3NR-19766-13283

3 vaccinations 7 coded responses 34 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 484 / MI
Registered: 2021-02-27

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

Y9A-19585-79353 Child or adolescent in my care · Male · 2021-11-21

W4C-24777-69842 Child or adolescent in my care · Female · 2021-11-21

Timeline

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

2021-02-26
Dose 1 — Moderna
2021-02-27
Registered in v-safe
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-03-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-26
Dose 2 — Moderna
2021-03-26
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Chills, Muscle or body aches

Adult check-in
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Palpitations — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: racing heart rate around 125bpm beginning around 4am lasting for approx 6 hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Feeling cold, Self-medication — Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: feeling really cold bad shivering no fever tylenol helped

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Nausea

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Limb discomfort, Muscular weakness — Feeling: Fair · Muscle or body aches, Nausea

Free text: left arm weakness (injection arm)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Limb discomfort, Muscular weakness — Feeling: Fair · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: heaviness or weakness in extremities especially L arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 7, dose 2
MedDRA: Asthenia, Muscular weakness — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: weakness overall and especially extremities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 14, dose 2
MedDRA: Burning sensation, Medical counselling, Myalgia, Nausea — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: ongoing nausea and muscle aches and burning but some improvement · Healthcare visit (other): appt scheduled

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-16
Survey response — day 21, dose 2
MedDRA: Abdominal discomfort, Abdominal distension, Back pain, Myalgia, Nausea, Office visit, Pain in extremity, Paraesthesia, Peripheral coldness — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: all continuing nausea, abdominal discomfort, bloating, aching muscles continuing in arms, legs, and back, cold and tingling feet · Healthcare visit (other): primary care doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-16
Dose 3 — Moderna
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-23
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-14
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-21
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-28
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-15
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-02-22
Call successful
Participant prefers to complete VAERS report online
2022-05-17
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-26	Moderna
3	2021-11-16	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-27

Systemic reaction (other): racing heart rate around 125bpm beginning around 4am lasting for approx 6 hours

2021-03-29

Systemic reaction (other): feeling really cold bad shivering no fever tylenol helped

2021-03-31

Systemic reaction (other): left arm weakness (injection arm)

2021-04-01

Systemic reaction (other): heaviness or weakness in extremities especially L arm

Release 6 — day 7, dose 2

2021-04-02

Systemic reaction (other): weakness overall and especially extremities

Release 7 — day 14, dose 2

2021-04-09

Symptoms: ongoing nausea and muscle aches and burning but some improvement

Healthcare visit (other): appt scheduled

Release 7 — day 21, dose 2

2021-04-16

Symptoms: all continuing nausea, abdominal discomfort, bloating, aching muscles continuing in arms, legs, and back, cold and tingling feet

Healthcare visit (other): primary care doctor

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Abdominal distension	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Burning sensation	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Peripheral coldness	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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