2QR-24138-91063

1 vaccination 6 coded responses 16 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 773 / TX
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

2021-03-20
Registered in v-safe
2021-03-20
Dose 1 — Moderna
2021-03-20
Survey response — day 0, dose 1
MedDRA: Anxiety, Hypoaesthesia, Hypoaesthesia oral, Paraesthesia, Paraesthesia oral — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: After shot had some axiety simptoms. Numness and tingles,in the hands,moulth-nose last 1 hour

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 · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Chest pain, Muscle spasms, Pain in extremity — Feeling: Poor · Site: Pain, Itching · 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: Chest pain- presure. Cramps,pooling pain in legs

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: Dizziness — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Light head.dizzy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Immunisation reaction, Muscle spasms, Self-medication, Unevaluable event — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Stil cramp in leg and chest (left side)mild · Healthcare visit (other): She said it has run thrue it course and she schedule the office visit in couple days. They told to tale ibuprofen and continiu my allergy pill.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-10
Survey response — day 21, dose 1
MedDRA: Ear pain, Headache, Lymphadenopathy, Self-medication — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: My lymphs are swollen. The Coller bone-neck tge Lymph size of quetter. My left sigght worse it is same side of vacination .My ears startying hurts and headeyck. · Healthcare visit (other): I will try yo see on monday. At yhus point i start taking benedryl and ibuprofen and steroid cream

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-17
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-04-24
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 42, dose 1
Feeling: Fair

Adult check-in
2021-06-19
Health check-in — 3 months, dose 1
Feeling: Fair

Adult check-in
2021-09-18
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2022-01-21
Call 1 — Left Voicemail
2022-03-21
Survey response — 12 months, dose 1
MedDRA: Ear infection, Fistula repair, Inflammation, Pain, Surgery, Unevaluable event — 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 · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I have a lot of inflammation for example Ear infections and on February 16th I had fistular surgery. I had a nut and then it started hurting and devolop like tunnel -line. · Healthcare visit (other): my first Surgery

MedDRA releases: 2024-11 · check-in free text available
2022-03-21
Report sent to call center — 12 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-22
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-20	Moderna

Call center

3 call center cases

3 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 6 — day 0, dose 1

2021-03-20

Systemic reaction (other): After shot had some axiety simptoms. Numness and tingles,in the hands,moulth-nose last 1 hour

Release 6 — days 1–6 daily, dose 1

2021-03-22

Systemic reaction (other): Chest pain- presure. Cramps,pooling pain in legs

2021-03-23

Systemic reaction (other): Light head.dizzy.

2021-03-24

Systemic reaction (other): Stil cramp in leg and chest (left side)mild

Healthcare visit (other): She said it has run thrue it course and she schedule the office visit in couple days. They told to tale ibuprofen and continiu my allergy pill.

Release 7 — day 21, dose 1

2021-04-10

Symptoms: My lymphs are swollen. The Coller bone-neck tge Lymph size of quetter. My left sigght worse it is same side of vacination .My ears startying hurts and headeyck.

Healthcare visit (other): I will try yo see on monday. At yhus point i start taking benedryl and ibuprofen and steroid cream

Release 11 — 12 months, dose 1

2022-03-21

Symptoms: I have a lot of inflammation for example Ear infections and on February 16th I had fistular surgery. I had a nut and then it started hurting and devolop like tunnel -line.

Healthcare visit (other): my first Surgery

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	Immunisation reaction	○	✓	○
HCVO	Self-medication	✓	✓	✓
HCVO	Surgery	·	·	✓
HCVO	Unevaluable event	○	✓	○
SD	Ear infection	·	·	✓
SD	Ear pain	✓	✓	✓
SD	Fistula repair	·	·	✓
SD	Headache	✓	✓	✓
SD	Inflammation	·	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Pain	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Paraesthesia oral	✓	✓	✓

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