369-92509-41632

3 vaccinations 6 coded responses 31 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 199 / DE
Registered: 2021-02-11

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-08
Dose 1 — Moderna
2021-02-11
Registered in v-safe
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-22
Survey response — day 14, dose 1
MedDRA: Injection site pain, Muscle tightness, Myalgia, Pruritus — Feeling: Good

Free text: Injected arm itching for about 10 minutes Saturday night. Arm is sore at injection sight when putting weight on arm for long periods of time. Muscle at top of shoulder tightens and soreness is felt.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-11
Dose 2 — Moderna
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 7, dose 2
Feeling: Fair · Fever · Chills

Adult check-in
2021-03-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-09
Survey response — 6 months, dose 2
MedDRA: Pneumonia, Pseudomonas infection — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Pneumonia BroncoactisSpuedmonis

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

1 call case(s)
2021-09-11
Call successful
Does not wish to fill out VAERS report
2021-10-26
Dose 3 — Moderna
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-18
Survey response — day 21, dose 3
MedDRA: Arthralgia — Feeling: Fair

Free text: Left arm is sore at the elbow to the waist.

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Survey response — day 28, dose 3
MedDRA: Back pain, Limb mass, Tenderness — Feeling: Good

Free text: Sore back forearm has a lump and is tender to touch.

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-07
Survey response — day 42, dose 3
MedDRA: Ligament sprain, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Back Sprain · Healthcare visit (other): Office Visit

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-08
Call 1 — Left Voicemail
2022-01-25
Survey response — 3 months, dose 3
MedDRA: Office visit, Respiratory tract infection, Spinal fracture — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Breathing infection and fractured bones in back. · Healthcare visit (other): Dr office

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-01
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Moderna
2	2021-03-11	Moderna
3	2021-10-26	Moderna	No

Call center

3 call center cases

1 successful · 2 unsuccessful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-22

Symptoms: Injected arm itching for about 10 minutes Saturday night. Arm is sore at injection sight when putting weight on arm for long periods of time. Muscle at top of shoulder tightens and soreness is felt.

Release 9 — 6 months, dose 2

2021-09-09

Symptoms: Pneumonia BroncoactisSpuedmonis

Release 10 — day 21, dose 3

2021-11-18

Symptoms: Left arm is sore at the elbow to the waist.

Release 10 — day 28, dose 3

2021-11-23

Symptoms: Sore back forearm has a lump and is tender to touch.

Release 10 — day 42, dose 3

2021-12-07

Symptoms: Back Sprain

Healthcare visit (other): Office Visit

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Breathing infection and fractured bones in back.

Healthcare visit (other): Dr office

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	Office visit	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Ligament sprain	·	·	✓
SD	Limb mass	·	·	✓
SD	Muscle tightness	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pneumonia	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Pseudomonas infection	·	·	✓
SD	Respiratory tract infection	·	·	✓
SD	Spinal fracture	·	·	✓
SD	Tenderness	·	·	✓

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