ZN8-18042-05389

2 vaccinations 9 coded responses 26 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 481 / MI
Registered: 2021-01-07

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Survey response — day 0, dose 1
MedDRA: Injection site pain — Feeling: Good

Free text: Mild - A little soreness in the arm muscle down to and including the elbow joint of the injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion — Feeling: Good

Free text: Mild Stuffy nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Survey response — day 14, dose 1
MedDRA: Diarrhoea — Feeling: Good

Free text: Diarrhea approximately one day after last check in. Very soft stool approximately 48 hours ago. Both were mild only occurring once.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-08
Dose 2 — Moderna
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Decreased appetite — Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Loss of appetite every day since injection and persistent cough for a few hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Loss of appetite - mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Good

Free text: Still not much of an appetite - mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-10
Survey response — 3 months, dose 2
MedDRA: Lethargy, Nasopharyngitis, Pain — Feeling: Good · Be unable to do your normal daily activities

Free text: I am quite certain all of my recent symptoms were related to my first dose of the shingle shot. The symptoms were similar to the Covid vaccine, cold, lethargic, mild body aches. They lasted 24-48 hours and then faded away over the next 24-48 hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-09
Survey response — 6 months, dose 2
MedDRA: Immunisation reaction, Reaction to previous exposure to any vaccine — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Had both Shingles vaccines and had as bad of a reaction to the 2nd Shingles shot as I did with the 2nd Covid shot.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-08
Survey response — 12 months, dose 2
MedDRA: Balance disorder, Dizziness, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Dizzy and loss of balance · Healthcare visit (other): Family doctor in person

MedDRA releases: 2024-11 · check-in free text available
2022-02-08
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-24
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-08	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-02-08	Successful 2022-03-24	Participant prefers to complete VAERS report online

Free text

Release 1 — day 0, dose 1

2021-01-07

Systemic reaction (other): Mild - A little soreness in the arm muscle down to and including the elbow joint of the injection.

Release 1 — days 1–6 daily, dose 1

2021-01-12

Systemic reaction (other): Mild Stuffy nose

Release 2 — day 14, dose 1

2021-01-22

Symptoms: Diarrhea approximately one day after last check in. Very soft stool approximately 48 hours ago. Both were mild only occurring once.

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Loss of appetite every day since injection and persistent cough for a few hours

2021-02-13

Systemic reaction (other): Loss of appetite - mild

2021-02-14

Systemic reaction (other): Still not much of an appetite - mild

Release 8 — 3 months, dose 2

2021-05-10

Symptoms: I am quite certain all of my recent symptoms were related to my first dose of the shingle shot. The symptoms were similar to the Covid vaccine, cold, lethargic, mild body aches. They lasted 24-48 hours and then faded away over the next 24-48 hours. cut off by CDC

Release 9 — 6 months, dose 2

2021-08-09

Symptoms: Had both Shingles vaccines and had as bad of a reaction to the 2nd Shingles shot as I did with the 2nd Covid shot.

Release 11 — 12 months, dose 2

2022-02-08

Symptoms: Dizzy and loss of balance

Healthcare visit (other): Family doctor in person

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	Balance disorder	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Immunisation reaction	✓	·	✓
SD	Lethargy	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Reaction to previous exposure to any vaccine	✓	·	✓
SRO	Cough	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓

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