ZQD-14815-95092

5 vaccinations 18 coded responses 45 check-ins 18 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 992 / WA
Registered: 2021-01-28

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

2021-01-27
Dose 1 — Moderna
2021-01-28
Registered in v-safe
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Lower respiratory tract infection, Nasal congestion — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Nasal congestion, a bit of "chest cold" sensation in the chest. No coughing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Epistaxis, Parosmia — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Since receiving the vaccine i have felt lightheaddness. The second night after shot i had a bad nosebleed during the night. For the first three days i also had intermittent scent oddities: it was a floral scent, not one i use nor any cleaning products, and i live alone. Smelled this both inside ,& outdoors and in my car. Not unpleasant, just odd.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — day 7, dose 1
Feeling: Good · Muscle or body aches

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

Adult check-in
2021-02-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-24
Dose 2 — Moderna
2021-02-24
Health check-in — day 0, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Nasal congestion — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Nasal congestion, some light headedness, taking aspirin & tylenol. First night after vaccine was much rougher than the first shot. Took ibuprofen & tylenol instead of usual aspirin. Worked much better. (I use aspirin for arthritis because other NSAIDs affect my kidney function). Yesterday ibuprofen also worked better than aspirin.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Headache increased overnight. More pronounced than after first shot, and more pronounced than prior days after this latest shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Headache is pretty annoying. Pain is mostly on entire left side of head. Not debilitating like a migraine but i hope it goes away soon.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Free text: The bad headache i had since the shot finally broke during the night. Hurray!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Headache is back today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — day 7, dose 2
MedDRA: Eye disorder, Headache, Respiratory tract congestion — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Just this pesky headache. Worse if i stand up suddenly or bend over, much like sinusitis or bad head cold. Not a migraine, seems associated with the mild congestion i have had since shot. Even after 8 days, without at least some ibuprofen every four hours i am really cross eyed. Otherwise, i would really be fine. Appreciate these checkins-thx for listening. Hope feedback is useful for stats.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — day 14, dose 2
MedDRA: Headache — Feeling: Good · Be unable to do your normal daily activities

Free text: The headache! It is not new or worsening, but continuing. Though, the last 2 days it has been less.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
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: Fair

Adult check-in
2021-05-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-06
Dose 3 — Moderna
2022-02-24
Survey response — 12 months, dose 2
MedDRA: Coronary arterial stent insertion, Myocardial infarction — 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 · Emergency room or emergency department visit, Hospitalization

Free text: Heart Attack 10-16-21 w/2 stents placed, 3rd stent 12-7-21

MedDRA releases: 2024-11 · check-in free text available
2022-02-24
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-02-28
Call 1 — Could Not Reach Participant
2022-03-03
Call 2 — Could Not Reach Participant
2022-05-18
Dose 4 — Moderna
2022-05-25
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2022-06-04
Survey response — day 14, dose 4
MedDRA: Angina unstable, Hospitalisation — 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 · Emergency room or emergency department visit, Hospitalization

Free text: Unstable angina led to current hospitalization with upcoming heart bypass surgery.

MedDRA releases: 2024-11 · check-in free text available
2022-06-04
Report sent to call center — day 14, 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-06-06
Call 3 — Requested Callback
2022-06-06
Call 1 — Requested Callback
2022-06-07
Call X — Left Voicemail
2022-06-07
Call 2 — Left Voicemail
2022-06-07
Callback requested for
02:00PM ET
2022-06-15
Survey response — day 28, dose 4
MedDRA: Coronary artery bypass — 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 · Emergency room or emergency department visit, Hospitalization

Free text: Underwent quadruple bypass heart surgery

MedDRA releases: 2024-11 · check-in free text available
2022-06-15
Report sent to call center — day 28, 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-06-16
Call 1 — Left Voicemail
2022-06-22
Survey response — day 35, dose 4
MedDRA: Cough — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Persistent cough

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Report sent to call center — day 35, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-29
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-08-17
Survey response — 3 months, dose 4
MedDRA: Anosmia, COVID-19, Coronary artery bypass, Cough, Malaise, SARS-CoV-2 test negative, Secretion discharge, Unevaluable event — 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, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Quadruple heart bypass surgery 6/7/22. From 6/19 to 7/4 was quite ill (as was my daughter age 48) with what appears to have been Covid. Negative rapid tests, but extremely severe cough & heavy mucous and 1 month loss of smell. Tx codeine expectorant · Healthcare visit (other): Chest xray

MedDRA releases: 2024-11 · check-in free text available
2022-08-17
Report sent to call center — 3 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-11
Dose 5 — Moderna
Co-administered: Flu
2022-10-12
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-10-13
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-14
Survey response — days 1–6 daily, dose 5
MedDRA: Ear pain — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Ears mildly aching

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-16
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-17
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-21
Health check-in — day 7, dose 5
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-25
Survey response — day 14, dose 5
MedDRA: Chest pain, Fatigue, Hypertension, Pain in jaw, Unevaluable event — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Chest pain, hpb, fatigue, jaw pain, · Healthcare visit (other): Echocardiogram appt

