2GT-32665-40640

2 vaccinations 8 coded responses 13 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 801 / CO
Registered: 2021-03-19

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

2021-03-18
Dose 1 — Moderna
2021-03-19
Registered in v-safe
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-25
Health check-in — day 7, dose 1
Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Dose 2 — Moderna
2021-04-16
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Nausea

Adult check-in
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Vaccine positive rechallenge — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Back pain and almosr period pains. I have had a hysterectomy. Had the same pains first shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Lower back pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Severe back pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — day 7, dose 2
MedDRA: Anxiety, Back pain, Brain fog, Confusional state, Feeling abnormal, Headache, Paranoia, Vaccine positive rechallenge — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Accute severe back pain. This happened last time when I got the very first shot in the exact time frame. I am also extremely paranoid an anxious. I'm confused having brain fog.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — day 14, dose 2
MedDRA: Anxiety, Arthralgia, Back pain, Condition aggravated, Confusional state, Electric shock sensation, Mental impairment, Neck pain, Pain, Paranoia, Pre-existing disease, Reaction to previous exposure to any vaccine — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Anxiety, paranoia, pain. Brain zaps confusion. Back pain leg pain neck shoulders hoints. Its hard yo thinks. · Healthcare visit (other): mri. I have previous back injury. One week after the shot both times it became accute.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-09
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-10-19
Survey response — 6 months, dose 2
MedDRA: COVID-19 — Feeling: Poor · 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, Emergency room or emergency department visit

Free text: I have covid

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
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 · Emergency room or emergency department visit · 1 call case(s)
2021-10-20
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-16	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-19

Systemic reaction (other): Dizzy

Release 7 — days 1–6 daily, dose 2

2021-04-17

Systemic reaction (other): Back pain

2021-04-19

Systemic reaction (other): Back pain and almosr period pains. I have had a hysterectomy. Had the same pains first shot.

2021-04-20

Systemic reaction (other): Lower back pain.

2021-04-21

Systemic reaction (other): Severe back pain.

Release 7 — day 7, dose 2

2021-04-23

Systemic reaction (other): Accute severe back pain. This happened last time when I got the very first shot in the exact time frame. I am also extremely paranoid an anxious. I'm confused having brain fog.

Release 8 — day 14, dose 2

2021-04-30

Symptoms: Anxiety, paranoia, pain. Brain zaps confusion. Back pain leg pain neck shoulders hoints. Its hard yo thinks.

Healthcare visit (other): mri. I have previous back injury. One week after the shot both times it became accute.

Release 10 — 6 months, dose 2

2021-10-19

Symptoms: I have covid

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	Condition aggravated	✓	✓	✓
HCVO	Pre-existing disease	✓	✓	✓
HCVO	Reaction to previous exposure to any vaccine	✓	✓	✓
SD	Anxiety	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Confusional state	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Electric shock sensation	✓	✓	✓
SD	Mental impairment	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Paranoia	✓	✓	✓
SRO	Anxiety	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Brain fog	✓	·	✓
SRO	Confusional state	✓	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	○	✓	○
SRO	Headache	○	✓	○
SRO	Paranoia	✓	✓	✓
SRO	Vaccine positive rechallenge	✓	✓	✓

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