3LS-39185-13582

3 vaccinations 7 coded responses 28 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 117 / NY
Registered: 2021-01-27

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

2021-01-22
Dose 1 — Moderna
2021-01-27
Registered in v-safe
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-19
Dose 2 — Moderna
2021-02-19
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-03-19
Survey response — day 28, dose 2
MedDRA: Arthralgia, Fatigue, Myalgia, Somnolence — Feeling: Good

Free text: Im still fatigued with sleepiness in the day and both shoulders hurt with some muscle pain intermittently everywhere.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-03
Survey response — day 42, dose 2
MedDRA: Irritable bowel syndrome, Pre-existing disease, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe IBS with acid reflux usually I only have IBS for one night now I have it ongoing for several days. · Healthcare visit (other): Going to my primary care doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-21
Survey response — 3 months, dose 2
MedDRA: Condition aggravated, Fatigue, Office visit, Pain in extremity, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: My arm where the shot went in sometimes is still sore. I also experience exhaustion on and off. I do have chronic fatigue and Lyme so those symptoms seemed to have escalated since the vaccine. Im glad to be vaccinated but worried about booster. · Healthcare visit (other): I went for another reason but let her know about the soreness, swelling, and itchy rash its better now but still gets tender.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-13
Call 1 — Left Voicemail
2021-06-21
Call successful
Participant prefers to complete VAERS report online
2021-08-22
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-10-29
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Extrasystoles, Palpitations — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I couldn't give you this update yesterday so this is based on yesterday's outcome Oct. 31 I had missed heartbeats yesterday palpitations and pain under my arm where the shot was

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Palpitations, Pre-existing disease — Feeling: Good

Free text: I am on a heart monitor for benign heart palpitations but since the vaccine they have been more frequent but getting more like they were prior

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

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

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-28
Survey response — day 28, dose 3
MedDRA: Ear infection, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I ended up with an ear infection not Covid though on antibiotics for it. Other than my usual heart palpitations and ear problems I am good.

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-29
Call 1 — Left Voicemail
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-28
Survey response — 3 months, dose 3
MedDRA: Office visit, Palpitations, Ventricular extrasystoles — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: As stated earlier I have heart palpitations pvc and am going to cardiologist for monitoring and medications. · Healthcare visit (other): Going to cardiologist

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-02-01
Call 1 — Left Voicemail
2022-05-01
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-19	Moderna
3	2021-10-29	Moderna	No

Call center

4 call center cases

2 successful · 2 unsuccessful

See the call center timeline

Free text

Release 5 — day 28, dose 2

2021-03-19

Symptoms: Im still fatigued with sleepiness in the day and both shoulders hurt with some muscle pain intermittently everywhere.

Release 6 — day 42, dose 2

2021-04-03

Symptoms: Severe IBS with acid reflux usually I only have IBS for one night now I have it ongoing for several days.

Healthcare visit (other): Going to my primary care doctor

Release 8 — 3 months, dose 2

2021-05-21

Symptoms: My arm where the shot went in sometimes is still sore. I also experience exhaustion on and off. I do have chronic fatigue and Lyme so those symptoms seemed to have escalated since the vaccine. Im glad to be vaccinated but worried about booster.

Healthcare visit (other): I went for another reason but let her know about the soreness, swelling, and itchy rash its better now but still gets tender.

Release 10 — days 1–6 daily, dose 3

2021-11-01

Systemic reaction (other): I couldn't give you this update yesterday so this is based on yesterday's outcome Oct. 31 I had missed heartbeats yesterday palpitations and pain under my arm where the shot was

2021-11-02

Systemic reaction (other): I am on a heart monitor for benign heart palpitations but since the vaccine they have been more frequent but getting more like they were prior

Release 10 — day 28, dose 3

2021-11-28

Symptoms: I ended up with an ear infection not Covid though on antibiotics for it. Other than my usual heart palpitations and ear problems I am good.

Release 11 — 3 months, dose 3

2022-01-28

Symptoms: As stated earlier I have heart palpitations pvc and am going to cardiologist for monitoring and medications.

Healthcare visit (other): Going to cardiologist

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	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Ear infection	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Irritable bowel syndrome	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Palpitations	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Ventricular extrasystoles	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Extrasystoles	·	·	✓
SRO	Palpitations	·	·	✓
SRO	Pre-existing disease	·	·	✓

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