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Report sent to call center — day 14, 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

Emergency room or emergency department visit · 1 call case(s)
2022-10-26
Call 1 — Left Voicemail
2022-11-01
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-11-09
Survey response — day 28, dose 5
MedDRA: Viral infection — Feeling: Fair

Free text: Chest virus

MedDRA releases: 2024-11 · check-in free text available
2022-11-15
Survey response — day 35, dose 5
MedDRA: Acute sinusitis, Cough — Feeling: Poor · Be unable to work or attend school, 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: Acute sinusitis, acute cough

MedDRA releases: 2024-11 · check-in free text available
2022-11-15
Report sent to call center — day 35, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-16
Call 2 — Left Voicemail
2022-11-16
Call 1 — Left Voicemail
2022-11-23
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-01-12
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-04-12
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Moderna
2	2021-02-24	Moderna
3	2021-12-06	Moderna	No
4	2022-05-18	Moderna	No
5	2022-10-11	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-02-24	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-04	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-15	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-22	Successful 2022-06-23	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-17	Successful 2022-08-19	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-25	Unsuccessful
2022-11-15	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-28

Systemic reaction (other): Nasal congestion, a bit of "chest cold" sensation in the chest. No coughing.

2021-01-31

Systemic reaction (other): Since receiving the vaccine i have felt lightheaddness. The second night after shot i had a bad nosebleed during the night. For the first three days i also had intermittent scent oddities: it was a floral scent, not one i use nor any cleaning products, and i live alone. Smelled this both inside ,& outdoors and in my car. Not unpleasant, just odd.

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): Nasal congestion, some light headedness, taking aspirin & tylenol. First night after vaccine was much rougher than the first shot. Took ibuprofen & tylenol instead of usual aspirin. Worked much better. (I use aspirin for arthritis because other NSAIDs affect my kidney function). Yesterday ibuprofen also worked better than aspirin.

2021-02-27

Systemic reaction (other): Headache increased overnight. More pronounced than after first shot, and more pronounced than prior days after this latest shot.

2021-02-28

Systemic reaction (other): Headache is pretty annoying. Pain is mostly on entire left side of head. Not debilitating like a migraine but i hope it goes away soon.

2021-03-01

Systemic reaction (other): The bad headache i had since the shot finally broke during the night. Hurray!

2021-03-02

Systemic reaction (other): Headache is back today.

Release 5 — day 7, dose 2

2021-03-03

Systemic reaction (other): Just this pesky headache. Worse if i stand up suddenly or bend over, much like sinusitis or bad head cold. Not a migraine, seems associated with the mild congestion i have had since shot. Even after 8 days, without at least some ibuprofen every four hours i am really cross eyed. Otherwise, i would really be fine. Appreciate these checkins-thx for listening. Hope feedback is useful for stats.

Release 5 — day 14, dose 2

2021-03-10

Symptoms: The headache! It is not new or worsening, but continuing. Though, the last 2 days it has been less.

Release 11 — 12 months, dose 2

2022-02-24

Symptoms: Heart Attack 10-16-21 w/2 stents placed, 3rd stent 12-7-21

Release 11 — day 14, dose 4

2022-06-04

Symptoms: Unstable angina led to current hospitalization with upcoming heart bypass surgery.

Release 12 — day 28, dose 4

2022-06-15

Symptoms: Underwent quadruple bypass heart surgery

Release 12 — day 35, dose 4

2022-06-22

Symptoms: Persistent cough

Release 12 — 3 months, dose 4

2022-08-17

Symptoms: Quadruple heart bypass surgery 6/7/22. From 6/19 to 7/4 was quite ill (as was my daughter age 48) with what appears to have been Covid. Negative rapid tests, but extremely severe cough & heavy mucous and 1 month loss of smell. Tx codeine expectorant cut off by CDC

Healthcare visit (other): Chest xray

Release 12 — days 1–6 daily, dose 5

2022-10-14

Systemic reaction (other): Ears mildly aching

Release 12 — day 14, dose 5

2022-10-25

Symptoms: Chest pain, hpb, fatigue, jaw pain,

Healthcare visit (other): Echocardiogram appt

Release 12 — day 28, dose 5

2022-11-09

Symptoms: Chest virus

Release 12 — day 35, dose 5

2022-11-15

Symptoms: Acute sinusitis, acute cough

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	Unevaluable event	·	·	✓
SD	Acute sinusitis	·	·	✓
SD	Angina unstable	·	·	✓
SD	Anosmia	·	·	✓
SD	Chest pain	·	·	✓
SD	Coronary arterial stent insertion	·	·	✓
SD	Coronary artery bypass	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	·	·	✓
SD	Hypertension	·	·	✓
SD	Malaise	·	·	✓
SD	Myocardial infarction	·	·	✓
SD	Pain in jaw	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Secretion discharge	·	·	✓
SD	Viral infection	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear pain	·	·	✓
SRO	Epistaxis	✓	✓	✓
SRO	Eye disorder	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Lower respiratory tract infection	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Parosmia	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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