2PF-12200-13377

4 vaccinations 12 coded responses 44 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 786 / TX
Registered: 2021-01-22

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Moderna
2021-01-22
Survey response — day 0, dose 1
MedDRA: Injection site warmth — Feeling: Good · Site: Redness

Free text: Warm at injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site reaction, Sleep disorder, Somnolence — Feeling: Fair · Site: Pain, Swelling · Be unable to do your normal daily activities

Free text: Injection site kept me from sleeping last night!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Insomnia — Feeling: Fair · Site: Pain

Free text: The injection site was VERY painful starting about 8 hours after the injection. could not sleep night 1 due to the pain. night 2 much better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia — Feeling: Fair · Chills, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: could not sleep! wide awake ladt night!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to work

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness, Diarrhea · Be unable to work

Adult check-in
2021-03-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 21, dose 2
MedDRA: Abdominal distension, Flatulence — Feeling: Good

Free text: Bloating and gas in abdomen.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — day 35, dose 2
MedDRA: Ear pain, Headache, Oral pain, Toothache — Feeling: Poor · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Terrible tooth pain with referred pain through mouth, ear canal and skull.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Report sent to call center — day 35, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-10
Survey response — day 42, dose 2
MedDRA: Abdominal distension — Feeling: Good

Free text: Abdominal bloating.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Dyspnoea exertional — Feeling: Good · Be unable to do your normal daily activities

Free text: Shortness of breath at high altitude- could not walk far.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Call successful
Participant prefers to complete VAERS report online
2021-10-27
Dose 3 — Moderna
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Rhinorrhoea — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: sniffles, blowing nose

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-03
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-11-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-26
Survey response — 3 months, dose 3
MedDRA: Fatigue, Oropharyngeal pain, Rhinorrhoea — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat, fatigue, runny nose.

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Dose 4 — Moderna
2022-04-27
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-04-27
Survey response — 6 months, dose 3
MedDRA: Immunisation reaction, Rotator cuff syndrome — Feeling: Poor · 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, Outpatient clinic or urgent care clinic visit

Free text: Reaction to 2nd booster. Rotator cuff tear.

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-04-28
Call 1 — Left Voicemail
2022-04-29
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-06
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-13
Survey response — day 21, dose 4
MedDRA: Nasopharyngitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Head cold

MedDRA releases: 2024-11 · check-in free text available
2022-05-22
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-05
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-25	Moderna
3	2021-10-27	Moderna	No
4	2022-04-22	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-22

Systemic reaction (other): Warm at injection site.

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): Injection site kept me from sleeping last night!

2021-01-24

Systemic reaction (other): The injection site was VERY painful starting about 8 hours after the injection. could not sleep night 1 due to the pain. night 2 much better

2021-01-27

Systemic reaction (other): could not sleep! wide awake ladt night!

Release 5 — day 21, dose 2

2021-03-18

Symptoms: Bloating and gas in abdomen.

Release 6 — day 35, dose 2

2021-04-04

Symptoms: Terrible tooth pain with referred pain through mouth, ear canal and skull.

Release 7 — day 42, dose 2

2021-04-10

Symptoms: Abdominal bloating.

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: Shortness of breath at high altitude- could not walk far.

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): sniffles, blowing nose

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: Sore throat, fatigue, runny nose.

Release 11 — 6 months, dose 3

2022-04-27

Symptoms: Reaction to 2nd booster. Rotator cuff tear.

Release 11 — day 21, dose 4

2022-05-13

Symptoms: Head cold

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	Abdominal distension	✓	✓	✓
SD	Dyspnoea exertional	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Flatulence	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Immunisation reaction	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oral pain	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Rotator cuff syndrome	·	·	✓
SD	Toothache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site reaction	✓	·	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Sleep disorder	✓	·	✓
SRO	Somnolence	○	✓	○

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