ZR3-44197-62864

5 vaccinations 7 coded responses 31 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 983 / WA
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-13
Health check-in — day 0, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-13
Report sent to call center — day 0, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Joint pains

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Joint pains, Muscle or body aches

Adult check-in
2021-01-20
Health check-in — day 7, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-01-27
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-22
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-11
Survey response — 3 months, dose 2
MedDRA: Cerebral disorder, Conjunctivitis, Essential tremor, Magnetic resonance imaging head abnormal, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: 1. Pink Eye2. MRI Diagnosis: Moderate White Matter Brain Disease3. Botox injections into larynx diagnosis: focal essential tremors in voice box, possible Spasmodic Dysphonia (neurological disease) · Healthcare visit (other): Primary Care Physician office visit, Neurologist office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
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
2021-08-10
Survey response — 6 months, dose 2
MedDRA: Nerve injury, Peripheral nerve injury — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Nerve damage in neck, shoulders, arms, and hands.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-10
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)
2021-08-18
Call 1 — Could Not Reach Participant
2021-11-01
Dose 3 — Moderna
2022-02-09
Survey response — 12 months, dose 2
MedDRA: Carpal tunnel syndrome, Gene mutation identification test positive, Surgery — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Diagnosed through genetic testing with CMT2N. Just had surgery on right hand for Carpal Tunnel Syndrome.

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Dose 4 — Moderna
2022-10-28
Dose 5 — Moderna
2022-10-30
Survey response — days 1–6 daily, dose 5
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Poor · Fever · Joint pains, Muscle or body aches, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: I have Charcot-Marie-Tooth Type 2N which is axonal nerve damage and muscle weakness. I feel the shot (this time) accentuated my CMT symptoms.

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Nausea

Adult check-in
2022-11-02
Survey response — days 1–6 daily, dose 5
MedDRA: Death — Feeling: Fair · Nausea

Free text: My husband died Monday

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Nausea

Adult check-in
2022-11-04
Survey response — day 7, dose 5
MedDRA: Hyperhidrosis — Feeling: Fair · Fever · Nausea · Be unable to do your normal daily activities

Free text: Extreme sweating

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Survey response — day 14, dose 5
MedDRA: Stress — Feeling: Good

Free text: Stress from losing my husband 10/31/2022.

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-11-25
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-12-02
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-12-09
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-01-27
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-04-28
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-09	Moderna
3	2021-11-01	Moderna	No
4	2022-05-05	Moderna	No
5	2022-10-28	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-13	priority 2/3
2021-05-11	Unsuccessful
2021-08-10	Unsuccessful

Free text

Release 8 — 3 months, dose 2

2021-05-11

Symptoms: 1. Pink Eye2. MRI Diagnosis: Moderate White Matter Brain Disease3. Botox injections into larynx diagnosis: focal essential tremors in voice box, possible Spasmodic Dysphonia (neurological disease)

Healthcare visit (other): Primary Care Physician office visit, Neurologist office visit

Release 9 — 6 months, dose 2

2021-08-10

Symptoms: Nerve damage in neck, shoulders, arms, and hands.

Release 11 — 12 months, dose 2

2022-02-09

Symptoms: Diagnosed through genetic testing with CMT2N. Just had surgery on right hand for Carpal Tunnel Syndrome.

Release 12 — days 1–6 daily, dose 5

2022-10-30

Systemic reaction (other): I have Charcot-Marie-Tooth Type 2N which is axonal nerve damage and muscle weakness. I feel the shot (this time) accentuated my CMT symptoms.

2022-11-02

Systemic reaction (other): My husband died Monday

Release 12 — day 7, dose 5

2022-11-04

Systemic reaction (other): Extreme sweating

Release 12 — day 14, dose 5

2022-11-11

Symptoms: Stress from losing my husband 10/31/2022.

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	✓	✓	✓
SD	Carpal tunnel syndrome	·	·	✓
SD	Cerebral disorder	✓	✓	✓
SD	Conjunctivitis	✓	✓	✓
SD	Essential tremor	✓	✓	✓
SD	Gene mutation identification test positive	·	·	✓
SD	Magnetic resonance imaging head abnormal	✓	✓	✓
SD	Nerve injury	✓	·	✓
SD	Peripheral nerve injury	✓	·	✓
SD	Stress	·	·	✓
SD	Surgery	·	·	✓
SRO	Condition aggravated	·	·	✓
SRO	Death	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Pre-existing disease	·	·	✓

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