ZLD-60086-75697

2 vaccinations 9 coded responses 21 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 790 / TX
Registered: 2021-01-14

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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Moderna
2021-01-14
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Insomnia, Lymphadenopathy — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Swollen lymph glands , pressure on my chest, insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain upper, Diarrhoea, Headache, Paraesthesia — Feeling: Fair · Headache, Nausea

Free text: My left hand tingled for about 4 hrs today. It has now subsided. Symptoms seems to come and go. My arm is 98% better. Mild headache that comes and goes. Not true diarrhea, but loose and a few stomach cramps

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Insomnia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Insomnia, severe chills all night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Injection site rash, Injection site swelling, Rhinorrhoea — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Fatigue or tiredness

Free text: A slight cough a few hours after infection still lingering, slight runny nose, ra large ash surrounding the swollen injection sight.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: Insomnia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Good · Site: Itching

Free text: Slight cough still lingering.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Peripheral swelling, Rash — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: Not sure why my arm is still splotchy, red and swollen after a week out? Guess that is ok.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-06
Survey response — day 21, dose 2
MedDRA: Bronchitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Bronchitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-11
Survey response — 12 months, dose 2
MedDRA: COVID-19, Office visit — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Covid · Healthcare visit (other): Dr office

MedDRA releases: 2024-11 · check-in free text available
2022-02-11
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-02-17
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-02-11	Successful 2022-02-17	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Swollen lymph glands , pressure on my chest, insomnia

2021-01-16

Systemic reaction (other): My left hand tingled for about 4 hrs today. It has now subsided. Symptoms seems to come and go. My arm is 98% better. Mild headache that comes and goes. Not true diarrhea, but loose and a few stomach cramps

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Insomnia, severe chills all night.

2021-02-13

Systemic reaction (other): A slight cough a few hours after infection still lingering, slight runny nose, ra large ash surrounding the swollen injection sight.

2021-02-14

Systemic reaction (other): Insomnia

2021-02-16

Systemic reaction (other): Slight cough still lingering.

2021-02-17

Systemic reaction (other): Not sure why my arm is still splotchy, red and swollen after a week out? Guess that is ok.

Release 5 — day 21, dose 2

2021-03-06

Symptoms: Bronchitis

Release 11 — 12 months, dose 2

2022-02-11

Symptoms: Covid

Healthcare visit (other): Dr office

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	Office visit	·	·	✓
SD	Bronchitis	✓	✓	✓
SD	COVID-19	·	·	✓
SRO	Abdominal pain upper	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site rash	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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