2RY-20180-95500

4 vaccinations 12 coded responses 43 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 945 / CA
Registered: 2021-02-13

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

2021-02-11
Dose 1 — Moderna
2021-02-13
Registered in v-safe
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Good

Free text: Felt a little blah. No pain or anything just blah

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair

Free text: Still feel blah mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: Arthritis, Condition aggravated, Pre-existing disease — Feeling: Good

Free text: Joint pains but I suspect its a normal flare up of arthritis and fibromyalgia.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 7, dose 1
MedDRA: Abdominal discomfort, Headache — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Woke with a nagging headache thats been with me all day and unsettled stomach

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-16
Dose 2 — Moderna
2021-03-25
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-06
Survey response — day 21, dose 2
MedDRA: Diarrhoea, Emergency care, Food poisoning, Vomiting — 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

Free text: Vomiting and diarrhea for over 3 hours Sunday morning ending up in Er. Doctor thought it was food poisoning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-14
Survey response — 6 months, dose 2
MedDRA: Diarrhoea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Diarreha since May

MedDRA releases: 2024-11 · check-in free text available
2021-09-14
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-16
Call successful
Does not wish to fill out VAERS report
2021-10-29
Dose 3 — Moderna
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness · Headache, Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Erythema — Feeling: Good · Site: Redness, Itching

Free text: The redness has spread a little but I think it's a lighter shade of pink. Helps to ice

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Erythema, Pruritus, Self-medication — Feeling: Good · Site: Redness, Itching

Free text: The redness increased in size a little bit but is much lighter in color now with still a little itching. Putting cortisone cream on it.

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Erythema — Feeling: Good · Site: Redness

Free text: Redness gets lighter every day

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Survey response — day 21, dose 3
MedDRA: Cystitis, Head discomfort, Office visit, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative, Throat irritation, Viral upper respiratory tract infection — Feeling: Fair · 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: Head fullness, runny nose, scratchy throat low grade fever, bladder infection. Doctor described it as upper respiratory bug. Covid test was negative.

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Report sent to call center — day 21, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-24
Call 1 — Left Voicemail
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-31
Survey response — 3 months, dose 3
MedDRA: Diarrhoea, Ear pain — Feeling: Fair

Free text: Ear ache and a little diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-07-09
Dose 4 — Moderna
2022-07-09
Survey response — day 0, dose 4
MedDRA: Chest pain, Hot flush, Immediate post-injection reaction, Medical counselling — Feeling: Good

Free text: About 10 minutes after booster I felt a flush go they my body and a pain in the middle of my chest that lasted less than 1 minute. Reported it to nurse who took blood pressure which was normal.

MedDRA releases: 2024-11 · check-in free text available
2022-07-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-07-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Itching · None

Adult check-in
2022-07-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-07-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-07-15
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-07-16
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-07-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-08-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-08-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-21
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-16	Moderna
3	2021-10-29	Moderna	No
4	2022-07-09	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-13

Systemic reaction (other): Felt a little blah. No pain or anything just blah

2021-02-14

Systemic reaction (other): Still feel blah mild

2021-02-17

Systemic reaction (other): Joint pains but I suspect its a normal flare up of arthritis and fibromyalgia.

Release 4 — day 7, dose 1

2021-02-18

Systemic reaction (other): Woke with a nagging headache thats been with me all day and unsettled stomach

Release 7 — day 21, dose 2

2021-04-06

Symptoms: Vomiting and diarrhea for over 3 hours Sunday morning ending up in Er. Doctor thought it was food poisoning.

Release 9 — 6 months, dose 2

2021-09-14

Symptoms: Diarreha since May

Release 10 — days 1–6 daily, dose 3

2021-11-01

Systemic reaction (other): The redness has spread a little but I think it's a lighter shade of pink. Helps to ice

2021-11-02

Systemic reaction (other): The redness increased in size a little bit but is much lighter in color now with still a little itching. Putting cortisone cream on it.

2021-11-03

Systemic reaction (other): Redness gets lighter every day

Release 10 — day 21, dose 3

2021-11-19

Symptoms: Head fullness, runny nose, scratchy throat low grade fever, bladder infection. Doctor described it as upper respiratory bug. Covid test was negative.

Release 11 — 3 months, dose 3

2022-01-31

Symptoms: Ear ache and a little diarrhea

Release 12 — day 0, dose 4

2022-07-09

Systemic reaction (other): About 10 minutes after booster I felt a flush go they my body and a pain in the middle of my chest that lasted less than 1 minute. Reported it to nurse who took blood pressure which was normal.

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	Cystitis	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Ear pain	·	·	✓
SD	Emergency care	✓	✓	✓
SD	Food poisoning	✓	✓	✓
SD	Head discomfort	·	·	✓
SD	Office visit	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Throat irritation	·	·	✓
SD	Viral upper respiratory tract infection	·	·	✓
SD	Vomiting	✓	✓	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Chest pain	·	·	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Erythema	·	·	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hot flush	·	·	✓
SRO	Immediate post-injection reaction	·	·	✓
SRO	Medical counselling	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	·	·	✓
SRO	Self-medication	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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