ZVN-72109-45934

4 vaccinations 3 coded responses 32 check-ins 3 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 548 / WI
Registered: 2021-01-07

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Survey response — day 0, dose 1
MedDRA: Angioedema, Hypoaesthesia, Hypoaesthesia oral, Swelling face — Feeling: Fair

Free text: Angioedema- right sided facial swelling, numbness on right lower lip, entire right side of head, and right side of esophagus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — day 7, dose 1
Feeling: Fair · Headache

Adult check-in
2021-01-22
Survey response — day 14, dose 1
MedDRA: Diarrhoea, Headache, Nausea — Feeling: Good · Be unable to work

Free text: Diarrhea and nausea, frequent headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-04
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-12
Dose 3 — Moderna
2022-02-04
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-09-30
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-10-18
Survey response — day 14, dose 4
MedDRA: Cough, Dyspnoea, Exposure to SARS-CoV-2, Illness, SARS-CoV-2 test negative, Wheezing — Feeling: Good · 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, Outpatient clinic or urgent care clinic visit

Free text: Persistent shortness of breath, wheezing, cough that have remained for 8 months since likely having covid (daughter and husband positive, I only tested negative). Continue with 2 inhalers daily for relief of symptoms, none previous to illness.

MedDRA releases: 2024-11 · check-in free text available
2022-10-18
Report sent to call center — day 14, dose 4
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-19
Call 1 — Left Voicemail
2022-10-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-21
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-04
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-13
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-03-31
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2021-11-12	Moderna	No
4	2022-09-30	Pfizer-BioNTech	Flu

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 1 — day 0, dose 1

2021-01-07

Systemic reaction (other): Angioedema- right sided facial swelling, numbness on right lower lip, entire right side of head, and right side of esophagus

Release 2 — day 14, dose 1

2021-01-22

Symptoms: Diarrhea and nausea, frequent headaches

Release 12 — day 14, dose 4

2022-10-18

Symptoms: Persistent shortness of breath, wheezing, cough that have remained for 8 months since likely having covid (daughter and husband positive, I only tested negative). Continue with 2 inhalers daily for relief of symptoms, none previous to illness.

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	Cough	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Headache	✓	✓	✓
SD	Illness	·	·	✓
SD	Nausea	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Wheezing	·	·	✓
SRO	Angioedema	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Swelling face	✓	✓	✓

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