3N5-26718-85468

2 vaccinations 5 coded responses 22 check-ins 5 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 982 / WA
Registered: 2021-01-21

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

2021-01-20
Dose 1 — Moderna
2021-01-21
Registered in v-safe
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: These only apply to today, I had more symptoms yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Diarrhea

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Survey response — day 14, dose 1
MedDRA: Arthralgia, Injection site erythema, Injection site inflammation, Injection site mass, Injection site pain, Injection site pruritus, Pain — Feeling: Good · Be unable to do your normal daily activities

Free text: 8 days post vacation I developed a new 2 3/4 x 2 inflamed, itchy red spot aprox 4 below injection site w/extremely sore lump...sore to the bone...lasted 3 days, prior to that the entire shoilder capsule was constant dull, achey, for two days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

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

Adult check-in
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-24
Survey response — day 35, dose 2
MedDRA: Arthralgia, Joint range of motion decreased — Feeling: Poor · Be unable to do your normal daily activities

Free text: Serious shoulder pain, loss ROM

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — day 42, dose 2
MedDRA: Fatigue, Office visit — Feeling: Fair · 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: Symptoms: Fatigued, exhausted... · Healthcare visit (other): Chiropractic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-17
Survey response — 12 months, dose 2
MedDRA: Micrographic skin surgery, Pre-existing disease, Surgery — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: Cancer/Diabetes/Kidney Damage · Healthcare visit (other): Mohs Surgery / Reconstructive Surgery

MedDRA releases: 2024-11 · check-in free text available
2022-02-17
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-02-18
Call 1 — Left Voicemail
2022-02-18
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-22

Systemic reaction (other): These only apply to today, I had more symptoms yesterday

Release 3 — day 14, dose 1

2021-02-03

Symptoms: 8 days post vacation I developed a new 2 3/4 x 2 inflamed, itchy red spot aprox 4 below injection site w/extremely sore lump...sore to the bone...lasted 3 days, prior to that the entire shoilder capsule was constant dull, achey, for two days.

Release 6 — day 35, dose 2

2021-03-24

Symptoms: Serious shoulder pain, loss ROM

Release 6 — day 42, dose 2

2021-03-31

Symptoms: Fatigued, exhausted...

Healthcare visit (other): Chiropractic

Release 11 — 12 months, dose 2

2022-02-17

Symptoms: Cancer/Diabetes/Kidney Damage

Healthcare visit (other): Mohs Surgery / Reconstructive Surgery

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	Micrographic skin surgery	·	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Surgery	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site inflammation	✓	✓	✓
SD	Injection site mass	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Joint range of motion decreased	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SRO	Adverse reaction	✓	✓	✓

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