3PJ-21271-77482

2 vaccinations 10 coded responses 17 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 761 / TX
Registered: 2021-01-08

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
Registered in v-safe
2021-01-08
Dose 1 — Moderna
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-09
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

no matching call case
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Visual impairment — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Vision issues and dizziness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

no matching call case
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-11
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

no matching call case
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Visual impairment — Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Still having problems with my vision at times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

no matching call case
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Back pain, Dizziness, Fall — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness. I fell last night and my back and shoulders are sore. Not sure if the dizziness caused the fall.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

no matching call case
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

no matching call case
2021-01-15
Health check-in — day 7, dose 1
Feeling: Fair · Chills, Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-01-15
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities

no matching call case
2021-01-22
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Moderna
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Arthritis, Axillary pain, Pre-existing disease — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: It seems like my arthritis is worse. Also, I am sore in my armpits.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Free text: Coughed during the night and feeling more congested.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — day 7, dose 2
Feeling: Fair · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Survey response — day 14, dose 2
MedDRA: Chest discomfort, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Congestion, tightness in my chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — day 21, dose 2
MedDRA: Rash erythematous, Rash macular, Rash pruritic — Feeling: Good · Be unable to do your normal daily activities

Free text: Red splotches that itch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-10
Survey response — day 35, dose 2
MedDRA: Lymphadenopathy, Neck pain — Feeling: Good

Free text: Pain in my neck. Lymph nodes on left side of my neck are enlarged.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — 3 months, dose 2
MedDRA: Back pain, Medical counselling, Nausea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain in lower back, nausea · Healthcare visit (other): Phone call to Dr who gave me an antibiotic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-09
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-01	Moderna

Call center

1 call center case

1 successful

7 check-ins flagged for a call with no call center case on record

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-10

Systemic reaction (other): Vision issues and dizziness.

2021-01-12

Systemic reaction (other): Still having problems with my vision at times

2021-01-13

Systemic reaction (other): Dizziness. I fell last night and my back and shoulders are sore. Not sure if the dizziness caused the fall.

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): Dizziness

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): It seems like my arthritis is worse. Also, I am sore in my armpits.

2021-02-07

Systemic reaction (other): Coughed during the night and feeling more congested.

Release 4 — day 14, dose 2

2021-02-17

Symptoms: Congestion, tightness in my chest

Release 4 — day 21, dose 2

2021-02-22

Symptoms: Red splotches that itch

Release 5 — day 35, dose 2

2021-03-10

Symptoms: Pain in my neck. Lymph nodes on left side of my neck are enlarged.

Release 8 — 3 months, dose 2

2021-05-03

Symptoms: Pain in lower back, nausea

Healthcare visit (other): Phone call to Dr who gave me an antibiotic

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	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Rash macular	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fall	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Visual impairment	✓	✓	✓

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