2P6-87092-74961

4 vaccinations 14 coded responses 22 check-ins 14 free-text entries 8 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 147 / NY
Registered: 2021-04-22

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

2021-03-25
Dose 1 — Moderna
2021-04-22
Registered in v-safe
2021-04-22
Dose 2 — Moderna
2021-04-22
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Office visit — Feeling: Fair · Headache · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Dizziness · Healthcare visit (other): In-office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness. It seems milder today. Hopefully it wont worsen in the evening.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Headache, Fatigue or tiredness

Free text: minor dizziness, not as bad

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — day 7, dose 2
MedDRA: Headache, Migraine, Musculoskeletal stiffness, Office visit, Pre-existing disease — Feeling: Fair · Headache · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Stiff neck · Healthcare visit (other): In-office with regular physician. Headache may not be connected to vaccine. Recurrance of migranes which Id been free of for some years.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — day 7, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — day 35, dose 2
MedDRA: Pain in extremity — Feeling: Good

Free text: Pain in L arm that goes from 4 above elbow to 4 below elbow. No injury to connect it to although have been more sctive with outdoor activities.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Survey response — day 42, dose 2
MedDRA: Arthralgia, Pain in extremity, Physiotherapy — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Left arm and knee pain, likely due to physical activity. · Healthcare visit (other): Physical therapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-22
Survey response — 3 months, dose 2
MedDRA: Headache, Neck pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Neck pain, headaches.

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Survey response — 6 months, dose 2
MedDRA: Dizziness, Fatigue, Headache, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Severe headaches, Dizziness, fatigue. · Healthcare visit (other): In person visit with doctors

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2021-10-22
Call 1 — Could Not Reach Participant
2021-10-27
Call 2 — Left Voicemail
2021-10-27
Call successful
Participant prefers to complete VAERS report online
2021-11-12
Dose 3 — Moderna
2022-03-30
Dose 4 — Moderna
2022-04-22
Survey response — 12 months, dose 2
MedDRA: Herpes zoster — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Light case of shingles

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-25
Call 1 — Left Voicemail
2022-04-25
Call successful
Does not wish to fill out VAERS report
2022-05-01
Survey response — day 28, dose 4
MedDRA: Herpes zoster — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Very Mild case of shingles April 2022

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-02
Call 1 — Left Voicemail
2022-05-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-11
Survey response — day 42, dose 4
MedDRA: Migraine, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Migraine increase lately.

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-12
Call successful
Participant prefers to complete VAERS report online
2022-05-12
Call successful
Participant prefers to complete VAERS report online
2022-05-12
Call successful
Participant prefers to complete VAERS report online
2022-05-12
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-01
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-29
Survey response — 6 months, dose 4
MedDRA: Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Rash on arm after Pfizer bivalent booster.

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-30
Call 1 — Left Voicemail
2022-09-30
Call successful
Participant prefers to complete VAERS report online
2023-04-05
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-25	Moderna
2	2021-04-22	Moderna
3	2021-11-12	Moderna	No
4	2022-03-30	Moderna	No

Call center

8 call center cases

8 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-23

Systemic reaction (other): Dizziness

2021-04-25

Systemic reaction (other): Dizziness

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): Dizziness

Healthcare visit (other): In-office visit

2021-04-27

Systemic reaction (other): Dizziness. It seems milder today. Hopefully it wont worsen in the evening.

2021-04-28

Systemic reaction (other): minor dizziness, not as bad

Release 8 — day 7, dose 2

2021-04-29

Systemic reaction (other): Stiff neck

Healthcare visit (other): In-office with regular physician. Headache may not be connected to vaccine. Recurrance of migranes which Id been free of for some years.

Release 8 — day 35, dose 2

2021-05-27

Symptoms: Pain in L arm that goes from 4 above elbow to 4 below elbow. No injury to connect it to although have been more sctive with outdoor activities.

Release 8 — day 42, dose 2

2021-06-03

Symptoms: Left arm and knee pain, likely due to physical activity.

Healthcare visit (other): Physical therapy

Release 9 — 3 months, dose 2

2021-07-22

Symptoms: Neck pain, headaches.

Release 10 — 6 months, dose 2

2021-10-21

Symptoms: Severe headaches, Dizziness, fatigue.

Healthcare visit (other): In person visit with doctors

Release 11 — 12 months, dose 2

2022-04-22

Symptoms: Light case of shingles

Release 11 — day 28, dose 4

2022-05-01

Symptoms: Very Mild case of shingles April 2022

Release 11 — day 42, dose 4

2022-05-11

Symptoms: Migraine increase lately.

Release 12 — 6 months, dose 4

2022-09-29

Symptoms: Rash on arm after Pfizer bivalent booster.

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	Headache	✓	✓	✓
HCVO	Migraine	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Physiotherapy	✓	✓	✓
HCVO	Pre-existing disease	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Herpes zoster	·	·	✓
SD	Migraine	·	·	✓
SD	Neck pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓

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