3MU-25887-09093

4 vaccinations 11 coded responses 26 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 503 / IA
Registered: 2021-02-08

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

2021-01-08
Dose 1 — Moderna
2021-02-05
Dose 2 — Moderna
2021-02-08
Registered in v-safe
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Nausea, Pain in extremity, Pyrexia — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Free text: Arm pain went away after 2nd day and wasnt as bad as after 1st shot but after 2nd shot I had arm pain plus fever, headache & nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal chest pain — Feeling: Poor · Site: Pain · Headache, Muscle or body aches

Free text: Left side rib pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 7, dose 2
MedDRA: Visual impairment — Feeling: Good · Headache

Free text: I feel like my vision is changing. It may not have anything to do with the vaccine but thought Id mention it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Survey response — day 35, dose 2
MedDRA: Pyrexia, Rhinorrhoea, Sneezing — Feeling: Fair

Free text: Runny nose. Sneezing. Low grade fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — 3 months, dose 2
MedDRA: Breast pain — Feeling: Good

Free text: Soreness under left breast. Havent been able to wear a bra for about a month. Starting to get better but was worried about it. Not sure if its related to vaccine but thought Id mention it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-06
Survey response — 6 months, dose 2
MedDRA: Nausea, Throat irritation — Feeling: Good

Free text: Was nauseous last Sunday-Monday. And thought I was on verge of sore throat but nothing happened. It went away.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-01
Dose 3 — Moderna
2022-02-05
Survey response — 12 months, dose 2
MedDRA: Fatigue, Throat irritation — Feeling: Good

Free text: Had a few days with scratchy throat. Tired. Never went to a sore throat though.

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-21
Dose 4 — Moderna
2022-10-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-23
Survey response — days 1–6 daily, dose 4
MedDRA: Body temperature increased — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Did have fever yesterday evening 99.8.

MedDRA releases: 2024-11 · check-in free text available
2022-10-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-10-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-10-28
Health check-in — day 7, dose 4
Feeling: Good · Headache

Adult check-in
2022-11-04
Survey response — day 14, dose 4
MedDRA: Cough, Diarrhoea, Headache, Nausea, Pyrexia, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · 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: Constant headache, nausea, congestion, runny nose, slight cough, diarrhea. Did have fever 10/28-10/31, but was after the last check in earlier that day when I was feeling ok.

MedDRA releases: 2024-11 · check-in free text available
2022-11-04
Report sent to call center — day 14, dose 4
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)
2022-11-07
Call successful
Participant prefers to complete VAERS report online
2022-11-11
Survey response — day 21, dose 4
MedDRA: Headache, Sneezing — Feeling: Good

Free text: Sneezing, still slight headache.

MedDRA releases: 2024-11 · check-in free text available
2022-12-02
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-20
Survey response — 3 months, dose 4
MedDRA: Sinus headache — Feeling: Good

MedDRA releases: 2024-11
2023-04-21
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna
3	2021-12-01	Moderna	No
4	2022-10-21	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-08

Systemic reaction (other): Arm pain went away after 2nd day and wasnt as bad as after 1st shot but after 2nd shot I had arm pain plus fever, headache & nausea

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Left side rib pain

Release 4 — day 7, dose 2

2021-02-12

Systemic reaction (other): I feel like my vision is changing. It may not have anything to do with the vaccine but thought Id mention it.

Release 5 — day 35, dose 2

2021-03-12

Symptoms: Runny nose. Sneezing. Low grade fever.

Release 8 — 3 months, dose 2

2021-05-07

Symptoms: Soreness under left breast. Havent been able to wear a bra for about a month. Starting to get better but was worried about it. Not sure if its related to vaccine but thought Id mention it.

Release 9 — 6 months, dose 2

2021-08-06

Symptoms: Was nauseous last Sunday-Monday. And thought I was on verge of sore throat but nothing happened. It went away.

Release 11 — 12 months, dose 2

2022-02-05

Symptoms: Had a few days with scratchy throat. Tired. Never went to a sore throat though.

Release 12 — days 1–6 daily, dose 4

2022-10-23

Systemic reaction (other): Did have fever yesterday evening 99.8.

Release 12 — day 14, dose 4

2022-11-04

Symptoms: Constant headache, nausea, congestion, runny nose, slight cough, diarrhea. Did have fever 10/28-10/31, but was after the last check in earlier that day when I was feeling ok.

Release 12 — day 21, dose 4

2022-11-11

Symptoms: Sneezing, still slight headache.

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	Breast pain	✓	✓	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Nausea	✓	·	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sinus headache	·	·	✓
SD	Sneezing	✓	✓	✓
SD	Throat irritation	✓	·	✓
SRO	Body temperature increased	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Musculoskeletal chest pain	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Visual impairment	✓	✓	✓

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