27X-48427-00353

5 vaccinations 6 coded responses 42 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 853 / AZ
Registered: 2021-04-17

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

2021-04-17
Registered in v-safe
2021-04-17
Dose 1 — Moderna
2021-04-17
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Brain fog, Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Feel very weak. Brain feels slighly fuzzy. Kind of like Covid-19 brain fog but not as bad.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-01
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-14
Dose 2 — Moderna
2021-05-16
Survey response — days 1–6 daily, dose 2
MedDRA: Retching — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Dry heaves

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-05-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-28
Survey response — day 14, dose 2
MedDRA: Office visit, Pain, Pre-existing disease, Surgery — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I had my second cataract surgery Wednesday. The pain was much worse than the first surgery on May 12 2021, which was before my 2nd vaccination on May 14, 2021 · Healthcare visit (other): Eye doctor office.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-18
Dose 3 — Moderna
2021-11-18
Health check-in — day 0, dose 3
Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-25
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-12-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-30
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-19
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-06
Call 1 — Could Not Reach Participant
2022-05-13
Call 2 — Left Voicemail
2022-05-19
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-23
Dose 4 — Pfizer-BioNTech
Co-administered: Tetanus
2022-05-26
Survey response — days 1–6 daily, dose 4
MedDRA: Retching — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Tue & wed had dry heaves. Severe both days. Today moderate

MedDRA releases: 2024-11 · check-in free text available
2022-05-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-30
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-07
Survey response — day 14, dose 4
MedDRA: Dizziness — Feeling: Good

Free text: I have been experiencing more lightheadedness than normal.

MedDRA releases: 2024-11 · check-in free text available
2022-06-15
Survey response — day 21, dose 4
MedDRA: Burning sensation, Pain in extremity, Varicophlebitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Pain (burning and aching) and inflammation in the bottom of my left calf. Appears to be towards the end of a vericose vein Started yesterday upon waking.

MedDRA releases: 2024-11 · check-in free text available
2022-06-15
Report sent to call center — day 21, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-16
Call 3 — Left Voicemail
2022-06-16
Call 1 — Left Voicemail
2022-06-16
Call successful
Participant prefers to complete VAERS report online
2022-06-16
Call successful
Participant prefers to complete VAERS report online
2022-06-20
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-28
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-04
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-22
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-24
Dose 5 — Pfizer-BioNTech

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-17	Moderna
2	2021-05-14	Moderna
3	2021-11-18	Moderna	No
4	2022-05-23	Pfizer-BioNTech	Tetanus
5	2022-10-24	Pfizer-BioNTech	No

Call center

2 call center cases

2 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-19

Systemic reaction (other): Feel very weak. Brain feels slighly fuzzy. Kind of like Covid-19 brain fog but not as bad.

Release 8 — days 1–6 daily, dose 2

2021-05-16

Systemic reaction (other): Dry heaves

Release 8 — day 14, dose 2

2021-05-28

Symptoms: I had my second cataract surgery Wednesday. The pain was much worse than the first surgery on May 12 2021, which was before my 2nd vaccination on May 14, 2021

Healthcare visit (other): Eye doctor office.

Release 11 — days 1–6 daily, dose 4

2022-05-26

Systemic reaction (other): Tue & wed had dry heaves. Severe both days. Today moderate

Release 11 — day 14, dose 4

2022-06-07

Symptoms: I have been experiencing more lightheadedness than normal.

Release 12 — day 21, dose 4

2022-06-15

Symptoms: Pain (burning and aching) and inflammation in the bottom of my left calf. Appears to be towards the end of a vericose vein Started yesterday upon waking.

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	✓	✓	✓
HCVO	Pain	✓	✓	✓
HCVO	Pre-existing disease	✓	✓	✓
SD	Burning sensation	·	·	✓
SD	Dizziness	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Surgery	✓	✓	✓
SD	Varicophlebitis	·	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Brain fog	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Retching	✓	✓	✓

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