ZW6-98594-62714

2 vaccinations 7 coded responses 25 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 773 / TX
Registered: 2021-01-15

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-15
Registered in v-safe
2021-01-15
Dose 1 — Moderna
2021-01-15
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia — Feeling: Fair · Site: Pain, Redness · Chills, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Loss of taste for food

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Decreased appetite — Feeling: Fair · Chills · Be unable to do your normal daily activities

Free text: Continue with loss of taste and no apple

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia — Feeling: Fair · Chills · Be unable to do your normal daily activities

Free text: Continued loss of taste

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia — Feeling: Good · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Loss of taste is improving. Eating a little more

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — day 7, dose 1
MedDRA: Ageusia, Night sweats — Feeling: Fair · Chills · Be unable to do your normal daily activities

Free text: Loss of taste is improving continuing with night sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-12
Dose 2 — Moderna
2021-02-12
Health check-in — day 0, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · None · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · None · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · None · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None · Be unable to do your normal daily activities

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-02-19
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-02-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 42, dose 2
MedDRA: Peripheral swelling, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Swollen feet for the past 6 weeks. I thought it was gout, will have diagnosis by my podiatrist on Tuesday, March 30th

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — 3 months, dose 2
MedDRA: Gout, Joint swelling, Office visit, Peripheral swelling, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Swelling in both feet and ankles. My gout returned around the end of March. Took Naproxen as ordered by my podiatrist for approximately 25 days. However, swelling has remained. · Healthcare visit (other): Doctor office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-14
Call successful
Does not wish to fill out VAERS report
2021-08-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-13
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-12	Moderna

Call center

3 call center cases

1 successful · 2 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): Loss of taste for food

2021-01-18

Systemic reaction (other): Continue with loss of taste and no apple

2021-01-19

Systemic reaction (other): Continued loss of taste

2021-01-21

Systemic reaction (other): Loss of taste is improving. Eating a little more

Release 2 — day 7, dose 1

2021-01-22

Systemic reaction (other): Loss of taste is improving continuing with night sweats

Release 6 — day 42, dose 2

2021-03-26

Symptoms: Swollen feet for the past 6 weeks. I thought it was gout, will have diagnosis by my podiatrist on Tuesday, March 30th

Release 8 — 3 months, dose 2

2021-05-14

Symptoms: Swelling in both feet and ankles. My gout returned around the end of March. Took Naproxen as ordered by my podiatrist for approximately 25 days. However, swelling has remained.

Healthcare visit (other): Doctor office visit

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	Gout	✓	✓	✓
SD	Joint swelling	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Ageusia	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Night sweats	✓	✓	✓

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