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2S4-39182-49814

5 vaccinations 17 coded responses 63 check-ins 15 free-text entries 5 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
301 / GA
Registered
2021-02-16
Relationship
Self
Race
Other
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-02-16
    Registered in v-safe
  2. 2021-02-16
    Dose 1 — Moderna
  3. 2021-02-16
    Survey response — day 0, dose 1
    MedDRA: Back pain — Feeling: Fair · Site: Pain, Redness · Headache
    Free text: Taking pain killers and muscle relaxant for back pain. I believe that my vaccine pain would likely be more severe if I was not taking my Rx
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-02-17
    Survey response — days 1–6 daily, dose 1
    MedDRA: Back pain — Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches
    Free text: Still taking prescription meds for back pain. Suspect these are minimizing the amount of pain I'm experiencing with the vaccine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-02-18
    Survey response — days 1–6 daily, dose 1
    MedDRA: Back pain — Feeling: Good · Site: Pain
    Free text: Still taking my Rxs, muscle relaxant and pain killers, for back pain
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-02-19
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pre-existing disease — Feeling: Good · Site: Pain
    Free text: Still on back pain prescription meds
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-02-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-02-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-02-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-02-23
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-03-02
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-03-09
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-03-16
    Dose 2 — Moderna
  14. 2021-03-16
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-03-17
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness — Feeling: Poor · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness
    Free text: Lightheadedness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-03-18
    Survey response — days 1–6 daily, dose 2
    MedDRA: Chills, Dizziness — Feeling: Good · Site: Pain
    Free text: After my check in yesterday, I started having chills and was very lightheaded. No fever. Was in bed around 5 p.m.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-03-19
    Survey response — days 1–6 daily, dose 2
    MedDRA: Back pain, Condition aggravated, Mobility decreased, Pain in extremity, Pre-existing disease — Feeling: Good · Site: Pain · Muscle or body aches
    Free text: Interestingly, I'm experiencing pain in both arms. The left, the original one, has been painful, intermittingly. Late yesterday, the pain in that left arm became rather intense for a while. Then went away just as quickly. The area is still sore to touch. Now able to raise both arms. Additionally, my backpain has intensified. Restarted Rxs for same
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-03-20
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches
    Free text: Still having soreness in both arms
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-03-21
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  20. 2021-03-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-03-23
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-03-30
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-06
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-04-13
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-04-22
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-04-27
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-06-15
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-09-14
    Survey response — 6 months, dose 2
    MedDRA: Emergency care, Gallbladder operation — Feeling: Good · 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: Emergency gall bladder surgery
    MedDRA releases: 2024-11 · check-in free text available
  29. 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)
  30. 2021-09-17
  31. 2021-09-17
    Call successful
    Participant prefers to complete VAERS report online
  32. 2021-10-27
    Dose 3 — Moderna
  33. 2021-10-28
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  34. 2021-10-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  35. 2021-10-30
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Headache
    Adult check-in
  36. 2021-10-31
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  37. 2021-11-01
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  38. 2021-11-02
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Headache
    Adult check-in
  39. 2021-11-03
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  40. 2021-11-11
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  41. 2021-11-17
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  42. 2021-11-24
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  43. 2021-12-01
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  44. 2021-12-08
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  45. 2022-01-26
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  46. 2022-04-18
    Dose 4 — Moderna
  47. 2022-04-20
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain · None
    Adult check-in
  48. 2022-04-21
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · Site: Pain · None
    Adult check-in
  49. 2022-04-22
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  50. 2022-04-24
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  51. 2022-04-25
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  52. 2022-05-03
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  53. 2022-05-09
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  54. 2022-05-16
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  55. 2022-05-23
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  56. 2022-05-30
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  57. 2022-07-18
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  58. 2022-10-07
    Dose 5 — Moderna
    Co-administered: Flu
  59. 2022-10-07
    Health check-in — day 0, dose 5
    Feeling: Poor · Site: Pain · Chills, Headache, Fatigue or tiredness
    Adult check-in
  60. 2022-10-08
    Survey response — days 1–6 daily, dose 5
    MedDRA: Dizziness — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Dizziness
    MedDRA releases: 2024-11 · check-in free text available
  61. 2022-10-09
    Survey response — days 1–6 daily, dose 5
    MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Forgot to mention, had flu shot at same time as this shot
    MedDRA releases: 2024-11 · check-in free text available
  62. 2022-10-10
    Survey response — days 1–6 daily, dose 5
    MedDRA: Dizziness — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: Dizziness
    MedDRA releases: 2024-11 · check-in free text available
  63. 2022-10-11
    Health check-in — days 1–6 daily, dose 5
    Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  64. 2022-10-13
    Survey response — days 1–6 daily, dose 5
    MedDRA: Unevaluable event — Feeling: Good · Headache, Joint pains, Muscle or body aches
    Free text: Reminder that I had flu shot at same time
    MedDRA releases: 2024-11 · check-in free text available
  65. 2022-10-14
    Health check-in — day 7, dose 5
    Feeling: Good · None
    Adult check-in
  66. 2022-10-21
    Health check-in — day 14, dose 5
    Feeling: Good
    Adult check-in
  67. 2022-10-28
    Survey response — day 21, dose 5
    MedDRA: Blood pressure increased, Chest discomfort, Chest pain, Medical counselling — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Chest pains, heaviness in chest, bp elevated · Healthcare visit (other): Spoke with my doctor's nurse. Doctor wants to see me. Appointment on Monday
    MedDRA releases: 2024-11 · check-in free text available
  68. 2022-10-28
    Report sent to call center — day 21, dose 5
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    1 call case(s)
  69. 2022-10-31
  70. 2022-10-31
  71. 2022-10-31
    Call successful
    Participant prefers to complete VAERS report online
  72. 2022-11-04
    Health check-in — day 28, dose 5
    Feeling: Good
    Adult check-in
  73. 2022-11-11
    Survey response — day 35, dose 5
    MedDRA: Abdominal pain upper, Arthralgia, Back pain, Mobility decreased, Neuropathy peripheral — 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 · Outpatient clinic or urgent care clinic visit
    Free text: Stomach pains and cramping. Pain in left shoulder/back - bit difficult to raise arm. Neuropothy diagnosis. Appointment to see GI dr on Wednesday
    MedDRA releases: 2024-11 · check-in free text available
  74. 2022-11-11
    Report sent to call center — day 35, dose 5
    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 · 1 call case(s)
  75. 2022-11-14
  76. 2022-11-19
    Health check-in — day 42, dose 5
    Feeling: Good
    Adult check-in
  77. 2023-01-06
    Survey response — 3 months, dose 5
    MedDRA: Feeling cold, Gastrointestinal disorder — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  78. 2023-01-06
    Report sent to call center — 3 months, dose 5
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  79. 2023-01-09
  80. 2023-01-09
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  81. 2023-01-09
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  82. 2023-04-07
    Survey response — 6 months, dose 5
    MedDRA: Appendicectomy, Bursitis, Hernia repair, Neuropathy peripheral, Surgery — 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 · Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  83. 2023-04-07
    Report sent to call center — 6 months, dose 5
    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 · 1 call case(s)
  84. 2023-04-11

