2GM-13450-06911

2 vaccinations 7 coded responses 16 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 923 / CA
Registered: 2021-03-20

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

2021-03-17
Dose 1 — Moderna
2021-03-20
Registered in v-safe
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness, Swelling · None

Adult check-in
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Breast swelling, Breast tenderness, Muscular weakness — Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Muscle weakness, swollen + tender breasts outer (quardrants)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Breast swelling, Breast tenderness — Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Swelling + tenderness both breasts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 7, dose 1
MedDRA: Breast tenderness — Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Swollen tender outer quadrants of both breasts.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-14
Dose 2 — Moderna
2021-04-21
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-28
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-05-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-14
Survey response — 3 months, dose 2
MedDRA: Unevaluable event, Vascular stenosis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Vascular stenosis of head and carotid. · Healthcare visit (other): CT, MRI-MRA

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-14
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-23
Call 1 — Left Voicemail
2021-10-13
Survey response — 6 months, dose 2
MedDRA: Carotid artery stenosis, Retinal artery occlusion, Supraventricular tachycardia, Unevaluable event — 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, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: SVT's, Right Carotid high grade stenosis, Right Eye Stoke... · Healthcare visit (other): OCT, CTs with & wow contrast, MRI

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-14
Call 1 — Left Voicemail
2022-04-17
Survey response — 12 months, dose 2
MedDRA: Unevaluable event, Visual impairment — 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, Emergency room or emergency department visit

Free text: Symptoms: Vision problems - anomalies in vision that are not caused by retinal tears or bleeds. Possibly caused by neuro pathway interruptions. ??? · Healthcare visit (other): Optical tests

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Report sent to call center — 12 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 · Emergency room or emergency department visit · 1 call case(s)
2022-04-19
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Moderna
2	2021-04-14	Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-21

Systemic reaction (other): Moderate

2021-03-22

Systemic reaction (other): Muscle weakness, swollen + tender breasts outer (quardrants)

2021-03-23

Systemic reaction (other): Swelling + tenderness both breasts

Release 6 — day 7, dose 1

2021-03-24

Systemic reaction (other): Swollen tender outer quadrants of both breasts.

Release 9 — 3 months, dose 2

2021-07-14

Symptoms: Vascular stenosis of head and carotid.

Healthcare visit (other): CT, MRI-MRA

Release 10 — 6 months, dose 2

2021-10-13

Symptoms: SVT's, Right Carotid high grade stenosis, Right Eye Stoke...

Healthcare visit (other): OCT, CTs with & wow contrast, MRI

Release 11 — 12 months, dose 2

2022-04-17

Symptoms: Vision problems - anomalies in vision that are not caused by retinal tears or bleeds. Possibly caused by neuro pathway interruptions. ???

Healthcare visit (other): Optical tests

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	Unevaluable event	✓	✓	✓
SD	Carotid artery stenosis	·	·	✓
SD	Retinal artery occlusion	·	·	✓
SD	Supraventricular tachycardia	·	·	✓
SD	Vascular stenosis	✓	✓	✓
SD	Visual impairment	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Breast swelling	✓	✓	✓
SRO	Breast tenderness	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓

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