ZRA-89111-33656

5 vaccinations 20 coded responses 32 check-ins 20 free-text entries 4 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 328 / FL
Registered: 2021-04-06

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-05
Dose 1 — Moderna
2021-04-02
Dose 2 — Moderna
2021-04-06
Registered in v-safe
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Hypersensitivity, Lethargy, Pain, Pre-existing disease, Pyrexia — Feeling: Fair · Site: Redness · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: 4/3 I had fever, body aches and lethargy on 4/4 I got Covid Arm and fever at night. Yesterday 4/5 I felt weak and allergic.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain — Feeling: Good · Headache, Fatigue or tiredness

Free text: Yesterday it was mostly abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-18
Survey response — day 14, dose 2
MedDRA: Abdominal pain upper, Constipation, Gastritis, Gastrooesophageal reflux disease — Feeling: Good

Free text: I experienced inflamation in my stomach like IBS. Stomach aches, acid reflux, constipation,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — day 21, dose 2
MedDRA: Fatigue, Heart rate increased, Respiratory tract congestion — Feeling: Fair

Free text: Tired, congested chest and resting heart rate creeping up 2 points per day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — day 28, dose 2
MedDRA: Asthma, Fatigue, Inflammation, Pruritus, Tongue pruritus, Urticaria — Feeling: Fair · Be unable to do your normal daily activities

Free text: My immune system is overreacting to everything on a daily basis. Hives, itchy tongue for no reason, skin itchiness, asthma at night. Feels like an inflamatory reaction. Makes me want to take a steroid to quiet the cytokenes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-02
Survey response — 3 months, dose 2
MedDRA: Hypersensitivity, Inflammation — 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

Free text: Auto immune issues, inflamation, unexplained allergies and reactions.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-07
Call 1 — Could Not Reach Participant
2021-07-12
Call 2 — Could Not Reach Participant
2021-10-02
Survey response — 6 months, dose 2
MedDRA: Inflammation, Pruritus — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Exagerated immune responses. Similar to whole body allergies. Itching, inflamation. Had to take prednisone

MedDRA releases: 2024-11 · check-in free text available
2021-10-02
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-07
Call 1 — Left Voicemail
2021-10-22
Dose 3 — Moderna
2021-10-31
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-06
Survey response — day 14, dose 3
MedDRA: Headache, Paranasal sinus discomfort — Feeling: Good

Free text: Head aches and sinus pressure

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Survey response — day 28, dose 3
MedDRA: Asthma, Cough, Productive cough — Feeling: Good

Free text: Asthma (coughing and flegm)

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-04-22
Survey response — 6 months, dose 3
MedDRA: Fatigue, Weight increased — Feeling: Fair

Free text: Just tired gained weight.

MedDRA releases: 2024-11 · check-in free text available
2022-04-23
Dose 4 — Moderna
2022-05-18
Survey response — day 21, dose 4
MedDRA: Brain fog, Lethargy, Pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lethargy, foggy mind, body aches, low grade fever

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-28
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-06
Survey response — day 42, dose 4
MedDRA: Immune system disorder, Pre-existing disease, Pruritus — Feeling: Fair

Free text: Body itching and overreactive immune actions. Allergies.

MedDRA releases: 2024-11 · check-in free text available
2022-07-23
Survey response — 3 months, dose 4
MedDRA: Fatigue, Weight increased — Feeling: Fair · Be unable to do your normal daily activities

Free text: Just tired more than usual and weight gain. No other conditions

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Dose 5 — Moderna
2022-10-02
Survey response — days 1–6 daily, dose 5
MedDRA: Injection site reaction, Urticaria — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Huge welt (3 inches by 4 inches) on my arm where I got

MedDRA releases: 2024-11 · check-in free text available
2022-10-03
Survey response — days 1–6 daily, dose 5
MedDRA: Somnolence — Feeling: Poor · Site: Redness, Swelling, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sleepy

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Survey response — days 1–6 daily, dose 5
MedDRA: Dizziness, Muscular weakness — Feeling: Poor · Site: Redness · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Light headed, weak legs

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Report sent to call center — days 1–6 daily, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-06
Survey response — days 1–6 daily, dose 5
MedDRA: Paraesthesia — Feeling: Fair · Site: Itching · Fatigue or tiredness

Free text: Prickly feelings around my body. But now on prednisone.

