ZQD-21152-96667

2 vaccinations 9 coded responses 23 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 931 / CA
Registered: 2021-01-21

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

2021-01-20
Dose 1 — Moderna
2021-01-21
Registered in v-safe
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: Chills — Feeling: Fair · Site: Pain, Redness, Swelling · Chills

Free text: Slight chill on day 1 1/20/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Diarrhea

Free text: Alight - but it was yesterday after I checkedbin

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Survey response — day 14, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: UTI - however I had a UTI just prior to the baccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-02-22
Dose 2 — Moderna
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Fatigue, Headache, Pyrexia — Feeling: Fair · Site: Pain, Swelling · Be unable to work, Be unable to do your normal daily activities

Free text: I had chills, fever, headache, & extreme fatigue yesterday - the day following my vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Urinary tract infection — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: Don't know if tiredness is from my concurrent UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Headache

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

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

Adult check-in
2021-03-08
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-22
Survey response — day 28, dose 2
MedDRA: Myalgia, Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I have had a continuing UTI and also strange muscle aches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-05
Survey response — day 42, dose 2
MedDRA: Herpes virus infection, Stress — Feeling: Fair

Free text: Herpes from streas

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Survey response — 3 months, dose 2
MedDRA: Hypersensitivity, Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Had another UTI and severe allergic reaction to environmental favgors

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-11
Call 1 — Left Voicemail
2021-08-23
Health check-in — 6 months, dose 2
Feeling: Poor

Adult check-in
2022-02-24
Survey response — 12 months, dose 2
MedDRA: Cystitis interstitial, Urinary tract infection — Feeling: Fair · Be unable to do your normal daily activities

Free text: UTI and IC

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-22	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-03	Unsuccessful
2021-03-22	Unsuccessful
2021-05-24	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-21

Systemic reaction (other): Slight chill on day 1 1/20/21

2021-01-25

Systemic reaction (other): Alight - but it was yesterday after I checkedbin

Release 3 — day 14, dose 1

2021-02-03

Symptoms: UTI - however I had a UTI just prior to the baccine

Release 4 — days 1–6 daily, dose 2

2021-02-24

Systemic reaction (other): I had chills, fever, headache, & extreme fatigue yesterday - the day following my vaccine

2021-02-25

Systemic reaction (other): Don't know if tiredness is from my concurrent UTI

Release 6 — day 28, dose 2

2021-03-22

Symptoms: I have had a continuing UTI and also strange muscle aches.

Release 6 — day 42, dose 2

2021-04-05

Symptoms: Herpes from streas

Release 8 — 3 months, dose 2

2021-05-24

Symptoms: Had another UTI and severe allergic reaction to environmental favgors

Release 11 — 12 months, dose 2

2022-02-24

Symptoms: UTI and IC

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	Cystitis interstitial	·	·	✓
SD	Herpes virus infection	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Stress	✓	✓	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Urinary tract infection	✓	✓	✓

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