ZL5-25398-90630

2 vaccinations 10 coded responses 20 check-ins 10 free-text entries 5 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 123 / NY
Registered: 2020-12-29

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Nasal congestion, Rhinorrhoea, Tinnitus — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Stuffy runny ,nose,back pain under rib,ringing in ears louder than normal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Musculoskeletal discomfort, Tinnitus — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Ears ringing louder than usual, back discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Flank pain, Tinnitus — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Ringing in ears-very loud and constant. Left flank pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-07
Survey response — day 7, dose 1
MedDRA: Injection site pruritus, Injection site swelling — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Free text: Itching, swelling at the injection site happened Tuesday 1/5, exactly 1wk from the initial injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: Good

Free text: Injection site itching on and off. This started exactly 1week after the initial injection. Swollen, red and itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Free text: Severe headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness · Fever · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pain — Feeling: Fair · Site: Redness · Headache, Fatigue or tiredness, Nausea

Free text: Eyes hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pain — Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Free text: Eyes feel sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-11
Survey response — day 42, dose 2
MedDRA: Tinnitus — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Ringing in ears for a year after having COVID symptoms last year. Ringing has never gone away

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-05-25
Call 1 — Left Voicemail
2021-07-28
Survey response — 6 months, dose 2
MedDRA: Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Still have ringing in my ears. All day everyday. Very loud. No one wants to link it to possible COVID in Feb when I believe I had covid.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-28
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-04
Call 1 — Could Not Reach Participant
2021-08-09
Call successful
Other
2022-01-26
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-02	priority 2/3
2021-01-03	priority 2/3
2021-01-04	priority 2/3
2021-03-11	Unsuccessful
2021-07-28	Successful 2021-08-09	Other

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-02

Systemic reaction (other): Stuffy runny ,nose,back pain under rib,ringing in ears louder than normal

2021-01-03

Systemic reaction (other): Ears ringing louder than usual, back discomfort

2021-01-04

Systemic reaction (other): Ringing in ears-very loud and constant. Left flank pain

Release 1 — day 7, dose 1

2021-01-07

Systemic reaction (other): Itching, swelling at the injection site happened Tuesday 1/5, exactly 1wk from the initial injection.

Release 1 — day 14, dose 1

2021-01-12

Symptoms: Injection site itching on and off. This started exactly 1week after the initial injection. Swollen, red and itching

Release 2 — days 1–6 daily, dose 2

2021-01-27

Systemic reaction (other): Severe headache

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): Eyes hurt

2021-01-30

Systemic reaction (other): Eyes feel sore

Release 5 — day 42, dose 2

2021-03-11

Symptoms: Ringing in ears for a year after having COVID symptoms last year. Ringing has never gone away

Release 9 — 6 months, dose 2

2021-07-28

Symptoms: Still have ringing in my ears. All day everyday. Very loud. No one wants to link it to possible COVID in Feb when I believe I had covid.

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	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Flank pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Musculoskeletal discomfort	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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