26T-16075-91196

4 vaccinations 10 coded responses 32 check-ins 9 free-text entries 5 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 761 / TX
Registered: 2020-12-31

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2020-12-31
Registered in v-safe
2020-12-31
Dose 1 — Moderna
2020-12-31
Health check-in — day 0, dose 1
Feeling: Good · Fatigue or tiredness

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

Adult check-in
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site warmth — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Injection site warm to the touch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-07
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-14
Survey response — day 14, dose 1
MedDRA: Injection site rash — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Large rash on my upper left arm at the site of injection from day 8 to present.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-03-08
Call successful
Participant prefers to complete VAERS report online
2021-04-01
Survey response — 3 months, dose 1
MedDRA: Fatigue, Head discomfort, Headache, Sinusitis, Upper-airway cough syndrome — 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: Worst sinus infection ever. Headache, extreme fatigue, head/face pressure, post nasal drip.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Report sent to call center — 3 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-07
Call 1 — Left Voicemail
2021-07-03
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Myalgia — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Fatigue or tiredness

Free text: Left axillary and left breast muscle pain and soreness

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Myalgia — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sore axillary on the left side and left side breast muscle

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Myalgia — Feeling: Fair · Site: Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Free text: Sore muscles on left arm and left breast

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · Site: Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-08
Survey response — day 14, dose 3
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Exhaustion

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-08
Dose 4 — Moderna
2022-04-10
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-04-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-17
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-22
Survey response — day 14, dose 4
MedDRA: Asthenia, Brain fog, Decreased appetite, Emergency care, Fatigue, Memory impairment, Mental impairment, Nausea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Brain fog, nausea, fatigue, unable to form coherent thoughts, loss of appetite, memory issues, weakness, loss of mental coordination. Currently in the ER.

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
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

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-04-25
Call successful
Participant prefers to complete VAERS report online
2022-04-25
Call successful
Participant prefers to complete VAERS report online
2022-04-30
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-05-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-10-07
Survey response — 6 months, dose 4
MedDRA: Amnesia, Brain fog, Dizziness, Fatigue, Motor dysfunction, Nervous system disorder, Sensory loss, Speech disorder — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Neurological issues: brain fog, memory loss, fatigue, dizziness, loss of motor/sensory function, speech issues

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
Report sent to call center — 6 months, 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

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-10-10
Call successful
Participant prefers to complete VAERS report online
2023-04-09
Survey response — 12 months, dose 4
MedDRA: Nervous system disorder, Office visit — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-04-09
Report sent to call center — 12 months, 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

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2023-04-11
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-26	Moderna	No
3	2021-10-23	Moderna	No
4	2022-04-08	Moderna	No

Call center

5 call center cases

4 successful · 1 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-02

Systemic reaction (other): Injection site warm to the touch

Release 2 — day 14, dose 1

2021-01-14

Symptoms: Large rash on my upper left arm at the site of injection from day 8 to present.

Release 6 — 3 months, dose 1

2021-04-01

Symptoms: Worst sinus infection ever. Headache, extreme fatigue, head/face pressure, post nasal drip.

Release 10 — days 1–6 daily, dose 3

2021-10-26

Systemic reaction (other): Left axillary and left breast muscle pain and soreness

2021-10-27

Systemic reaction (other): Sore axillary on the left side and left side breast muscle

2021-10-28

Systemic reaction (other): Sore muscles on left arm and left breast

Release 10 — day 14, dose 3

2021-11-08

Symptoms: Exhaustion

Release 11 — day 14, dose 4

2022-04-22

Symptoms: Brain fog, nausea, fatigue, unable to form coherent thoughts, loss of appetite, memory issues, weakness, loss of mental coordination. Currently in the ER.

Release 12 — 6 months, dose 4

2022-10-07

Symptoms: Neurological issues: brain fog, memory loss, fatigue, dizziness, loss of motor/sensory function, speech issues

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	Amnesia	·	·	✓
SD	Asthenia	·	·	✓
SD	Brain fog	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Dizziness	·	·	✓
SD	Emergency care	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Head discomfort	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Memory impairment	·	·	✓
SD	Mental impairment	·	·	✓
SD	Motor dysfunction	·	·	✓
SD	Nausea	·	·	✓
SD	Nervous system disorder	·	·	✓
SD	Office visit	·	·	✓
SD	Sensory loss	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Speech disorder	·	·	✓
SD	Upper-airway cough syndrome	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Myalgia	·	·	✓

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