoms: Occasional light headed feeling. Occasional double vision in right eye.

Release 6 — day 14, dose 2

2021-03-20

Symptoms: Fatigue

Release 6 — day 28, dose 2

2021-04-04

Symptoms: Fatigue all day

Release 7 — day 42, dose 2

2021-04-17

Symptoms: Fatigue

Release 10 — days 1–6 daily, dose 3

2021-11-03

Systemic reaction (other): Urinary hesitancy for past 3 days

Release 10 — day 7, dose 3

2021-11-04

Systemic reaction (other): Urinary hesitancy

Release 10 — day 21, dose 3

2021-11-19

Symptoms: For past 2 weeks, left eye has progressively developed serious dry cornea requiring on going medical treatment. 2 unusual dizzy spells (room spinning) lasting 10 -15 seconds. Never happened to me before. Did not seek medical care for dizzy spells. cut off by CDC

Release 10 — day 28, dose 3

2021-11-25

Symptoms: Demes of cornea continues. Still seeing doctor for care.

Release 10 — day 35, dose 3

2021-12-02

Symptoms: Random dizziness lasting 5-7 minutes. One day episode was around 4 hours requiring me to sit for 10 minutes then lingering light headed ness for remainder of time. Previously reported dry cornea has improved by about 90%.

Release 11 — days 1–6 daily, dose 4

2022-04-23

Systemic reaction (other): Trembling arms and hands, but is lessening over past few hours.

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	Corneal disorder	·	·	✓
SD	Diplopia	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dry eye	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Office visit	·	·	✓
SD	Vertigo	·	·	✓
SRO	Tremor	·	·	✓
SRO	Urinary hesitation	·	·	✓

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