ZLK-99120-31245

2 vaccinations 4 coded responses 25 check-ins 4 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 606 / IL
Registered: 2021-01-06

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

2021-01-05
Dose 1 — Moderna
2021-01-06
Registered in v-safe
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-06
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-07
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-01-08
Report sent to call center — days 1–6 daily, dose 1
Be unable to work

1 call case(s)
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-01-09
Report sent to call center — days 1–6 daily, dose 1
Be unable to work

1 call case(s)
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

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

Adult check-in
2021-01-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-26
Health check-in — day 21, dose 1
Feeling: Good

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Survey response — day 14, dose 2
MedDRA: Arthralgia, Arthritis, Myalgia, Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Painful muscles and joints. Especially painful in my legs. My MD thinks the vaccine may have caused my poly inflammatory arthritis to flare up. This decreases my ability to do tasks of daily living.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-05-26
Call successful
Participant prefers to complete VAERS report online
2021-08-03
Survey response — 6 months, dose 2
MedDRA: Contusion, Fatigue, Unevaluable event, Weight decreased — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: 12 lb weight loss in 1 month. Easy bruising Some fatigue · Healthcare visit (other): PET scan scheduled for 8/5/21

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-03
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-12
Call 1 — Left Voicemail
2022-02-04
Survey response — 12 months, dose 2
MedDRA: Abnormal loss of weight, Cancer surgery, Hospitalisation, Lung neoplasm malignant, Robotic surgery — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: 9/15/21 a very small lung nodule that was cancer and was removed. No further treatment is necessary Unintended weight loss of 20 pounds. I am otherwise fine. I do not think any of this is related at all to the vaccinations. A · Healthcare visit (other): Inpatient robotic surgery

MedDRA releases: 2024-11 · check-in free text available
2022-02-04
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-02-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-02	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-06	priority 2/3
2021-01-07	priority 2/3
2021-01-08	priority 2/3
2021-01-09	priority 2/3
2021-02-16	Successful 2021-05-26	Participant prefers to complete VAERS report online
2021-08-03	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-04	Successful 2022-02-07	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Coughing

Release 4 — day 14, dose 2

2021-02-16

Symptoms: Painful muscles and joints. Especially painful in my legs. My MD thinks the vaccine may have caused my poly inflammatory arthritis to flare up. This decreases my ability to do tasks of daily living.

Release 9 — 6 months, dose 2

2021-08-03

Symptoms: 12 lb weight loss in 1 month. Easy bruising Some fatigue

Healthcare visit (other): PET scan scheduled for 8/5/21

Release 11 — 12 months, dose 2

2022-02-04

Symptoms: 9/15/21 a very small lung nodule that was cancer and was removed. No further treatment is necessary Unintended weight loss of 20 pounds. I am otherwise fine. I do not think any of this is related at all to the vaccinations. A

Healthcare visit (other): Inpatient robotic surgery

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	Hospitalisation	·	·	✓
HCVO	Robotic surgery	·	·	✓
HCVO	Unevaluable event	✓	·	✓
SD	Abnormal loss of weight	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Arthritis	✓	✓	✓
SD	Cancer surgery	·	·	✓
SD	Contusion	✓	·	✓
SD	Fatigue	✓	·	✓
SD	Lung neoplasm malignant	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Weight decreased	✓	·	✓
SRO	Cough	✓	✓	✓

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