Vaccinations

DoseDateManufacturerCo-administered
12021-02-16Moderna
22021-03-16Moderna
32021-10-27Moderna No
42022-04-18Moderna No
52022-10-07Moderna Flu

Call center

5 call center cases

4 successful · 1 unsuccessful

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-02-16

Systemic reaction (other): Taking pain killers and muscle relaxant for back pain. I believe that my vaccine pain would likely be more severe if I was not taking my Rx

Release 4 — days 1–6 daily, dose 1

2021-02-17

Systemic reaction (other): Still taking prescription meds for back pain. Suspect these are minimizing the amount of pain I'm experiencing with the vaccine

2021-02-18

Systemic reaction (other): Still taking my Rxs, muscle relaxant and pain killers, for back pain

2021-02-19

Systemic reaction (other): Still on back pain prescription meds

Release 5 — days 1–6 daily, dose 2

2021-03-17

Systemic reaction (other): Lightheadedness

2021-03-18

Systemic reaction (other): After my check in yesterday, I started having chills and was very lightheaded. No fever. Was in bed around 5 p.m.

2021-03-19

Systemic reaction (other): Interestingly, I'm experiencing pain in both arms. The left, the original one, has been painful, intermittingly. Late yesterday, the pain in that left arm became rather intense for a while. Then went away just as quickly. The area is still sore to touch. Now able to raise both arms. Additionally, my backpain has intensified. Restarted Rxs for same

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Still having soreness in both arms

Release 9 — 6 months, dose 2

2021-09-14

Symptoms: Emergency gall bladder surgery

Release 12 — days 1–6 daily, dose 5

2022-10-08

Systemic reaction (other): Dizziness

2022-10-09

Systemic reaction (other): Forgot to mention, had flu shot at same time as this shot

2022-10-10

Systemic reaction (other): Dizziness

2022-10-13

Systemic reaction (other): Reminder that I had flu shot at same time

Release 12 — day 21, dose 5

2022-10-28

Symptoms: Chest pains, heaviness in chest, bp elevated
Healthcare visit (other): Spoke with my doctor's nurse. Doctor wants to see me. Appointment on Monday

Release 12 — day 35, dose 5

2022-11-11

Symptoms: Stomach pains and cramping. Pain in left shoulder/back - bit difficult to raise arm. Neuropothy diagnosis. Appointment to see GI dr on Wednesday

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

FieldPreferred term2021-092023-042024-11
HCVOMedical counselling · · ✓
HCVOSurgery · · ✓
SDAbdominal pain upper · · ✓
SDAppendicectomy · · ✓
SDArthralgia · · ✓
SDBack pain · · ✓
SDBlood pressure increased · · ✓
SDBursitis · · ✓
SDChest discomfort · · ✓
SDChest pain · · ✓
SDEmergency care · · ✓
SDFeeling cold · · ✓
SDGallbladder operation · · ✓
SDGastrointestinal disorder · · ✓
SDHernia repair · · ✓
SDMobility decreased · · ✓
SDNeuropathy peripheral · · ✓
SROBack pain ✓ ✓ ✓
SROChills ✓ ✓ ✓
SROCondition aggravated ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROMobility decreased ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROUnevaluable event · · ✓

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

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