2BK-24089-87182

4 vaccinations 18 coded responses 40 check-ins 18 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 906 / CA
Registered: 2021-02-14

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

2021-02-13
Dose 1 — Moderna
2021-02-14
Registered in v-safe
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Eye irritation, Heart rate increased, Ocular hyperaemia, Rhinorrhoea, Sinus congestion, Sneezing — Feeling: Fair · Site: Pain, Swelling · 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: Elevated heart rate of 107, dizziness, burning eyes, red eyes, sinus congestion, runny nose, sneezing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Eye irritation, Photophobia — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Eye burning , sensitivity to light

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pain, Vision blurred — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Blurry vision, eye pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzyness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-02-20
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-06
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-13
Dose 2 — Moderna
2021-03-13
Survey response — day 0, dose 2
MedDRA: Oropharyngeal pain, Throat tightness — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: About one hour after the injection it felt like my thriat closed up a little and became sore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate abnormal — Feeling: Fair · Site: Pain · 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: Heart rate of 102

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Eye irritation, Sinus disorder — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Eyes burning, sinus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Somnolence — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Sleepiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches · Be unable to work

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches · Be unable to work

Adult check-in
2021-03-20
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Muscle or body aches · Be unable to work

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-10
Survey response — day 28, dose 2
MedDRA: Bacterial vaginosis, Brain fog, Dizziness, Feeling abnormal, Urinary tract infection — Feeling: Fair · Be unable to do your normal daily activities

Free text: Urinary tract infection, BV, brain fog, occasional lightheadedness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-11
Survey response — 6 months, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Possible Sjogrens Syndrome

MedDRA releases: 2024-11 · check-in free text available
2021-09-11
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-16
Call successful
Participant prefers to complete VAERS report online
2021-10-22
Dose 3 — Moderna
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-13
Survey response — day 21, dose 3
MedDRA: Neuropathy peripheral, Pain — Feeling: Fair

Free text: Increasing pain, neuropathy.

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Survey response — day 28, dose 3
MedDRA: Neuropathy peripheral — Feeling: Fair · Be unable to do your normal daily activities

Free text: Neuropathy worsening

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Survey response — day 35, dose 3
MedDRA: Neuropathy peripheral — Feeling: Fair

Free text: Neuropathy,

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-21
Survey response — 3 months, dose 3
MedDRA: Sciatica — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sciatica

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Dose 4 — Moderna
2022-04-22
Survey response — 6 months, dose 3
MedDRA: Dizziness, Electrocardiogram QT prolonged, Hospitalisation, Nausea, Vertigo — 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: Dizziness, vertigo, nausea, hospitalization, lengthened QT.

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Report sent to call center — 6 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)
2022-04-25
Call successful
Participant prefers to complete VAERS report online
2022-05-14
Survey response — day 21, dose 4
MedDRA: Hospitalisation, Implantable cardiac monitor insertion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Hospitalization, loop recorder

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Survey response — day 28, dose 4
MedDRA: Arrhythmia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Exhaustion, arrythmia

MedDRA releases: 2024-11 · check-in free text available
2022-05-24
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-05-30
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-18
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-17
Survey response — 6 months, dose 4
MedDRA: COVID-19 — Feeling: Fair · Be unable to do your normal daily activities

Free text: Had Covid 19 on 08/25/2022 for the 2nd time.

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Moderna
2	2021-03-13	Moderna
3	2021-10-22	Moderna	No
4	2022-04-18	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-14

Systemic reaction (other): Elevated heart rate of 107, dizziness, burning eyes, red eyes, sinus congestion, runny nose, sneezing

2021-02-15

Systemic reaction (other): Eye burning , sensitivity to light

2021-02-16

Systemic reaction (other): Blurry vision, eye pain

2021-02-17

Systemic reaction (other): Dizzyness

Release 5 — day 0, dose 2

2021-03-13

Systemic reaction (other): About one hour after the injection it felt like my thriat closed up a little and became sore.

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): Heart rate of 102

2021-03-15

Systemic reaction (other): Eyes burning, sinus

2021-03-16

Systemic reaction (other): Sleepiness

Release 7 — day 28, dose 2

2021-04-10

Symptoms: Urinary tract infection, BV, brain fog, occasional lightheadedness.

Release 9 — 6 months, dose 2

2021-09-11

Symptoms: Possible Sjogrens Syndrome

Release 10 — day 21, dose 3

2021-11-13

Symptoms: Increasing pain, neuropathy.

Release 10 — day 28, dose 3

2021-11-21

Symptoms: Neuropathy worsening

Release 10 — day 35, dose 3

2021-11-27

Symptoms: Neuropathy,

Release 11 — 3 months, dose 3

2022-01-21

Symptoms: Sciatica

Release 11 — 6 months, dose 3

2022-04-22

Symptoms: Dizziness, vertigo, nausea, hospitalization, lengthened QT.

Release 11 — day 21, dose 4

2022-05-14

Symptoms: Hospitalization, loop recorder

Release 11 — day 28, dose 4

2022-05-16

Symptoms: Exhaustion, arrythmia

Release 12 — 6 months, dose 4

2022-10-17

Symptoms: Had Covid 19 on 08/25/2022 for the 2nd time.

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	Arrhythmia	·	·	✓
SD	Bacterial vaginosis	✓	✓	✓
SD	Brain fog	✓	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Electrocardiogram QT prolonged	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling abnormal	✓	✓	○
SD	Hospitalisation	·	·	✓
SD	Implantable cardiac monitor insertion	·	·	✓
SD	Nausea	·	·	✓
SD	Neuropathy peripheral	·	·	✓
SD	Pain	·	·	✓
SD	Sciatica	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Urinary tract infection	✓	✓	✓
SD	Vertigo	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Eye irritation	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Heart rate abnormal	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Ocular hyperaemia	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Photophobia	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Throat tightness	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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