2RB-21076-64018

4 vaccinations 4 coded responses 22 check-ins 4 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 932 / CA
Registered: 2021-04-02

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

2021-03-04
Dose 1 — Moderna
2021-04-01
Dose 2 — Moderna
2021-04-02
Registered in v-safe
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Headache, Injection site erythema, Injection site pruritus, Injection site rash, Injection site swelling — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work

Free text: Injection site is raised , re, swollen 4 inces across with itchy rash from elbow up and over that shoulder onto scapula area. Generally achy joints and a mild headache.e

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-04-08
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness · Headache · Be unable to work or attend school

Adult check-in
2021-04-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-22
Dose 3 — Moderna
2022-04-01
Survey response — 12 months, dose 2
MedDRA: Cardiac disorder, Coronary arterial stent insertion, Fatigue, Myocardial infarction, Pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Experienced heart issues and had to have a stent placed. Pain and fatigue actually started after 2nd dose of Moderna and got worse after booster... heart attack 3 weeks after the booster.

MedDRA releases: 2024-11 · check-in free text available
2022-04-01
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-05
Call 1 — Left Voicemail
2022-09-22
Dose 4 — Pfizer-BioNTech
2022-10-07
Survey response — day 14, dose 4
MedDRA: Coronary artery occlusion, Myocardial infarction — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Heart attack from blockage that occurred after dose #3

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
Report sent to call center — day 14, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-10-10
Call successful
Participant prefers to complete VAERS report online
2022-10-10
Call successful
Participant prefers to complete VAERS report online
2022-10-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-20
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-10-27
Survey response — day 35, dose 4
MedDRA: Fatigue, Pain, Reaction to previous exposure to any vaccine — Feeling: Fair

Free text: Body aches come and go. Still a bit of farigue that was worse after the booster... from prior Covid vaccine and boosters this takes several weeks to go away. Maybe it won't last as long with the lesser dose.

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-12-25
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-25
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna
3	2021-11-22	Moderna	No
4	2022-09-22	Pfizer-BioNTech	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): Injection site is raised , re, swollen 4 inces across with itchy rash from elbow up and over that shoulder onto scapula area. Generally achy joints and a mild headache.e

Release 11 — 12 months, dose 2

2022-04-01

Symptoms: Experienced heart issues and had to have a stent placed. Pain and fatigue actually started after 2nd dose of Moderna and got worse after booster... heart attack 3 weeks after the booster.

Release 12 — day 14, dose 4

2022-10-07

Symptoms: Heart attack from blockage that occurred after dose #3

Release 12 — day 35, dose 4

2022-10-27

Symptoms: Body aches come and go. Still a bit of farigue that was worse after the booster... from prior Covid vaccine and boosters this takes several weeks to go away. Maybe it won't last as long with the lesser dose.

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	Cardiac disorder	·	·	✓
SD	Coronary arterial stent insertion	·	·	✓
SD	Coronary artery occlusion	·	·	✓
SD	Fatigue	·	·	✓
SD	Myocardial infarction	·	·	✓
SD	Pain	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site rash	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓

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