ZVA-12122-59976

2 vaccinations 16 coded responses 18 check-ins 16 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 629 / IL
Registered: 2021-04-04

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

2021-03-24
Dose 1 — Moderna
2021-04-04
Registered in v-safe
2021-04-04
Survey response — day 7, dose 1
MedDRA: Dizziness — Feeling: Poor · 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: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 14, dose 1
MedDRA: Asthenia, Somnolence, Taste disorder — Feeling: Poor · Be unable to do your normal daily activities

Free text: More sleeping. Food tastes horrible. No energy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-27
Dose 2 — Moderna
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Nasal congestion, Oropharyngeal 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: Cough, stuffy nose, sore throat, had to use my inhalor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Constipation, Feeling abnormal — Feeling: Poor · Site: Pain, Swelling, 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: Constipation, brain fog,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Brain fog, dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Nasal congestion, Oropharyngeal pain — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Stuffy nose and cough, sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Dizziness, Dyspnoea, Nasal congestion, Oropharyngeal pain — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Hard to breathe, sore throat, stuffy nose, dizzy,brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Survey response — day 7, dose 2
MedDRA: Cough, Dizziness, Dyspnoea, Feeling abnormal — Feeling: Poor · 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: Brain fog , short of breath, cough, dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — day 14, dose 2
MedDRA: Abdominal pain upper, Decreased appetite, Muscle spasms — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sharp pains in stomach. Horrible leg cramps. Don't want to eat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — day 21, dose 2
MedDRA: Abdominal pain upper, Dyspnoea, Fatigue, Headache, Nausea, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Horrible body pain. Stomach hurts to even touch. Queasy. Headache. Very tired. Hard to breathe.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Survey response — day 28, dose 2
MedDRA: Asthenia, Decreased appetite, Dyspnoea, Feeding disorder, Headache, Pre-existing disease, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: You needed better research before having people with autoimmune systems take the shot. I have been getting worse. It is really hard to breathe. Worse headache. More weakness. Hard to eat. Don't want to eat. I should have not had the shots · Healthcare visit (other): Appointments and tests

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-01
Survey response — day 35, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities

Free text: You dont care so why bother.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-08
Survey response — day 42, dose 2
MedDRA: Abdominal pain upper, Decreased appetite, Dyspnoea, Feeling abnormal — Feeling: Poor · Be unable to do your normal daily activities

Free text: I feel worse every day. Harder to breathe. No appetite. Stomach pain all the time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-27
Survey response — 3 months, dose 2
MedDRA: Chest pain, Cough, Dyspnoea, Dyspnoea exertional, Gait disturbance, Nasal congestion, Pain, Painful respiration, Rhinorrhoea — Feeling: Poor · Be unable to do your normal daily activities

Free text: Full body severe pain. Really hard to breathe. Hurts my chest to inhale. Difficulty walking. Can't stand without losing my breath. Stuffy runny nose. Cough.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-26
Survey response — 6 months, dose 2
MedDRA: Brain fog, Cough, Dyspnoea, Gait disturbance, Headache, Middle ear effusion, Oropharyngeal pain, Staphylococcal infection, Ulcer — Feeling: Poor · Be unable to do your normal daily activities

Free text: Big sores with MRSA . Worse headache. Harder to walk. Brain fog. Hard to breathe. Water behind both ear drums. Sore throat. Cough.

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Health check-in — 12 months, dose 2
Feeling: Poor

Adult check-in
2022-04-29
Callback requested for
10:00AM ET
2022-05-03
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna
2	2021-04-27	Moderna

Call center

1 call center case

1 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 6 — day 7, dose 1

2021-04-04

Systemic reaction (other): Dizziness

Release 7 — day 14, dose 1

2021-04-07

Symptoms: More sleeping. Food tastes horrible. No energy.

Release 8 — days 1–6 daily, dose 2

2021-04-28

Systemic reaction (other): Cough, stuffy nose, sore throat, had to use my inhalor

2021-04-29

Systemic reaction (other): Constipation, brain fog,

2021-04-30

Systemic reaction (other): Brain fog, dizzy

2021-05-01

Systemic reaction (other): Brain fog

2021-05-02

Systemic reaction (other): Stuffy nose and cough, sore throat

2021-05-03

Systemic reaction (other): Hard to breathe, sore throat, stuffy nose, dizzy,brain fog

Release 8 — day 7, dose 2

2021-05-04

Systemic reaction (other): Brain fog , short of breath, cough, dizzy

Release 8 — day 14, dose 2

2021-05-11

Symptoms: Sharp pains in stomach. Horrible leg cramps. Don't want to eat.

Release 8 — day 21, dose 2

2021-05-18

Symptoms: Horrible body pain. Stomach hurts to even touch. Queasy. Headache. Very tired. Hard to breathe.

Release 8 — day 28, dose 2

2021-05-25

Symptoms: You needed better research before having people with autoimmune systems take the shot. I have been getting worse. It is really hard to breathe. Worse headache. More weakness. Hard to eat. Don't want to eat. I should have not had the shots

Healthcare visit (other): Appointments and tests

Release 8 — day 35, dose 2

2021-06-01

Symptoms: You dont care so why bother.

Release 8 — day 42, dose 2

2021-06-08

Symptoms: I feel worse every day. Harder to breathe. No appetite. Stomach pain all the time

Release 9 — 3 months, dose 2

2021-07-27

Symptoms: Full body severe pain. Really hard to breathe. Hurts my chest to inhale. Difficulty walking. Can't stand without losing my breath. Stuffy runny nose. Cough.

Release 10 — 6 months, dose 2

2021-10-26

Symptoms: Big sores with MRSA . Worse headache. Harder to walk. Brain fog. Hard to breathe. Water behind both ear drums. Sore throat. Cough.

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	Unevaluable event	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Chest pain	✓	·	✓
SD	Cough	✓	·	✓
SD	Decreased appetite	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Dyspnoea exertional	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeding disorder	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Gait disturbance	✓	·	✓
SD	Headache	✓	✓	✓
SD	Middle ear effusion	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Nasal congestion	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Painful respiration	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rhinorrhoea	✓	·	✓
SD	Somnolence	✓	✓	✓
SD	Staphylococcal infection	·	·	✓
SD	Taste disorder	✓	✓	✓
SD	Ulcer	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Brain fog	✓	✓	✓
SRO	Constipation	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓

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