ZNU-33832-43399

4 vaccinations 8 coded responses 34 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 115 / NY
Registered: 2021-03-13

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

2021-02-11
Dose 1 — Moderna
2021-03-11
Dose 2 — Moderna
2021-03-13
Registered in v-safe
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Chills, Erythema, Fatigue, Headache, Nausea, Pain, Pyrexia, Swelling face, Vomiting — Feeling: Fair · Site: Pain, Swelling, Itching · Be unable to do your normal daily activities

Free text: 3/11 and 3/12 had headache, body aches, chills, joint pains, muscle body aches, fatigue and tiredness, nausea, vomiting, red puffy face and fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Fatigue, Headache, Malaise, Myalgia — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: I cant remember if I checked off yesterdays symptoms 3/13 bc so out of it. Had headache, muscle body aches and fatigue/ exhaustion - symtoms were severe 3/11/21- 3/12/21. Some dizziness today too.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-09
Dose 3 — Moderna
2021-12-10
Survey response — days 1–6 daily, dose 3
MedDRA: Eye pain — 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

Free text: Eye pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Survey response — days 1–6 daily, dose 3
MedDRA: Energy increased, Eye pain, Photophobia, Sensitive skin, Tinnitus — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I can't recall if I mentioned eye pain for the first two days. Sensitivity to light. Skin was very sensitive. And was wired since I received the booster. I finally fell asleep 42 hours later. And ringing in ears. Today still some ringing in ears.

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Survey response — days 1–6 daily, dose 3
MedDRA: Energy increased, Tinnitus — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness

Free text: Wired. Ears ringing a little

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-12-16
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain, Redness, Itching · Fatigue or tiredness

Adult check-in
2021-12-23
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-30
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-08
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-15
Survey response — day 35, dose 3
MedDRA: Fatigue, Nausea, Respiratory tract congestion — Feeling: Good

Free text: Tired, Nausea and congestion

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-11
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-09
Survey response — 6 months, dose 3
MedDRA: Ageusia, Anosmia, Asthma, COVID-19, Chest discomfort, Chills, Cough, Eye pain, Fatigue, Headache, Nausea, Palpitations, Photophobia, Respiratory tract congestion, Sensitive skin, Sneezing — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Had covid. Very congested. Eyes hurt. Sensitivity to light. Headache. Some chills. Skin sensitivity. Very mild nausea I sometimes. Cough and Sneezed at times. Lost most of sense of smell and taste. Very tired. Tight in chest. Heart racing. Asthma

MedDRA releases: 2024-11 · check-in free text available
2022-06-09
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-22
Dose 4 — Moderna
2022-11-02
Survey response — day 7, dose 4
MedDRA: Eye pain, Photophobia — Feeling: Good · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Eye pain. Sensitivity to light

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-12
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-03
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-21
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-22
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-11	Moderna
3	2021-12-09	Moderna	No
4	2022-10-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-06-09	Successful 2022-06-10	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): 3/11 and 3/12 had headache, body aches, chills, joint pains, muscle body aches, fatigue and tiredness, nausea, vomiting, red puffy face and fever

2021-03-14

Systemic reaction (other): I cant remember if I checked off yesterdays symptoms 3/13 bc so out of it. Had headache, muscle body aches and fatigue/ exhaustion - symtoms were severe 3/11/21- 3/12/21. Some dizziness today too.

Release 10 — days 1–6 daily, dose 3

2021-12-10

Systemic reaction (other): Eye pain

2021-12-11

Systemic reaction (other): I can't recall if I mentioned eye pain for the first two days. Sensitivity to light. Skin was very sensitive. And was wired since I received the booster. I finally fell asleep 42 hours later. And ringing in ears. Today still some ringing in ears.

2021-12-12

Systemic reaction (other): Wired. Ears ringing a little

Release 10 — day 35, dose 3

2022-01-15

Symptoms: Tired, Nausea and congestion

Release 12 — 6 months, dose 3

2022-06-09

Symptoms: Had covid. Very congested. Eyes hurt. Sensitivity to light. Headache. Some chills. Skin sensitivity. Very mild nausea I sometimes. Cough and Sneezed at times. Lost most of sense of smell and taste. Very tired. Tight in chest. Heart racing. Asthma

Release 12 — day 7, dose 4

2022-11-02

Systemic reaction (other): Eye pain. Sensitivity to light

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
SD	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Asthma	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Eye pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Nausea	·	·	✓
SD	Palpitations	·	·	✓
SD	Photophobia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sensitive skin	·	·	✓
SD	Sneezing	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Energy increased	·	·	✓
SRO	Erythema	✓	✓	✓
SRO	Eye pain	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Photophobia	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Sensitive skin	·	·	✓
SRO	Swelling face	✓	✓	✓
SRO	Tinnitus	·	·	✓
SRO	Vomiting	✓	✓	✓

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