24N-23751-44225

3 vaccinations 12 coded responses 34 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 554 / MN
Registered: 2021-03-30

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

2021-03-27
Dose 1 — Moderna
2021-03-30
Registered in v-safe
2021-03-30
Survey response — days 1–6 daily, dose 1
MedDRA: Hyperhidrosis, Injection site nodule, Mobility decreased, Oropharyngeal pain, Pain, Throat tightness — Feeling: Fair · Site: Pain, Swelling · 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: Sweats, tight throat, sore throat, knot or bulge in injection site,couldn't lift arm without pain or help from other arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema, Skin exfoliation — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting

Free text: My sin turned red and was peeling on one side of my neck (injection side)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Productive cough — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches

Free text: Forgot to mention phlegm in throat and coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-17
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-24
Dose 2 — Moderna
2021-04-24
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising, Pain in extremity — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Lump and pain in arm and a bruise on injection arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Oropharyngeal pain, Productive cough — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Sore throat, cough w/phlegm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Nausea

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-01
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-05-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-22
Survey response — day 28, dose 2
MedDRA: Arthralgia, Cough, Dyspnoea, Headache, Hyperhidrosis, Lethargy, Myalgia, Nausea, Oedema, Productive cough, Vomiting — Feeling: Poor · 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: Nausea,vomiting, cough,phlegm, edema,headache,shortness of breath, lethargy,dizziness, muscle and joint aches,sweats.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
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)
2021-05-29
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-24
Survey response — 3 months, dose 2
MedDRA: Chills, Headache, Hyperhidrosis, Lethargy, Nausea, Pain, Pyrexia, Vomiting — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fever,chills,sweats,headache body aches, nausea, vomiting and lethargy

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-23
Survey response — 6 months, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2021-10-23
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-26
Call 1 — Left Voicemail
2021-10-27
Call successful
Participant prefers to complete VAERS report online
2021-11-11
Dose 3 — Moderna
2021-11-14
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain, Productive cough, Pruritus, Retching, Secretion discharge — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: Lots of phlegm and mucus gagging me and extreme sore throat and itchy scalp.

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-17
Survey response — days 1–6 daily, dose 3
MedDRA: Productive cough — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Lots of foamy phlegm

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Survey response — day 7, dose 3
MedDRA: Productive cough, Secretion discharge — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Coughing up foamy mucus

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-02
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-09
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-16
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-10
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-05-12
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-13
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-27	Moderna
2	2021-04-24	Moderna
3	2021-11-11	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-30

Systemic reaction (other): Sweats, tight throat, sore throat, knot or bulge in injection site,couldn't lift arm without pain or help from other arm.

2021-03-31

Systemic reaction (other): My sin turned red and was peeling on one side of my neck (injection side)

2021-04-02

Systemic reaction (other): Forgot to mention phlegm in throat and coughing

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Lump and pain in arm and a bruise on injection arm

2021-04-27

Systemic reaction (other): Sore throat, cough w/phlegm

Release 8 — day 28, dose 2

2021-05-22

Symptoms: Nausea,vomiting, cough,phlegm, edema,headache,shortness of breath, lethargy,dizziness, muscle and joint aches,sweats.

Release 9 — 3 months, dose 2

2021-07-24

Symptoms: Fever,chills,sweats,headache body aches, nausea, vomiting and lethargy

Release 10 — 6 months, dose 2

2021-10-23

Symptoms: Shortness of breath

Release 10 — days 1–6 daily, dose 3

2021-11-14

Systemic reaction (other): Sore throat

2021-11-15

Systemic reaction (other): Lots of phlegm and mucus gagging me and extreme sore throat and itchy scalp.

2021-11-17

Systemic reaction (other): Lots of foamy phlegm

Release 10 — day 7, dose 3

2021-11-18

Systemic reaction (other): Coughing up foamy mucus

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	Arthralgia	✓	✓	✓
SD	Chills	✓	·	✓
SD	Cough	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Lethargy	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oedema	✓	✓	✓
SD	Pain	✓	·	✓
SD	Productive cough	✓	✓	✓
SD	Pyrexia	✓	·	✓
SD	Vomiting	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Erythema	✓	·	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site nodule	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Productive cough	✓	✓	✓
SRO	Pruritus	·	·	✓
SRO	Retching	·	·	✓
SRO	Secretion discharge	·	·	✓
SRO	Skin exfoliation	✓	✓	✓
SRO	Throat tightness	✓	✓	✓

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