ZLU-26104-50017

3 vaccinations 7 coded responses 28 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 060 / CT
Registered: 2021-02-20

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

2021-02-20
Registered in v-safe
2021-02-20
Dose 1 — Moderna
2021-02-20
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: yesterday at Mass at 5:15 i experienced a sharp shooting pain from my elbow down my arm to my wrist. that is when the soreness began.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Diarrhoea — Feeling: Fair · Site: Pain · Fatigue or tiredness, Abdominal pain

Free text: only very mild shoulder pain but loose bowels

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-20
Dose 2 — Moderna
2021-03-20
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Fair · Chills, Fatigue or tiredness

Free text: not yet...last time it was 8 hrs before i got a shooting pain in my arm. fir hrs after the vaccine, i felt awesome then i got tired...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness

Free text: 2 tips if i might that i wish i knew before my 1st vaccine...do arm rotations as much as possible and hydrate hydrate hydrate!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-25
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities

Free text: i dont think its due to the covid vaccine i got...i have severe scoliosis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-27
Survey response — day 7, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: prob due to my severe scoliosis, doubt its from the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-24
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-01
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-19
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-03
Dose 3 — Moderna
2022-03-20
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-05-04
Survey response — 6 months, dose 3
MedDRA: Deafness, Medical counselling, Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: i tested positive for covid on 4/23/2022. 4/22/2022 (the day before i tested) was the worst day. i still can't hear out of my left ear as well as still being congested otherwise i feel great. · Healthcare visit (other): no visit just a phone call to my GP

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-05
Call 1 — Left Voicemail
2022-05-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-03
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-20	Moderna
2	2021-03-20	Moderna
3	2021-11-03	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-05-04	Successful 2022-05-05	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-21

Systemic reaction (other): yesterday at Mass at 5:15 i experienced a sharp shooting pain from my elbow down my arm to my wrist. that is when the soreness began.

2021-02-22

Systemic reaction (other): only very mild shoulder pain but loose bowels

Release 6 — day 0, dose 2

2021-03-20

Systemic reaction (other): not yet...last time it was 8 hrs before i got a shooting pain in my arm. fir hrs after the vaccine, i felt awesome then i got tired...

Release 6 — days 1–6 daily, dose 2

2021-03-22

Systemic reaction (other): 2 tips if i might that i wish i knew before my 1st vaccine...do arm rotations as much as possible and hydrate hydrate hydrate!

2021-03-25

Systemic reaction (other): i dont think its due to the covid vaccine i got...i have severe scoliosis.

Release 6 — day 7, dose 2

2021-03-27

Systemic reaction (other): prob due to my severe scoliosis, doubt its from the vaccine

Release 11 — 6 months, dose 3

2022-05-04

Symptoms: i tested positive for covid on 4/23/2022. 4/22/2022 (the day before i tested) was the worst day. i still can't hear out of my left ear as well as still being congested otherwise i feel great.

Healthcare visit (other): no visit just a phone call to my GP

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	Medical counselling	·	·	✓
SD	Deafness	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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