MedDRA releases: 2024-11 · check-in free text available
2022-10-06
Call successful
Participant prefers to complete VAERS report online
2022-10-06
Call successful
Participant prefers to complete VAERS report online
2022-10-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-07
Survey response — day 7, dose 5
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school

Free text: Light headed

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-23
Survey response — day 21, dose 5
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigued?

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Survey response — day 28, dose 5
MedDRA: Heart rate increased, Lethargy, Vertigo — 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 · Telehealth, virtual health, or email health consultation

Free text: Lethargy and vertigo - high resting heart rate

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Report sent to call center — day 28, 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)
2022-10-31
Call 1 — Left Voicemail
2022-11-01
Call 2 — Requested Callback
2022-11-02
Callback requested for
02:00PM ET
2022-11-02
Call successful
Participant prefers to complete VAERS report online
2022-11-05
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-13
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-03-31
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-02	Moderna
3	2021-10-22	Moderna	No
4	2022-04-23	Moderna	No
5	2022-09-30	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-02	Successful 2022-10-06	Participant prefers to complete VAERS report online
2021-10-02	Successful 2022-10-06	Participant prefers to complete VAERS report online
2022-10-05	Successful 2022-10-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-28	Successful 2022-11-02	Participant prefers to complete VAERS report online

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): 4/3 I had fever, body aches and lethargy on 4/4 I got Covid Arm and fever at night. Yesterday 4/5 I felt weak and allergic.

2021-04-08

Systemic reaction (other): Yesterday it was mostly abdominal pain

Release 7 — day 14, dose 2

2021-04-18

Symptoms: I experienced inflamation in my stomach like IBS. Stomach aches, acid reflux, constipation,

Release 7 — day 21, dose 2

2021-04-23

Symptoms: Tired, congested chest and resting heart rate creeping up 2 points per day.

Release 8 — day 28, dose 2

2021-04-30

Symptoms: My immune system is overreacting to everything on a daily basis. Hives, itchy tongue for no reason, skin itchiness, asthma at night. Feels like an inflamatory reaction. Makes me want to take a steroid to quiet the cytokenes.

Release 9 — 3 months, dose 2

2021-07-02

Symptoms: Auto immune issues, inflamation, unexplained allergies and reactions.

Release 9 — 6 months, dose 2

2021-10-02

Symptoms: Exagerated immune responses. Similar to whole body allergies. Itching, inflamation. Had to take prednisone

Release 10 — day 14, dose 3

2021-11-06

Symptoms: Head aches and sinus pressure

Release 10 — day 28, dose 3

2021-11-19

Symptoms: Asthma (coughing and flegm)

Release 11 — 6 months, dose 3

2022-04-22

Symptoms: Just tired gained weight.

Release 11 — day 21, dose 4

2022-05-18

Symptoms: Lethargy, foggy mind, body aches, low grade fever

Release 11 — day 42, dose 4

2022-06-06

Symptoms: Body itching and overreactive immune actions. Allergies.

Release 12 — 3 months, dose 4

2022-07-23

Symptoms: Just tired more than usual and weight gain. No other conditions

Release 12 — days 1–6 daily, dose 5

2022-10-02

Systemic reaction (other): Huge welt (3 inches by 4 inches) on my arm where I got

2022-10-03

Systemic reaction (other): Sleepy

2022-10-05

Systemic reaction (other): Light headed, weak legs

2022-10-06

Systemic reaction (other): Prickly feelings around my body. But now on prednisone.

Release 12 — day 7, dose 5

2022-10-07

Systemic reaction (other): Light headed

Release 12 — day 21, dose 5

2022-10-23

Symptoms: Fatigued?

Release 12 — day 28, dose 5

2022-10-28

Symptoms: Lethargy and vertigo - high resting heart rate

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	Abdominal pain upper	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Constipation	✓	✓	✓
SD	Cough	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastritis	✓	✓	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Headache	·	·	✓
SD	Heart rate increased	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Immune system disorder	·	·	✓
SD	Inflammation	✓	✓	✓
SD	Lethargy	·	·	✓
SD	Pain	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Productive cough	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Tongue pruritus	✓	✓	✓
SD	Urticaria	✓	✓	✓
SD	Vertigo	·	·	✓
SD	Weight increased	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Injection site reaction	·	·	✓
SRO	Lethargy	✓	✓	✓
SRO	Muscular weakness	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Paraesthesia	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Somnolence	·	·	✓
SRO	Urticaria	·	·	✓

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