2AN-26653-94652

5 vaccinations 15 coded responses 39 check-ins 12 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 601 / IL
Registered: 2021-02-28

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-29
Dose 1 — Moderna
2021-02-26
Dose 2 — Moderna
2021-02-28
Registered in v-safe
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Somnolence — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Free text: Drowsiness Sleeepiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Somnolence — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Free text: Drowsiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Somnolence — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Free text: Sleepiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — day 14, dose 2
Feeling: Good

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

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

Adult check-in
2021-04-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-30
Survey response — 3 months, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Worsening of usual reflux (GERD) symptoms -- NOT REALTED TO VACCINATION

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-10
Dose 3 — Moderna
Co-administered: Flu
2021-12-11
Survey response — days 1–6 daily, dose 3
MedDRA: Somnolence — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Free text: Drowsiness

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Survey response — days 1–6 daily, dose 3
MedDRA: Somnolence — Feeling: Good · Site: Pain, Swelling · Chills, Muscle or body aches, Fatigue or tiredness

Free text: Drowsiness

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-17
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-24
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-03-15
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-12
Call 1 — Left Voicemail
2022-06-11
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-08-12
Dose 4 — Moderna
2022-08-12
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · None

Adult check-in
2022-08-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-08-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-08-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-08-19
Survey response — day 7, dose 4
MedDRA: Somnolence — Feeling: Good

Free text: Sleeping more

MedDRA releases: 2024-11 · check-in free text available
2022-08-26
Survey response — day 14, dose 4
MedDRA: Constipation — Feeling: Good

Free text: Constipation

MedDRA releases: 2024-11 · check-in free text available
2022-09-02
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-09-09
Survey response — day 28, dose 4
MedDRA: Immunoglobulins increased, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: *NO symptoms*, but extremely ELEVATED Total IgE level, over 4000 (drawn 9/02, 20 days post-booster) done for follow-up of long-standing ABPA (Allergic Bronchopulmonary Aspergillosis)

MedDRA releases: 2024-11 · check-in free text available
2022-09-09
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-09-12
Call successful
Does not wish to fill out VAERS report
2022-09-12
Call successful
Does not wish to fill out VAERS report
2022-09-18
Survey response — day 35, dose 4
MedDRA: Asthma, Blood immunoglobulin E increased, Condition aggravated, Pre-existing disease — Feeling: Good

Free text: Elevated IgE, probable Allergic Bronchopulmonary Aspergillosis flare / asthma flare

MedDRA releases: 2024-11 · check-in free text available
2022-09-26
Survey response — day 42, dose 4
MedDRA: Asthma, Condition aggravated, Pre-existing disease — Feeling: Good

Free text: ABPA (Allergic Bronchopulmonary Aspergillosis) flare; asthma flare

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-12-19
Dose 5 — Moderna
2022-12-20
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-12-21
Survey response — days 1–6 daily, dose 5
MedDRA: Somnolence — Feeling: Good · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Free text: Sleepiness

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-12-23
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-12-30
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2023-01-02
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2023-01-09
Survey response — day 21, dose 5
MedDRA: Back pain — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-01-16
Survey response — day 28, dose 5
MedDRA: Back pain, Pre-existing disease, Spinal compression fracture — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11
2023-01-16
Report sent to call center — day 28, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2023-01-17
Call successful
Not applicable - Accidental Reporting
2023-01-24
Survey response — day 35, dose 5
MedDRA: Back pain, Medical counselling, Osteoporosis, Spinal compression fracture — 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 · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-01-24
Report sent to call center — day 35, dose 5
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 · 1 call case(s)
2023-01-25
Call successful
Not applicable - Accidental Reporting
2023-02-01
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-12-10	Moderna	Flu
4	2022-08-12	Moderna	No
5	2022-12-19	Moderna	No

Call center

4 call center cases

4 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-03-02

Systemic reaction (other): Drowsiness Sleeepiness

2021-03-03

Systemic reaction (other): Drowsiness

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Sleepiness

Release 8 — 3 months, dose 2

2021-05-30

Symptoms: Worsening of usual reflux (GERD) symptoms -- NOT REALTED TO VACCINATION

Release 10 — days 1–6 daily, dose 3

2021-12-11

Systemic reaction (other): Drowsiness

2021-12-12

Systemic reaction (other): Drowsiness

Release 12 — day 7, dose 4

2022-08-19

Systemic reaction (other): Sleeping more

Release 12 — day 14, dose 4

2022-08-26

Symptoms: Constipation

Release 12 — day 28, dose 4

2022-09-09

Symptoms: *NO symptoms*, but extremely ELEVATED Total IgE level, over 4000 (drawn 9/02, 20 days post-booster) done for follow-up of long-standing ABPA (Allergic Bronchopulmonary Aspergillosis)

Release 12 — day 35, dose 4

2022-09-18

Symptoms: Elevated IgE, probable Allergic Bronchopulmonary Aspergillosis flare / asthma flare

Release 12 — day 42, dose 4

2022-09-26

Symptoms: ABPA (Allergic Bronchopulmonary Aspergillosis) flare; asthma flare

Release 12 — days 1–6 daily, dose 5

2022-12-21

Systemic reaction (other): Sleepiness

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	Medical counselling	·	·	✓
SD	Asthma	·	·	✓
SD	Back pain	·	·	✓
SD	Blood immunoglobulin E increased	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Constipation	·	·	✓
SD	Immunoglobulins increased	·	·	✓
SD	Osteoporosis	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Spinal compression fracture	·	·	✓
SRO	Somnolence	✓	✓	✓

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