2QR-28788-03168

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

Sex: Female
Age at first dose: 66+
ZIP prefix: 629 / IL
Registered: 2021-03-02

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

2021-01-23
Dose 1 — Moderna
2021-03-02
Registered in v-safe
2021-03-02
Dose 2 — Moderna
2021-03-02
Survey response — day 0, dose 2
MedDRA: Dizziness, Feeling abnormal — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Dizziness, brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Nausea

Free text: Dizziness, brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema — Feeling: Good · Site: Redness, Swelling, Itching

Free text: The redness has spread below the injection site and is bigger than yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Redness, Itching

Free text: Swollen lymph node on left side of my neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-31
Survey response — 6 months, dose 2
MedDRA: Hypersensitivity, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Lots more allergy problems. · Healthcare visit (other): Urgent care visit in my car.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-31
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-02
Call 1 — Left Voicemail
2021-10-28
Dose 3 — Moderna
2022-03-02
Survey response — 12 months, dose 2
MedDRA: Ear pain, Sinusitis, Unevaluable event, Vertigo — Feeling: Fair · 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: Inner ear pain, vertigo, sinus infection · Healthcare visit (other): MRI, CT scan, VGN, hearing test

MedDRA releases: 2024-11 · check-in free text available
2022-03-02
Report sent to call center — 12 months, dose 2
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)
2022-03-03
Call successful
Does not wish to fill out VAERS report
2022-05-26
Dose 4 — Moderna
2022-06-25
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-07
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-25
Survey response — 3 months, dose 4
MedDRA: Arthritis, Diverticulitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Arthritis in right hand, and diverticulitis in upper left abdomen area

MedDRA releases: 2024-11 · check-in free text available
2022-08-25
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-26
Call 1 — Left Voicemail
2022-11-24
Survey response — 6 months, dose 4
MedDRA: Flank pain, Gastrooesophageal reflux disease — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Severe pain in right side; ruled out heart problems. Probably gerd.

MedDRA releases: 2024-11 · check-in free text available
2022-11-24
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-11-25
Call 2 — Left Voicemail
2022-11-25
Call 1 — Left Voicemail
2023-05-26
Health check-in — 12 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-23	Moderna
2	2021-03-02	Moderna
3	2021-10-28	Moderna	No
4	2022-05-26	Moderna	No

Call center

4 call center cases

2 successful · 2 unsuccessful

See the call center timeline

Free text

Release 4 — day 0, dose 2

2021-03-02

Systemic reaction (other): Dizziness, brain fog

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Dizziness, brain fog

2021-03-05

Systemic reaction (other): The redness has spread below the injection site and is bigger than yesterday.

2021-03-07

Systemic reaction (other): Swollen lymph node on left side of my neck

Release 9 — 6 months, dose 2

2021-08-31

Symptoms: Lots more allergy problems.

Healthcare visit (other): Urgent care visit in my car.

Release 11 — 12 months, dose 2

2022-03-02

Symptoms: Inner ear pain, vertigo, sinus infection

Healthcare visit (other): MRI, CT scan, VGN, hearing test

Release 12 — 3 months, dose 4

2022-08-25

Symptoms: Arthritis in right hand, and diverticulitis in upper left abdomen area

Release 12 — 6 months, dose 4

2022-11-24

Symptoms: Severe pain in right side; ruled out heart problems. Probably gerd.

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	Office visit	✓	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthritis	·	·	✓
SD	Diverticulitis	·	·	✓
SD	Ear pain	·	·	✓
SD	Flank pain	·	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Hypersensitivity	✓	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Sinusitis	·	·	✓
SD	Vertigo	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓

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