ZTL-33885-58274

1 vaccination 7 coded responses 12 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 988 / WA
Registered: 2021-02-11

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

2021-02-10
Dose 1 — Moderna
2021-02-11
Registered in v-safe
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain, Immediate post-injection reaction — Feeling: Good · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: A little bit of chest pain for about half hour after getting the injection

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 · Site: Swelling · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Irritability — Feeling: Fair · Site: Swelling · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Irritable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: SARS-CoV-2 test negative — Feeling: Poor · Site: Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Called Covid testing negative test results

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-17
Health check-in — day 7, dose 1
Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-25
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-06
Survey response — day 21, dose 1
MedDRA: Unevaluable event — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Unsure if theres anything to do with the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Report sent to call center — day 21, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Survey response — day 28, dose 1
MedDRA: Impaired work ability, Nasopharyngitis, Pre-existing disease, SARS-CoV-2 test, Seizure — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: After the first shot my seizures started after not having them since 2018. I got really sick like a cold on steroids to the point the had me get a Covid test. I havent beenAble to work because of being sick.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — day 28, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Survey response — day 35, dose 1
MedDRA: Feeling abnormal, Headache, Mental impairment, Respiratory tract congestion, Rhinorrhoea, Seizure, Vision blurred — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Headaches, still having seizures, congestion and runny nose it switches up, very clouded mind cant focus or think right I wont get the second one

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Report sent to call center — day 35, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Survey response — day 42, dose 1
MedDRA: Feeling abnormal, Hypersensitivity, Infection, Respiratory tract congestion, Seizure — Feeling: Poor · Be unable to work

Free text: Still having seizures and still sick either congestions, infection, bad allergies, cloudy head

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-03
Call 1 — Could Not Reach Participant
2021-08-06
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-10	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-15	Unsuccessful
2021-03-06	Unsuccessful
2021-03-11	Unsuccessful
2021-03-19	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-11

Systemic reaction (other): A little bit of chest pain for about half hour after getting the injection

2021-02-14

Systemic reaction (other): Irritable

2021-02-15

Healthcare visit (other): Called Covid testing negative test results

Release 5 — day 21, dose 1

2021-03-06

Symptoms: Unsure if theres anything to do with the vaccine

Release 5 — day 28, dose 1

2021-03-11

Symptoms: After the first shot my seizures started after not having them since 2018. I got really sick like a cold on steroids to the point the had me get a Covid test. I havent beenAble to work because of being sick.

Release 5 — day 35, dose 1

2021-03-19

Symptoms: Headaches, still having seizures, congestion and runny nose it switches up, very clouded mind cant focus or think right I wont get the second one

Release 6 — day 42, dose 1

2021-03-24

Symptoms: Still having seizures and still sick either congestions, infection, bad allergies, cloudy head

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	SARS-CoV-2 test negative	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Impaired work ability	✓	✓	✓
SD	Infection	✓	✓	✓
SD	Mental impairment	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	SARS-CoV-2 test	✓	✓	✓
SD	Seizure	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SD	Vision blurred	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Irritability	✓	✓	✓

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