ZLX-30681-85047

2 vaccinations 12 coded responses 29 check-ins 12 free-text entries 5 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 997 / AK
Registered: 2021-01-08

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

2021-01-08
Registered in v-safe
2021-01-08
Dose 1 — Moderna
2021-01-08
Survey response — day 0, dose 1
MedDRA: Chest discomfort, Paraesthesia — Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: chest heaviness, tingling in nose and cheeks

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Report sent to call center — day 0, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

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

1 call case(s)
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Site: Pain · Headache, Nausea, Diarrhea

Free text: symptoms come in waves throughout the day

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

Adult check-in
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Aphthous ulcer, Medical counselling, Oral herpes — Feeling: Fair · Nausea · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): i have had multiple ulcers in my mouth for two days and a cold sore that appeared about 36 hours ago · Healthcare visit (other): got prescription for abreva

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Mouth ulceration, Oral herpes — Feeling: Good · Nausea

Free text: continued ulcers in mouth and cold sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good

Free text: continued ulcers but not getting worse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — day 7, dose 1
MedDRA: Pain in jaw — Feeling: Good · Fatigue or tiredness

Free text: jaw pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-29
Survey response — day 21, dose 1
MedDRA: Oral herpes — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: continuous cold sore outbreaks since 3 days after vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-05
Survey response — day 28, dose 1
MedDRA: Oral herpes — Feeling: Good

Free text: cold sore worsened but is now healed. first time since a few days after vaccination that i dont have a cold sore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 35, dose 1
Feeling: Poor

Adult check-in
2021-02-19
Survey response — day 42, dose 1
MedDRA: Cough, Fatigue, Headache, Paranasal sinus hypersecretion, SARS-CoV-2 test positive — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: tested positive for covid 12feb so having headache, cough, fatigue, sinus drainage

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Call 1 — Left Voicemail
2021-03-02
Dose 2 — Moderna
2021-03-02
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None

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

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-23
Survey response — day 21, dose 2
MedDRA: Chest pain, Dyspnoea, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: shortness of breath and chest burning but honestly think it is from covid which. got between my shots

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-13
Survey response — day 42, dose 2
MedDRA: Amnesia, Headache — Feeling: Fair

Free text: memory lapses, HAs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-31
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-04
Survey response — 12 months, dose 2
MedDRA: Ovarian cyst, Pulmonary mass — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: ovarian cyst- lung nodules

MedDRA releases: 2024-11 · check-in free text available
2022-03-04
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-23
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-03-02	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-08	Unsuccessful
2021-01-09	Unsuccessful
2021-01-12	Unsuccessful
2021-01-29	Unsuccessful
2022-03-04	Unsuccessful

Free text

Release 1 — day 0, dose 1

2021-01-08

Systemic reaction (other): chest heaviness, tingling in nose and cheeks

Release 1 — days 1–6 daily, dose 1

2021-01-10

Systemic reaction (other): symptoms come in waves throughout the day

2021-01-12

Systemic reaction (other): i have had multiple ulcers in my mouth for two days and a cold sore that appeared about 36 hours ago

Healthcare visit (other): got prescription for abreva

2021-01-13

Systemic reaction (other): continued ulcers in mouth and cold sore

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): continued ulcers but not getting worse

Release 2 — day 7, dose 1

2021-01-15

Systemic reaction (other): jaw pain

Release 3 — day 21, dose 1

2021-01-29

Symptoms: continuous cold sore outbreaks since 3 days after vaccine

Release 3 — day 28, dose 1

2021-02-05

Symptoms: cold sore worsened but is now healed. first time since a few days after vaccination that i dont have a cold sore.

Release 4 — day 42, dose 1

2021-02-19

Symptoms: tested positive for covid 12feb so having headache, cough, fatigue, sinus drainage

Release 6 — day 21, dose 2

2021-03-23

Symptoms: shortness of breath and chest burning but honestly think it is from covid which. got between my shots

Release 7 — day 42, dose 2

2021-04-13

Symptoms: memory lapses, HAs

Release 11 — 12 months, dose 2

2022-03-04

Symptoms: ovarian cyst- lung nodules

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	Amnesia	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Oral herpes	✓	✓	✓
SD	Ovarian cyst	·	·	✓
SD	Paranasal sinus hypersecretion	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pulmonary mass	·	·	✓
SD	SARS-CoV-2 test positive	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Aphthous ulcer	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Mouth ulceration	✓	✓	✓
SRO	Oral herpes	✓	✓	✓
SRO	Pain in jaw	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	○	○	○

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