ZP3-14848-62487

4 vaccinations 10 coded responses 34 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 990 / WA
Registered: 2021-02-01

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

2021-01-28
Dose 1 — Moderna
2021-02-01
Registered in v-safe
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lightheaded feeling

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

Adult check-in
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-18
Survey response — day 21, dose 1
MedDRA: Arthralgia, Back pain, Malaise, Myalgia, Neck pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Unwell feeling and fairly intense muscle ache starting in my neck and shoulders and gradually moving down my back. ~ 4 days. Now OK.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Dose 2 — Moderna
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · 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: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Joint pains, Fatigue or tiredness

Free text: Just some light headed was, dont know if it is vaccine related.

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: Good · Joint pains

Adult check-in
2021-03-03
Survey response — day 7, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — day 14, dose 2
MedDRA: Back pain, Fatigue — Feeling: Good

Free text: Back ache, fatigue after exertion. Now starting to improve.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-24
Survey response — day 28, dose 2
MedDRA: Arthralgia — Feeling: Fair

Free text: Joint pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — 3 months, dose 2
MedDRA: Nasopharyngitis — Feeling: Poor · Be unable to do your normal daily activities

Free text: Currently I have what seems to be a be a bad cold after stressful travel, but I dont think it has anything to do with the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-25
Survey response — 6 months, dose 2
MedDRA: Bronchitis — 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: Bronchitis

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-25
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call 2 — Left Voicemail
2021-11-13
Dose 3 — Moderna
2022-02-24
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-10-25
Dose 4 — Moderna
2022-10-26
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-10-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-10-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-10-29
Survey response — days 1–6 daily, dose 4
MedDRA: Asthenia, Hyperhidrosis — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Weakness, unusual sweating. Surprised I have still not fully recovered after so many days. Worst reaction since #2

MedDRA releases: 2024-11 · check-in free text available
2022-10-30
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-10-31
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-01
Health check-in — day 7, dose 4
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-08
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-15
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-11-22
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-01
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-06
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-24
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-25
Survey response — 6 months, dose 4
MedDRA: Bronchitis, Nasopharyngitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-04-25
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-04-26
Call 1 — Left Voicemail
2023-04-26
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-24	Moderna
3	2021-11-13	Moderna	No
4	2022-10-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-25	Unsuccessful
2023-04-25	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-01

Systemic reaction (other): Lightheaded feeling

Release 4 — day 21, dose 1

2021-02-18

Symptoms: Unwell feeling and fairly intense muscle ache starting in my neck and shoulders and gradually moving down my back. ~ 4 days. Now OK.

Release 4 — days 1–6 daily, dose 2

2021-03-01

Systemic reaction (other): Just some light headed was, dont know if it is vaccine related.

Release 5 — day 7, dose 2

2021-03-03

Systemic reaction (other): Brain fog

Release 5 — day 14, dose 2

2021-03-10

Symptoms: Back ache, fatigue after exertion. Now starting to improve.

Release 6 — day 28, dose 2

2021-03-24

Symptoms: Joint pain

Release 8 — 3 months, dose 2

2021-05-28

Symptoms: Currently I have what seems to be a be a bad cold after stressful travel, but I dont think it has anything to do with the vaccine.

Release 9 — 6 months, dose 2

2021-08-25

Symptoms: Bronchitis

Release 12 — days 1–6 daily, dose 4

2022-10-29

Systemic reaction (other): Weakness, unusual sweating. Surprised I have still not fully recovered after so many days. Worst reaction since #2

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	Arthralgia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Bronchitis	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Neck pain	✓	✓	✓
SRO	Asthenia	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hyperhidrosis	·	·	✓

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