ZPU-20557-90692

3 vaccinations 7 coded responses 20 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 117 / NY
Registered: 2021-05-08

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

2021-04-08
Dose 1 — Moderna
2021-05-06
Dose 2 — Moderna
2021-05-08
Registered in v-safe
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-10
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Loss of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Headache · Be unable to do your normal daily activities

Adult check-in
2021-05-13
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-05-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — day 21, dose 2
MedDRA: Cough — Feeling: Good

Free text: Chronic cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-06
Survey response — 3 months, dose 2
MedDRA: Dyspnoea — Feeling: Fair

Free text: Occasionally feel like I cant breath

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-04
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-07
Dose 3 — Moderna
2022-05-02
Survey response — day 21, dose 3
MedDRA: Dyspnoea — Feeling: Fair · Be unable to work or attend school

Free text: Trouble breathing. Could be unrelated but it started after my booster.

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-05-12
Survey response — day 35, dose 3
MedDRA: Arthralgia, Gastrooesophageal reflux disease, Myalgia, Office visit, Pre-existing disease, Tooth disorder, Tooth injury — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Tons of joint and muscle pain. Could be related or not. I don't know. Also for some ungodly reason after the first injections I've developed acid reflux disease and it's eating the teeth out of my head despite medication and OCD oral care routine. · Healthcare visit (other): Saw GI Dr for endoscopy, seeing dentist who informed me that my teeth are doomed.

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-13
Call successful
Participant prefers to complete VAERS report online
2022-05-19
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-07-07
Survey response — 3 months, dose 3
MedDRA: Dizziness, Office visit, Tremor — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Trembling hands, light headedness, dizziness. Had full blood panel run and no obvious cause like blood sugar etc. As my doctor said, your blood work is "perfect". Also EKG was normal. · Healthcare visit (other): I visited my GP for blood work, ekg, and physical

MedDRA releases: 2024-11 · check-in free text available
2022-07-07
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

1 call case(s)
2022-07-08
Call 1 — Left Voicemail
2022-10-08
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2023-04-09
Survey response — 12 months, dose 3
MedDRA: Dizziness, Nausea, Somnolence — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-08	Moderna
2	2021-05-06	Moderna
3	2022-04-07	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-05-12	Successful 2022-05-13	Participant prefers to complete VAERS report online
2022-07-07	Unsuccessful

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-10

Systemic reaction (other): Loss of appetite

Release 8 — day 21, dose 2

2021-05-27

Symptoms: Chronic cough

Release 9 — 3 months, dose 2

2021-08-06

Symptoms: Occasionally feel like I cant breath

Release 11 — day 21, dose 3

2022-05-02

Symptoms: Trouble breathing. Could be unrelated but it started after my booster.

Release 11 — day 35, dose 3

2022-05-12

Symptoms: Tons of joint and muscle pain. Could be related or not. I don't know. Also for some ungodly reason after the first injections I've developed acid reflux disease and it's eating the teeth out of my head despite medication and OCD oral care routine. cut off by CDC

Healthcare visit (other): Saw GI Dr for endoscopy, seeing dentist who informed me that my teeth are doomed.

Release 12 — 3 months, dose 3

2022-07-07

Symptoms: Trembling hands, light headedness, dizziness. Had full blood panel run and no obvious cause like blood sugar etc. As my doctor said, your blood work is "perfect". Also EKG was normal.

Healthcare visit (other): I visited my GP for blood work, ekg, and physical

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	·	·	✓
HCVO	Tooth disorder	·	·	✓
SD	Arthralgia	·	·	✓
SD	Cough	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	✓	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	·	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Somnolence	·	·	✓
SD	Tooth injury	·	·	✓
SD	Tremor	·	·	✓
SRO	Decreased appetite	✓	✓	✓

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