2QZ-28045-48411

3 vaccinations 7 coded responses 12 check-ins 7 free-text entries 5 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 688 / NE
Registered: 2021-03-17

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

2021-02-26
Dose 1 — Moderna
2021-03-17
Registered in v-safe
2021-03-17
Survey response — day 14, dose 1
MedDRA: Headache, Occupational therapy, Office visit, Pain, Pain in extremity, Peripheral swelling, Pre-existing disease, Skin discolouration, Sleep disorder — 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: Right arm pain (same arm shot was given). On scale 1-10, 4 without movement; 9 with movement. From wrist to shoulder. Right hand purple. Entire arm and fingers swollen. Back of head pain. Wake up in pain during night. Unable to sleep. Do have Lupus. · Healthcare visit (other): Chiropractor, orthopedic dr., family dr., occupational therapist.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 14, dose 1
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)
2021-03-21
Health check-in — day 21, dose 1
Feeling: Poor

Adult check-in
2021-03-28
Dose 2 — Moderna
2021-03-28
Survey response — day 0, dose 2
MedDRA: Emotional disorder — Feeling: Good · Site: Pain, Redness, Swelling · Chills, Headache

Free text: Emotional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Dose 3 — Other-Unknown
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: General symptom — Feeling: Good · Site: Redness

Free text: This is 2nd shot only. Still having symptoms from 1st shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Headache, Joint pains, Muscle or body aches · 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: I have had all of these symptoms since 1st injection on February 26.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Report sent to call center — days 1–6 daily, 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)
2021-04-12
Survey response — day 14, dose 2
MedDRA: Condition aggravated, Physiotherapy, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I Continue to have problems since my first vaccination on February 26. It was Moderna. I am still seeing the chiropractor and spending three hours a week minimum with the physical therapist. I am in pain 24 seven and my nights are bad. · Healthcare visit (other): Physical therapy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
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)
2021-05-02
Health check-in — day 35, dose 2
Feeling: Poor

Adult check-in
2021-05-09
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-14
Call 1 — Left Voicemail
2021-06-14
Call 1 — Left Voicemail
2021-06-14
Call 1 — Left Voicemail
2021-06-27
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Neck pain, 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: More shoulder, neck pain. · Healthcare visit (other): Orthopedic, (b)(6) Clinic, will be having MRI of shoulder on June 30, and neurologist on July 1

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-27
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-06-29
Call 1 — Left Voicemail
2021-08-17
Call successful
Participant prefers to complete VAERS report online
2021-09-26
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-03-28
Survey response — 12 months, dose 2
MedDRA: COVID-19, COVID-19 pneumonia, Dizziness, Dyspnoea, Impaired work ability, Pre-existing disease — 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, Emergency room or emergency department visit

Free text: SOB, dizziness, covidPneumonia Was put on steroids, antibiotics, breathing treatments. Still having problems. I had Covid 1/31/22. Diagnosed with long haulers Covid. Since having my 1st vaccine 2/26/21, I have not been able to work. Still no drivi

MedDRA releases: 2024-11 · check-in free text available
2022-03-28
Report sent to call center — 12 months, dose 2
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 · Emergency room or emergency department visit · 1 call case(s)
2022-03-29
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-28	Moderna
3	2021-03-29	Other-Unknown	No

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-17

Symptoms: Right arm pain (same arm shot was given). On scale 1-10, 4 without movement; 9 with movement. From wrist to shoulder. Right hand purple. Entire arm and fingers swollen. Back of head pain. Wake up in pain during night. Unable to sleep. Do have Lupus. cut off by CDC

Healthcare visit (other): Chiropractor, orthopedic dr., family dr., occupational therapist.

Release 6 — day 0, dose 2

2021-03-28

Systemic reaction (other): Emotional

Release 6 — days 1–6 daily, dose 2

2021-03-30

Systemic reaction (other): This is 2nd shot only. Still having symptoms from 1st shot

2021-04-02

Systemic reaction (other): I have had all of these symptoms since 1st injection on February 26.

Release 7 — day 14, dose 2

2021-04-12

Symptoms: I Continue to have problems since my first vaccination on February 26. It was Moderna. I am still seeing the chiropractor and spending three hours a week minimum with the physical therapist. I am in pain 24 seven and my nights are bad.

Healthcare visit (other): Physical therapy

Release 9 — 3 months, dose 2

2021-06-27

Symptoms: More shoulder, neck pain.

Healthcare visit (other): Orthopedic, (b)(6) Clinic, will be having MRI of shoulder on June 30, and neurologist on July 1

redacted (b)(6)

Release 11 — 12 months, dose 2

2022-03-28

Symptoms: SOB, dizziness, covidPneumonia Was put on steroids, antibiotics, breathing treatments. Still having problems. I had Covid 1/31/22. Diagnosed with long haulers Covid. Since having my 1st vaccine 2/26/21, I have not been able to work. Still no drivi cut off by CDC

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	Occupational therapy	·	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Physiotherapy	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	COVID-19	·	·	✓
SD	COVID-19 pneumonia	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Headache	·	·	✓
SD	Impaired work ability	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Office visit	✓	✓	○
SD	Pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Skin discolouration	·	·	✓
SD	Sleep disorder	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Emotional disorder	✓	✓	✓
SRO	General symptom	✓	✓	✓

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