ZSB-10114-59103

3 vaccinations 8 coded responses 20 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 450 / OH
Registered: 2021-02-10

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

2021-02-09
Dose 1 — Moderna
2021-02-10
Registered in v-safe
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My normal body temperature is in the 96-97 degree range

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

Free text: I have autoimmune hepatitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Sneezing, Throat irritation — Feeling: Good · Fatigue or tiredness

Free text: Lots of sneezing, raw throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2021-02-23
Health check-in — day 14, dose 1
Feeling: Good

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

Adult check-in
2021-03-09
Dose 2 — Moderna
2021-03-16
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-14
Survey response — day 35, dose 2
MedDRA: Fatigue, Neck pain — Feeling: Fair

Free text: I've had great fatigue the last few days and pain on the left side of my neck which comes and goes!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 42, dose 2
MedDRA: Headache, Neck pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have neck pain mostly on the left side up to the left back of my head- some in the right side as well. Mild nagging headache as well

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Survey response — 3 months, dose 2
MedDRA: Lymphadenopathy, Pain in jaw — Feeling: Good · 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: Not sure if this was since the last check in but recently had a left swollen gland with some ear and jaw pain. Doctor prescribed strong antibiotics and after 14 days was gone except for lingering mild jaw, ear sensation but no pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
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)
2021-09-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-09
Dose 3 — Moderna
2021-11-17
Call 1 — Left Voicemail
2021-12-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-10
Survey response — 6 months, dose 3
MedDRA: Asthenia, Hypersensitivity, Sneezing — Feeling: Good

Free text: I have developed allergies which I have not been able to pinpoint ! I sneeze alot and don't have my usual amount of energy !!

MedDRA releases: 2024-11 · check-in free text available
2022-09-10
Survey response — 12 months, dose 3
MedDRA: Dyspnoea exertional, Fatigue, Medical counselling — Feeling: Good

Free text: Lately, I have noticed more shortness of breath when walking or working outdoors. This, I have mentioned to my doctor. Because of that, there are times when im more fatigued as well.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-09	Moderna
2	2021-03-09	Moderna
3	2021-09-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-08	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): My normal body temperature is in the 96-97 degree range

2021-02-11

Systemic reaction (other): I have autoimmune hepatitis

2021-02-14

Systemic reaction (other): Lots of sneezing, raw throat

Release 7 — day 35, dose 2

2021-04-14

Symptoms: I've had great fatigue the last few days and pain on the left side of my neck which comes and goes!

Release 7 — day 42, dose 2

2021-04-22

Symptoms: I have neck pain mostly on the left side up to the left back of my head- some in the right side as well. Mild nagging headache as well

Release 8 — 3 months, dose 2

2021-06-08

Symptoms: Not sure if this was since the last check in but recently had a left swollen gland with some ear and jaw pain. Doctor prescribed strong antibiotics and after 14 days was gone except for lingering mild jaw, ear sensation but no pain

Release 11 — 6 months, dose 3

2022-03-10

Symptoms: I have developed allergies which I have not been able to pinpoint ! I sneeze alot and don't have my usual amount of energy !!

Release 12 — 12 months, dose 3

2022-09-10

Symptoms: Lately, I have noticed more shortness of breath when walking or working outdoors. This, I have mentioned to my doctor. Because of that, there are times when im more fatigued as well.

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	Asthenia	·	·	✓
SD	Dyspnoea exertional	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypersensitivity	·	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Medical counselling	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Pain in jaw	✓	✓	✓
SD	Sneezing	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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