3P4-23377-47577

4 vaccinations 17 coded responses 48 check-ins 14 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 021 / MA
Registered: 2021-04-05

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Registered dependents

KK8-10772-69963 Child or adolescent in my care · Male · 2022-08-11

Timeline

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

2021-04-05
Registered in v-safe
2021-04-05
Dose 1 — Janssen/Johnson & Johnson
2021-04-05
Health check-in — day 0, dose 1
Feeling: Poor · Headache, Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to work

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Heart rate abnormal — Feeling: Poor · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Weakness, elevated heart rate

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

Adult check-in
2021-04-12
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-26
Survey response — day 21, single dose
MedDRA: Back pain, Musculoskeletal disorder, Pain, Pain in extremity — Feeling: Good

Free text: Upper back pain radiating to arm upon reaching. Likely related to a chronic musculoskeletal condition.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — day 28, single dose
MedDRA: Pain, Pain in extremity — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Upper right arm pain when extending overhead

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — day 28, single dose
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-10
Survey response — day 35, single dose
MedDRA: Cough, Nasal congestion, Oropharyngeal pain — Feeling: Good

Free text: Sore throat, nasal congestion, cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-05-27
Call 1 — Left Voicemail
2021-06-02
Call 2 — Left Voicemail
2021-07-05
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-10-04
Survey response — 6 months, dose 1
MedDRA: Bacterial infection, Sinusitis, Upper respiratory tract infection — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Multiple upper respiratory infections and most recently a sinus infection diagnosed as bacterial and treated with Augmentin.

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Report sent to call center — 6 months, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-05
Call 1 — Left Voicemail
2021-10-05
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-10
Dose 2 — Moderna
2021-11-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-12
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms — Feeling: Good · Site: Pain, Redness, Swelling

Free text: Muscle spasms in thumb and index finger of injection arm

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Muscle twitching — Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches

Free text: Swollen lymph nodes in armpit and neck of injection arm; thumb and index finger on injection arm twitching

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Muscle twitching — Feeling: Poor · Site: Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Thumb and index finger twitching on injection arm hand; swollen lymph nodes in armpit of injection arm

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy, Muscle twitching — Feeling: Good

Free text: Swollen lymph node in injection arm; thumb and index finger twitching on injection arm hand

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-20
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-11-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-22
Survey response — day 42, dose 2
MedDRA: Diarrhoea — Feeling: Good · Be unable to do your normal daily activities

Free text: Diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-02-10
Survey response — 3 months, dose 2
MedDRA: Pregnancy, Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Pregnancy, upper respiratory infection

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Survey response — 6 months, dose 2
MedDRA: Respiratory symptom — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Upper respiratory symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-12
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-12
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-25
Dose 3 — Moderna
2022-08-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-08-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-08-23
Survey response — day 28, dose 3
MedDRA: Cough, Oropharyngeal pain, Rhinorrhoea, Upper respiratory tract infection — Feeling: Fair

Free text: Upper respiratory infection - sore throat, runny nose, cough

MedDRA releases: 2024-11 · check-in free text available
2022-08-30
Survey response — day 35, dose 3
MedDRA: Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea — Feeling: Good

Free text: Congestion, runny nose, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-09-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-10-26
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-12-18
Dose 4 — Moderna
2022-12-18
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-12-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-12-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-12-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-12-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-12-23
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Nausea, Vomiting, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-12-25
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2023-01-01
Survey response — day 14, dose 4
MedDRA: Cough, Rhinorrhoea, Sneezing — Feeling: Good

MedDRA releases: 2024-11
2023-01-10
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2023-01-15
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-01-22
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-01-29
Survey response — day 42, dose 4
MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Fair

MedDRA releases: 2024-11
2023-03-21
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-06-19
Survey response — 6 months, dose 4
MedDRA: Cough, Oropharyngeal pain, Rhinorrhoea — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-05	Janssen/Johnson & Johnson
2	2021-11-10	Moderna	No
3	2022-07-25	Moderna	No
4	2022-12-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-03	Successful 2022-05-12	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-04	Successful 2021-10-05	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-11	Successful 2022-05-12	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): Weakness, elevated heart rate

Release 8 — day 21, single dose

2021-04-26

Symptoms: Upper back pain radiating to arm upon reaching. Likely related to a chronic musculoskeletal condition.

Release 8 — day 28, single dose

2021-05-03

Symptoms: Upper right arm pain when extending overhead

Release 8 — day 35, single dose

2021-05-10

Symptoms: Sore throat, nasal congestion, cough

Release 9 — 6 months, dose 1

2021-10-04

Symptoms: Multiple upper respiratory infections and most recently a sinus infection diagnosed as bacterial and treated with Augmentin.

Release 10 — days 1–6 daily, dose 2

2021-11-12

Systemic reaction (other): Muscle spasms in thumb and index finger of injection arm

2021-11-13

Systemic reaction (other): Swollen lymph nodes in armpit and neck of injection arm; thumb and index finger on injection arm twitching

2021-11-14

Systemic reaction (other): Thumb and index finger twitching on injection arm hand; swollen lymph nodes in armpit of injection arm

2021-11-15

Systemic reaction (other): Swollen lymph node in injection arm; thumb and index finger twitching on injection arm hand

Release 10 — day 42, dose 2

2021-12-22

Symptoms: Diarrhea

Release 11 — 3 months, dose 2

2022-02-10

Symptoms: Pregnancy, upper respiratory infection

Release 11 — 6 months, dose 2

2022-05-11

Symptoms: Upper respiratory symptoms

Release 12 — day 28, dose 3

2022-08-23

Symptoms: Upper respiratory infection - sore throat, runny nose, cough

Release 12 — day 35, dose 3

2022-08-30

Symptoms: Congestion, runny nose, sore throat

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	Back pain	✓	✓	✓
SD	Bacterial infection	·	·	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Musculoskeletal disorder	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Respiratory symptom	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinusitis	·	·	✓
SD	Sneezing	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Heart rate abnormal	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Muscle spasms	·	·	✓
SRO	Muscle twitching	·	·	✓

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