2RC-42603-56440

3 vaccinations 5 coded responses 29 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 195 / PA
Registered: 2021-04-30

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

2021-04-30
Registered in v-safe
2021-04-30
Dose 1 — Moderna
2021-04-30
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Fatigue or tiredness

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Fatigue or tiredness

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-06
Survey response — days 1–6 daily, dose 1
MedDRA: Cheilitis, Rhinalgia — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Sores in my left nostril for 3 days. Woke up with sore on my lower lip. Left side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness

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

Adult check-in
2021-05-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-28
Dose 2 — Moderna
2021-05-28
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-05-31
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pain, Flank pain, Headache, Hypoaesthesia — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Right side of face felt numb. Right eye pain. Extreme pain rt side and back of head for 12-14 hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Diarrhea

Adult check-in
2021-06-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Nausea

Adult check-in
2021-06-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-06-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-07-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-27
Survey response — 3 months, dose 2
MedDRA: Fatigue, Headache, Oropharyngeal pain, Pre-existing disease — Feeling: Good · 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: Chronic sinusitis FatigueHeadaches Sore throat

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-27
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-08
Call 2 — Left Voicemail
2021-11-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-31
Dose 3 — Moderna
2022-05-03
Survey response — day 28, dose 3
MedDRA: COVID-19, Feeling abnormal, Malaise — 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 · Telehealth, virtual health, or email health consultation

Free text: After the third vaccine I became extremely ill with the same exact symptoms I had when I had Covid in January. I should have been in the hospital. It was completely awful I will not get another shot

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Report sent to call center — day 28, 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 · 1 call case(s)
2022-05-04
Call successful
Participant prefers to complete VAERS report online
2022-05-05
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-05-12
Survey response — day 42, dose 3
MedDRA: Spinal pain — 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 · Telehealth, virtual health, or email health consultation

Free text: Severe spine pain

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Report sent to call center — day 42, 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 · 1 call case(s)
2022-05-13
Call 1 — Left Voicemail
2022-05-13
Call 1 — Left Voicemail
2022-05-13
Call 1 — Left Voicemail
2022-06-30
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-30	Moderna
2	2021-05-28	Moderna
3	2022-03-31	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 1

2021-05-06

Systemic reaction (other): Sores in my left nostril for 3 days. Woke up with sore on my lower lip. Left side

Release 8 — days 1–6 daily, dose 2

2021-05-31

Systemic reaction (other): Right side of face felt numb. Right eye pain. Extreme pain rt side and back of head for 12-14 hours

Release 9 — 3 months, dose 2

2021-08-27

Symptoms: Chronic sinusitis FatigueHeadaches Sore throat

Release 11 — day 28, dose 3

2022-05-03

Symptoms: After the third vaccine I became extremely ill with the same exact symptoms I had when I had Covid in January. I should have been in the hospital. It was completely awful I will not get another shot

Release 11 — day 42, dose 3

2022-05-12

Symptoms: Severe spine pain

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	COVID-19	·	·	✓
SD	Fatigue	✓	·	✓
SD	Feeling abnormal	·	·	✓
SD	Headache	✓	·	✓
SD	Malaise	·	·	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Spinal pain	·	·	✓
SRO	Cheilitis	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Flank pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Rhinalgia	✓	✓	✓

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