ZLX-48498-19198

3 vaccinations 10 coded responses 22 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 200 / DC
Registered: 2021-01-17

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

2021-01-17
Registered in v-safe
2021-01-17
Dose 1 — Moderna
2021-01-17
Survey response — day 0, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Free text: Current chemo patient

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Am a chemo patient. Often very tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Chemotherapy, Fatigue, Headache, Injection site discolouration — Feeling: Good · Site: Redness · Headache, Fatigue or tiredness

Free text: Chemo patient on some heparin soInjection site isBlack and blue. Headache and fatigue could also be Chemo. Kadcyla infusion 4 days before covid vaccine #1

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction, Chemotherapy, Pre-existing disease — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Chemo patient. Hard to know if symptoms are vaccine or chemo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Chemotherapy, Immunisation, Pre-existing disease — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chemo patient. 3- day interval btwn chemo and covid vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — day 7, dose 1
MedDRA: Adverse reaction — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chemo patient. Difficult to tease out which side effects are covid vaccine vsChemo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-07
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-14
Dose 2 — Moderna
2021-02-14
Survey response — day 0, dose 2
MedDRA: Headache, Pre-existing disease — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Am a chemo patient. Symptoms are hard to tell apart. Have a headache since receiving vaccine earlier today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-07
Survey response — day 21, dose 2
MedDRA: Chest discomfort, Respiratory disorder — Feeling: Fair · Be unable to do your normal daily activities

Free text: Breathing issues. Cheat heaviness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 35, dose 2
MedDRA: Chest pain, Neoplasm malignant, Office visit, Pre-existing disease, Tremor — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Shakey. Chest pain ( maybe heartburn. Never had it before). But Ive been a cancer patient in chemo foe almost one year. · Healthcare visit (other): Tests. Pulmonologist Lung CT. Cardiologist echocardiogram

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-18
Survey response — 3 months, dose 2
MedDRA: Chemotherapy, Unevaluable event — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Related to chemotherapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-17
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-09-17
Dose 3 — Moderna
Co-administered: Flu
2021-10-26
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-17
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-03-07
Call 1 — Could Not Reach Participant
2022-03-10
Call 2 — Could Not Reach Participant
2022-03-20
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-17	Moderna
2	2021-02-14	Moderna
3	2021-09-17	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-03-23	Unsuccessful

Free text

Release 2 — day 0, dose 1

2021-01-17

Systemic reaction (other): Current chemo patient

Release 2 — days 1–6 daily, dose 1

2021-01-18

Systemic reaction (other): Am a chemo patient. Often very tired.

2021-01-19

Systemic reaction (other): Chemo patient on some heparin soInjection site isBlack and blue. Headache and fatigue could also be Chemo. Kadcyla infusion 4 days before covid vaccine #1

2021-01-22

Systemic reaction (other): Chemo patient. Hard to know if symptoms are vaccine or chemo

2021-01-23

Systemic reaction (other): Chemo patient. 3- day interval btwn chemo and covid vaccine

Release 2 — day 7, dose 1

2021-01-24

Systemic reaction (other): Chemo patient. Difficult to tease out which side effects are covid vaccine vsChemo

Release 4 — day 0, dose 2

2021-02-14

Systemic reaction (other): Am a chemo patient. Symptoms are hard to tell apart. Have a headache since receiving vaccine earlier today

Release 5 — day 21, dose 2

2021-03-07

Symptoms: Breathing issues. Cheat heaviness

Release 6 — day 35, dose 2

2021-03-23

Symptoms: Shakey. Chest pain ( maybe heartburn. Never had it before). But Ive been a cancer patient in chemo foe almost one year.

Healthcare visit (other): Tests. Pulmonologist Lung CT. Cardiologist echocardiogram

Release 8 — 3 months, dose 2

2021-05-18

Symptoms: Related to chemotherapy

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	Chemotherapy	✓	✓	○
SD	Chest discomfort	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Neoplasm malignant	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory disorder	✓	✓	✓
SD	Tremor	✓	✓	✓
SD	Unevaluable event	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Chemotherapy	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immunisation	○	✓	○
SRO	Injection site discolouration	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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