ZNQ-27757-64044

3 vaccinations 13 coded responses 35 check-ins 13 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 937 / CA
Registered: 2021-01-28

Relationship: Self
Race: N/A
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-27
Dose 1 — Moderna
2021-01-28
Registered in v-safe
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-19
Survey response — day 21, dose 1
MedDRA: Asthma, Dyspnoea, Lymphadenopathy, Pre-existing disease — Feeling: Fair

Free text: slightly swollen nodes in arm pits, slight shortness of breath probably my asthma flare up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Dose 2 — Moderna
2021-02-24
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good · Headache

Free text: Injection site bruising improving from day of injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Survey response — day 7, dose 2
MedDRA: Chest discomfort, Dizziness — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Chest tightness, lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 14, dose 2
MedDRA: Chest discomfort, Dizziness, Dyspnoea, Office visit, Palpitations — Feeling: Poor · Be unable to work, 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: Symptoms: Palpitations, tightness of my chest, shortness of breath, lightheadedness · Healthcare visit (other): Cardiologist office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-17
Health check-in — day 21, dose 2
Feeling: Fair

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

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — 3 months, dose 2
MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair

Free text: Congestion, sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-25
Survey response — 6 months, dose 2
MedDRA: Blood glucose increased — Feeling: Good · Be unable to do your normal daily activities

Free text: Higher blood sugar levels. Could also be result of less physical activity?

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-16
Dose 3 — Moderna
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Muscle or body aches, Abdominal pain

Adult check-in
2021-11-23
Health check-in — day 7, dose 3
Feeling: Good · Muscle or body aches, Abdominal pain

Adult check-in
2021-11-30
Survey response — day 14, dose 3
MedDRA: Chest discomfort — Feeling: Fair

Free text: Chest tightness . It May be asthma.

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Survey response — day 21, dose 3
MedDRA: Chest discomfort, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Congestion and right chest discomfort/ pressure

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — day 28, dose 3
MedDRA: Chest discomfort, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chest tightness / congestion

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Survey response — day 35, dose 3
MedDRA: Chest discomfort — Feeling: Fair

Free text: Chest tighhtness

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Survey response — day 42, dose 3
MedDRA: Chest discomfort, Musculoskeletal chest pain, Respiratory tract congestion — Feeling: Fair · 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: Discomfort across chest area and chest congestion . Tender areas around rib cage in chest.

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Report sent to call center — day 42, dose 3
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)
2021-12-29
Call 1 — Left Voicemail
2022-02-15
Survey response — 3 months, dose 3
MedDRA: Cough, Oropharyngeal pain, Productive cough, Pyrexia, Respiratory tract congestion — 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: Jan 6 started Sore throat, low grade fever , chest congestion, phlegm, cough. Currently have a lingering occasional cough,

MedDRA releases: 2024-11 · check-in free text available
2022-02-15
Report sent to call center — 3 months, dose 3
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)
2022-02-16
Call 1 — Could Not Reach Participant
2022-02-21
Call 2 — Left Voicemail
2022-05-19
Survey response — 6 months, dose 3
MedDRA: Respiratory tract congestion — Feeling: Good · Be unable to do your normal daily activities

Free text: Chest congestion

MedDRA releases: 2024-11 · check-in free text available
2022-11-16
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Moderna
2	2021-02-24	Moderna
3	2021-11-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-11	Unsuccessful
2021-12-28	Unsuccessful
2022-02-15	Unsuccessful

Free text

Release 4 — day 21, dose 1

2021-02-19

Symptoms: slightly swollen nodes in arm pits, slight shortness of breath probably my asthma flare up

Release 4 — days 1–6 daily, dose 2

2021-02-28

Systemic reaction (other): Injection site bruising improving from day of injection

Release 5 — day 7, dose 2

2021-03-03

Systemic reaction (other): Chest tightness, lightheaded

Release 5 — day 14, dose 2

2021-03-11

Symptoms: Palpitations, tightness of my chest, shortness of breath, lightheadedness

Healthcare visit (other): Cardiologist office visit

Release 8 — 3 months, dose 2

2021-05-28

Symptoms: Congestion, sore throat

Release 9 — 6 months, dose 2

2021-08-25

Symptoms: Higher blood sugar levels. Could also be result of less physical activity?

Release 10 — day 14, dose 3

2021-11-30

Symptoms: Chest tightness . It May be asthma.

Release 10 — day 21, dose 3

2021-12-07

Symptoms: Congestion and right chest discomfort/ pressure

Release 10 — day 28, dose 3

2021-12-14

Symptoms: Chest tightness / congestion

Release 10 — day 35, dose 3

2021-12-22

Symptoms: Chest tighhtness

Release 10 — day 42, dose 3

2021-12-28

Symptoms: Discomfort across chest area and chest congestion . Tender areas around rib cage in chest.

Release 11 — 3 months, dose 3

2022-02-15

Symptoms: Jan 6 started Sore throat, low grade fever , chest congestion, phlegm, cough. Currently have a lingering occasional cough,

Release 11 — 6 months, dose 3

2022-05-19

Symptoms: Chest congestion

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	Asthma	✓	✓	✓
SD	Blood glucose increased	✓	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Cough	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Musculoskeletal chest pain	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Productive cough	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓

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