ZLS-27517-28117

2 vaccinations 10 coded responses 26 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 911 / CA
Registered: 2021-03-26

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

2021-03-26
Registered in v-safe
2021-03-26
Dose 1 — Moderna
2021-03-26
Health check-in — day 0, dose 1
Feeling: Good · Site: Itching · Abdominal pain

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-30
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Dysphonia — Feeling: Good · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness, Nausea

Free text: Chest tightness with voice hoarseness for 3 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-09
Survey response — day 14, dose 1
MedDRA: Nausea, Pain — Feeling: Fair

Free text: Body aches and nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 21, dose 1
MedDRA: Alopecia, Myalgia, Rash — Feeling: Good

Free text: Extreme hair loss for the last 3 weeks. Muscle pain and rash that wont go away

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Dose 2 — Moderna
2021-04-23
Health check-in — day 0, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort, Chest pain, Painful respiration — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Chest tightness a d pain when breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Dizziness — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Very lightheaded and weak. Almost passing out

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work

Free text: Very lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Very lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-30
Health check-in — day 7, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-05-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-04
Survey response — day 42, dose 2
MedDRA: Chest discomfort, Dysphonia, Dyspnoea, Pulmonary pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lung pain, chest tightness and voice hoarseness and winded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-23
Health check-in — 3 months, dose 2
Feeling: Poor

Adult check-in
2021-10-22
Survey response — 6 months, dose 2
MedDRA: Back pain, Chest discomfort, Dyspnoea, Pain, Pulmonary pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Shortness of breath, chest tightness, back lung pain and severe body aches for months now

MedDRA releases: 2024-11 · check-in free text available
2022-01-04
Call successful
Participant prefers to complete VAERS report online
2022-04-23
Survey response — 12 months, dose 2
MedDRA: Bone pain, Cough, Dyspnoea, Nausea — Feeling: Fair · Be unable to work or attend school

Free text: Shortness of breath, cough, bone pain and nausea

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-26	Moderna
2	2021-04-23	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-24	Successful 2022-01-04	Participant prefers to complete VAERS report online

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-30

Systemic reaction (other): Chest tightness with voice hoarseness for 3 days

Release 7 — day 14, dose 1

2021-04-09

Symptoms: Body aches and nausea

Release 7 — day 21, dose 1

2021-04-16

Symptoms: Extreme hair loss for the last 3 weeks. Muscle pain and rash that wont go away

Release 7 — days 1–6 daily, dose 2

2021-04-24

Systemic reaction (other): Chest tightness a d pain when breathing

2021-04-25

Systemic reaction (other): Very lightheaded and weak. Almost passing out

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Very lightheaded

2021-04-27

Systemic reaction (other): Very lightheaded

Release 8 — day 42, dose 2

2021-06-04

Symptoms: Lung pain, chest tightness and voice hoarseness and winded

Release 10 — 6 months, dose 2

2021-10-22

Symptoms: Shortness of breath, chest tightness, back lung pain and severe body aches for months now

Release 11 — 12 months, dose 2

2022-04-23

Symptoms: Shortness of breath, cough, bone pain and nausea

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	Alopecia	✓	✓	✓
SD	Back pain	·	·	✓
SD	Bone pain	·	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Cough	·	·	✓
SD	Dysphonia	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pulmonary pain	✓	✓	✓
SD	Rash	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysphonia	✓	✓	✓
SRO	Painful respiration	✓	✓	✓

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