ZM2-16503-29762

4 vaccinations 7 coded responses 37 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 210 / MD
Registered: 2021-01-16

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

2021-01-16
Registered in v-safe
2021-01-16
Dose 1 — Moderna
2021-01-16
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-06
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-13
Dose 2 — Moderna
2021-02-13
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Fatigue or tiredness

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Malaise, Pyrexia, Tremor — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Fever and feeling pretty sick for about 24 hours now. Had extreme chills and could not stop shaking last night.

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, Swelling · Fever · Chills, Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Congested

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-02-20
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-08
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Influenza like illness, Loss of personal independence in daily activities, Pyrexia — Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Joint pains, Fatigue or tiredness, Nausea

Free text: Better today. Had a fever of 102 and flu like symptoms making activity impossible for about 36-48 hours

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Nausea

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Joint pains

Adult check-in
2021-11-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-21
Survey response — day 28, dose 3
MedDRA: Gastrointestinal disorder — Feeling: Fair

Free text: GI issues

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-22
Survey response — 3 months, dose 3
MedDRA: Fatigue, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue, low fever, sore throat · Healthcare visit (other): Covid test

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-01-27
Call 1 — Left Voicemail
2022-04-14
Dose 4 — Moderna
2022-04-18
Survey response — days 1–6 daily, dose 4
MedDRA: Fatigue, Headache, Myalgia, Pyrexia — Feeling: Fair · Headache, Joint pains

Free text: After vaccine had fever of 102.6 and significant fatigue, headache, and muscle pain for two days.

MedDRA releases: 2024-11 · check-in free text available
2022-04-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache

Adult check-in
2022-04-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-04-24
Health check-in — day 7, dose 4
Feeling: Good · Chills

Adult check-in
2022-10-13
Survey response — 6 months, dose 4
MedDRA: Fatigue, Headache, Pain, Pyrexia — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fever, body aches, fatigue, mild headache

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-16	Moderna
2	2021-02-13	Moderna
3	2021-10-23	Moderna	No
4	2022-04-14	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-22	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): Fever and feeling pretty sick for about 24 hours now. Had extreme chills and could not stop shaking last night.

2021-02-16

Systemic reaction (other): Congested

Release 10 — days 1–6 daily, dose 3

2021-10-26

Systemic reaction (other): Better today. Had a fever of 102 and flu like symptoms making activity impossible for about 36-48 hours

Release 10 — day 28, dose 3

2021-11-21

Symptoms: GI issues

Release 11 — 3 months, dose 3

2022-01-22

Symptoms: Fatigue, low fever, sore throat

Healthcare visit (other): Covid test

Release 11 — days 1–6 daily, dose 4

2022-04-18

Systemic reaction (other): After vaccine had fever of 102.6 and significant fatigue, headache, and muscle pain for two days.

Release 12 — 6 months, dose 4

2022-10-13

Symptoms: Fever, body aches, fatigue, mild headache

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	SARS-CoV-2 test	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Headache	·	·	✓
SRO	Influenza like illness	·	·	✓
SRO	Loss of personal independence in daily activities	·	·	✓
SRO	Malaise	✓	✓	✓
SRO	Myalgia	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Tremor	✓	✓	✓

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