ZT6-26111-29747

2 vaccinations 9 coded responses 27 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 385 / TN
Registered: 2021-03-16

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

2021-03-16
Registered in v-safe
2021-03-16
Dose 1 — Moderna
2021-03-16
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Glossodynia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Sores on tongue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches

Adult check-in
2021-03-30
Survey response — day 14, dose 1
MedDRA: Muscle discomfort, Myalgia, Pruritus, Rash erythematous, Skin warm — Feeling: Fair · Be unable to do your normal daily activities

Free text: On 3/27/21 the muscle in my arm near injection site became hot to the touch, sore, itch and uncomfortable. The next day there was also a red rash. I also had muscle aches. It has improved somewhat but not gone away.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-13
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-14
Dose 2 — Moderna
2021-04-14
Survey response — day 0, dose 2
MedDRA: Pre-existing disease, Tinnitus — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Seems to have caused chronic tinnitus to flare

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Ear pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-04-16
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-21
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-28
Survey response — day 14, dose 2
MedDRA: Muscle spasms, Sleep disorder — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscle cramps in feet and calf that wake me up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-26
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Muscle spasms, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Worsened sleep apnea and muscle cramps.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-14
Survey response — 3 months, dose 2
MedDRA: Asthma, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Asthma · Healthcare visit (other): Primary care

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-14
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)
2021-07-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-14
Survey response — 6 months, dose 2
MedDRA: Asthma — Feeling: Fair

Free text: Asthma diagnosis

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Survey response — 12 months, dose 2
MedDRA: COVID-19 — Feeling: Good · Be unable to do your normal daily activities

Free text: Covid

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Moderna
2	2021-04-14	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-16	Successful
2021-05-26	Successful
2021-07-14	Successful 2021-07-22	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Sores on tongue

Release 6 — day 14, dose 1

2021-03-30

Symptoms: On 3/27/21 the muscle in my arm near injection site became hot to the touch, sore, itch and uncomfortable. The next day there was also a red rash. I also had muscle aches. It has improved somewhat but not gone away.

Release 7 — day 0, dose 2

2021-04-14

Systemic reaction (other): Seems to have caused chronic tinnitus to flare

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Ear pain

Release 8 — day 14, dose 2

2021-04-28

Symptoms: Muscle cramps in feet and calf that wake me up.

Release 8 — day 42, dose 2

2021-05-26

Symptoms: Worsened sleep apnea and muscle cramps.

Release 9 — 3 months, dose 2

2021-07-14

Symptoms: Asthma

Healthcare visit (other): Primary care

Release 10 — 6 months, dose 2

2021-10-14

Symptoms: Asthma diagnosis

Release 11 — 12 months, dose 2

2022-04-14

Symptoms: Covid

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	Asthma	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Muscle discomfort	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Skin warm	✓	✓	✓
SD	Sleep disorder	·	·	✓
SRO	Ear pain	✓	✓	✓
SRO	Glossodynia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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