ZP6-24624-17465

5 vaccinations 8 coded responses 37 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 488 / MI
Registered: 2021-02-19

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

2021-02-19
Registered in v-safe
2021-02-19
Dose 1 — Moderna
2021-02-19
Survey response — day 0, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Site: Pain · Headache, Nausea, Diarrhea

Free text: Suffer from chronic migraines and had migraine prior to injection. Also have IBS so unsure if vaccine related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal discomfort, Decreased appetite, Headache — Feeling: Fair · Site: Pain · Headache, Nausea

Free text: Upset stomach, no interest eating. Do suffer from chronic migraines so dont know if headache due to shot or just migrsine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain lower, Haematochezia, Mucous stools — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Severe bloody stool and bloody mucus stool starting 32 hrs post vaccine. Severe abdominal (lower) cramps

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Headache, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction, Decreased appetite — Feeling: Fair · Headache, Nausea, Abdominal pain · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): In appetence · Healthcare visit (other): Was regarding previous days symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Survey response — day 7, dose 1
MedDRA: Migraine — Feeling: Good · Headache

Free text: Do have chronic migraines so could be why have headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-19
Dose 2 — Moderna
2021-03-19
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Headache

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness · Headache, Fatigue or tiredness

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-26
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-30
Survey response — day 42, dose 2
MedDRA: Asthma, Pre-existing disease, Wheezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: More wheeze, asthma not as regulated (maybe weather related)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-19
Call 2 — Left Voicemail
2021-09-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-04
Dose 3 — Moderna
2021-12-05
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-02-03
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-03-30
Dose 4 — Moderna
2022-05-07
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-19
Dose 5 — Moderna
Co-administered: Flu
2022-09-28
Health check-in — day 7, dose 5
Feeling: Good · Headache

Adult check-in
2022-10-03
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-10
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-10-18
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-24
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-31
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-12-19
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-20
Survey response — 6 months, dose 5
MedDRA: Abdominal discomfort, COVID-19, Cough, Headache, Lethargy, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, Wheezing — 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 · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-03-20
Report sent to call center — 6 months, dose 5
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)
2023-03-22
Call 1 — Left Voicemail
2023-03-22
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-19	Moderna
2	2021-03-19	Moderna
3	2021-11-04	Moderna	No
4	2022-03-30	Moderna	No
5	2022-09-19	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-02-23	Unsuccessful
2023-03-20	Unsuccessful

Free text

Release 4 — day 0, dose 1

2021-02-19

Systemic reaction (other): Suffer from chronic migraines and had migraine prior to injection. Also have IBS so unsure if vaccine related

Release 4 — days 1–6 daily, dose 1

2021-02-20

Systemic reaction (other): Upset stomach, no interest eating. Do suffer from chronic migraines so dont know if headache due to shot or just migrsine

2021-02-21

Systemic reaction (other): Severe bloody stool and bloody mucus stool starting 32 hrs post vaccine. Severe abdominal (lower) cramps

2021-02-23

Systemic reaction (other): In appetence

Healthcare visit (other): Was regarding previous days symptoms

Release 4 — day 7, dose 1

2021-02-26

Systemic reaction (other): Do have chronic migraines so could be why have headache

Release 5 — day 0, dose 2

2021-03-19

Systemic reaction (other): Dizziness

Release 8 — day 42, dose 2

2021-04-30

Symptoms: More wheeze, asthma not as regulated (maybe weather related)

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	Adverse reaction	✓	✓	✓
SD	Abdominal discomfort	·	·	✓
SD	Asthma	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Headache	·	·	✓
SD	Lethargy	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Wheezing	✓	✓	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Abdominal pain lower	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Haematochezia	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Mucous stools	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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