ZX4-22228-54528

3 vaccinations 6 coded responses 27 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 503 / IA
Registered: 2021-03-22

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

2021-03-22
Registered in v-safe
2021-03-22
Dose 1 — Moderna
2021-03-22
Survey response — day 0, dose 1
MedDRA: Hypoaesthesia, Hypoaesthesia oral — Feeling: Good · Site: Pain, Redness

Free text: Numbness on left side of face and tongue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Diarrhea

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal pain — Feeling: Good

Free text: I had some abdominal pain last night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-17
Dose 2 — Moderna
2021-04-17
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Fever · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal stiffness — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Stiff neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-05-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-16
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Back pain, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Severe hip and lower back pain. · Healthcare visit (other): Steroid injection in SI joint.

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-22
Call 1 — Left Voicemail
2021-12-01
Dose 3 — Moderna
2022-04-18
Survey response — 12 months, dose 2
MedDRA: Gastrointestinal disorder, Nephrolithiasis — 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, Emergency room or emergency department visit

Free text: Kidney stone and GI illness.

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Report sent to call center — 12 months, dose 2
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 · Emergency room or emergency department visit · 1 call case(s)
2022-05-04
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-05-04
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-12-03
Survey response — 12 months, dose 3
MedDRA: Anal incontinence, Dehydration, Diarrhoea, Emergency care, Eye pain, Fatigue, Headache, Neck pain, Pyrexia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Explosive diarrhea w/fecal incontinence, headache, neck pain on right side, pain behind my right eye, low grade fever, fatigue. In ER for dehydration last Saturday and Monday. Still have diarrhea and fatigue. Eating solid food starting Wednesday.

MedDRA releases: 2024-11 · check-in free text available
2022-12-03
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · 1 call case(s)
2022-12-05
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-17	Moderna
3	2021-12-01	Moderna	No

Call center

3 call center cases

3 successful

VAERS report filed, before or during a call: 2

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-03-22

Systemic reaction (other): Numbness on left side of face and tongue

Release 6 — days 1–6 daily, dose 1

2021-03-25

Systemic reaction (other): I had some abdominal pain last night.

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Stiff neck

Release 10 — 6 months, dose 2

2021-10-16

Symptoms: Severe hip and lower back pain.

Healthcare visit (other): Steroid injection in SI joint.

Release 11 — 12 months, dose 2

2022-04-18

Symptoms: Kidney stone and GI illness.

Release 12 — 12 months, dose 3

2022-12-03

Symptoms: Explosive diarrhea w/fecal incontinence, headache, neck pain on right side, pain behind my right eye, low grade fever, fatigue. In ER for dehydration last Saturday and Monday. Still have diarrhea and fatigue. Eating solid food starting Wednesday.

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	Anal incontinence	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Dehydration	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Emergency care	·	·	✓
SD	Eye pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	·	·	✓
SD	Neck pain	·	·	✓
SD	Nephrolithiasis	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓

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