ZLQ-13779-10663

4 vaccinations 15 coded responses 57 check-ins 15 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 782 / TX
Registered: 2021-02-22

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

2021-02-22
Registered in v-safe
2021-02-22
Dose 1 — Moderna
2021-02-22
Survey response — day 0, dose 1
MedDRA: Dizziness, Dry mouth, Feeling abnormal — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness, heavy feeling, dry mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity, Paraesthesia — Feeling: Poor · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Major pain and some tingling in entire right arm, shoulder to fingertips

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — day 7, dose 1
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Still have major pain in entire right arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — day 14, dose 1
MedDRA: Immunisation reaction, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I had a bad autoimmune reaction to the vaccine. I have had major pain in my entire right arm. My doctor prescribed prednisone. My doctor and I will discuss whether or not I should get the second shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-15
Survey response — day 21, dose 1
MedDRA: Autoimmune disorder, Nonspecific reaction, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Autoimmune reaction, doctor prescribed prednisone · Healthcare visit (other): Primary care physician

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-22
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-04-06
Health check-in — day 42, dose 1
Feeling: Fair

Adult check-in
2021-04-07
Dose 2 — Moderna
2021-04-07
Survey response — day 0, dose 2
MedDRA: Discomfort, Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness, heavy feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Thirst — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Extreme thirst

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Thirst — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Shortness of breath, thirsty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-14
Health check-in — day 7, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-28
Health check-in — day 21, dose 2
Feeling: Fair

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

Adult check-in
2021-05-12
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-19
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-07
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-06
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-13
Call 1 — Left Voicemail
2021-12-31
Dose 3 — Moderna
2021-12-31
Survey response — day 0, dose 3
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-01-01
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-03
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-01-07
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-01-14
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-21
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-01-28
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-02-04
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-02-11
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-04-01
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-07-01
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-11-04
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-11-04
Survey response — day 0, dose 4
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Itching · Chills, Headache, Fatigue or tiredness, Nausea

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-11-05
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-11-06
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-08
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-09
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-11-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-11-11
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-11-18
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-11-25
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-12-02
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-12-09
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-12-16
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-02-03
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-05-05
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-22	Moderna
2	2021-04-07	Moderna
3	2021-12-31	Moderna	No
4	2022-11-04	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-03-08	Unsuccessful
2021-03-15	Unsuccessful

Free text

Release 4 — day 0, dose 1

2021-02-22

Systemic reaction (other): Dizziness, heavy feeling, dry mouth

Release 4 — days 1–6 daily, dose 1

2021-02-23

Systemic reaction (other): Dizziness

2021-02-24

Systemic reaction (other): Dizziness

2021-02-28

Systemic reaction (other): Major pain and some tingling in entire right arm, shoulder to fingertips

Release 4 — day 7, dose 1

2021-03-01

Systemic reaction (other): Still have major pain in entire right arm

Release 5 — day 14, dose 1

2021-03-08

Symptoms: I had a bad autoimmune reaction to the vaccine. I have had major pain in my entire right arm. My doctor prescribed prednisone. My doctor and I will discuss whether or not I should get the second shot.

Release 5 — day 21, dose 1

2021-03-15

Symptoms: Autoimmune reaction, doctor prescribed prednisone

Healthcare visit (other): Primary care physician

Release 7 — day 0, dose 2

2021-04-07

Systemic reaction (other): Dizziness, heavy feeling

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): Extreme thirst

2021-04-09

Systemic reaction (other): Shortness of breath, thirsty

2021-04-11

Systemic reaction (other): Sore throat

Release 10 — day 0, dose 3

2021-12-31

Systemic reaction (other): Dizziness

Release 12 — day 0, dose 4

2022-11-04

Systemic reaction (other): Dizziness

Release 12 — days 1–6 daily, dose 4

2022-11-05

Systemic reaction (other): Dizziness

2022-11-06

Systemic reaction (other): Dizziness

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	Autoimmune disorder	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Nonspecific reaction	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dry mouth	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Thirst	✓	✓	✓

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