3QN-27470-31790

2 vaccinations 8 coded responses 9 check-ins 8 free-text entries 7 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 112 / NY
Registered: 2021-05-13

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

2021-05-06
Dose 1 — Moderna
2021-05-13
Registered in v-safe
2021-05-13
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Chills, Headache · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-21
Survey response — day 14, dose 1
MedDRA: Dizziness, Fatigue, Irritability, Rash, Rash pruritic, Somnolence — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: I'm tired, sleepy, dizzyI got a rash or irritation on armpits, groins, legs/hips. Is very itchy and annoying

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Survey response — day 21, dose 1
MedDRA: Fatigue, Office visit, Pruritus, Rash, Somnolence — Feeling: Poor · Be unable to work, 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: More tired and sleepy Bigger rash all over the my body, had to go to dr and get medications, very itchy, really bad reaction

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Report sent to call center — day 21, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-03
Dose 2 — Moderna
2021-06-10
Survey response — day 7, dose 2
MedDRA: Rash — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, 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: Huga, heaby rash all over the body, especially near groints and armpits and neck area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Report sent to call center — day 7, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-17
Survey response — day 14, dose 2
MedDRA: Headache, Pain, Pruritus, Rash — Feeling: Poor · 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: More rash, feel like ripping my skin off, headaches, body pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Report sent to call center — day 14, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-06-17
Call 1 — Left Voicemail
2021-06-24
Call 1 — Left Voicemail
2021-06-28
Survey response — day 21, dose 2
MedDRA: Office visit, Rash pruritic — Feeling: Poor · 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: Rash, rash rash. It doesn't go away. I've been with 2 drs and still have the itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-28
Report sent to call center — day 21, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-06-30
Call 1 — Left Voicemail
2021-07-01
Survey response — day 28, dose 2
MedDRA: Fatigue, Pruritus, Tremor — Feeling: Poor · 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: Still itchy, tired, shaky

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-01
Report sent to call center — day 28, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-06
Call 1 — Left Voicemail
2021-07-12
Survey response — day 35, dose 2
MedDRA: Contusion, Pruritus, Skin haemorrhage — Feeling: Poor · 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: The itchiness is not going away. I feel like reaping my skin off. I have huge bruises all over and I'm bleeding from scratching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-12
Report sent to call center — day 35, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-16
Survey response — day 42, dose 2
MedDRA: Bradykinesia, Bradyphrenia, Fatigue — Feeling: Poor · 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: Tiredness, slower in thoughts and actions

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-16
Report sent to call center — day 42, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-21
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-06	Moderna
2	2021-06-03	Moderna

Call center

7 call center cases

7 successful

See the call center timeline

Free text

Release 8 — day 14, dose 1

2021-05-21

Symptoms: I'm tired, sleepy, dizzyI got a rash or irritation on armpits, groins, legs/hips. Is very itchy and annoying

Release 8 — day 21, dose 1

2021-05-28

Symptoms: More tired and sleepy Bigger rash all over the my body, had to go to dr and get medications, very itchy, really bad reaction

Release 9 — day 7, dose 2

2021-06-10

Systemic reaction (other): Huga, heaby rash all over the body, especially near groints and armpits and neck area

Release 9 — day 14, dose 2

2021-06-17

Symptoms: More rash, feel like ripping my skin off, headaches, body pain

Release 9 — day 21, dose 2

2021-06-28

Symptoms: Rash, rash rash. It doesn't go away. I've been with 2 drs and still have the itching

Release 9 — day 28, dose 2

2021-07-01

Symptoms: Still itchy, tired, shaky

Release 9 — day 35, dose 2

2021-07-12

Symptoms: The itchiness is not going away. I feel like reaping my skin off. I have huge bruises all over and I'm bleeding from scratching

Release 9 — day 42, dose 2

2021-07-16

Symptoms: Tiredness, slower in thoughts and actions

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	Bradykinesia	✓	·	✓
SD	Bradyphrenia	✓	·	✓
SD	Contusion	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Irritability	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Skin haemorrhage	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Tremor	✓	✓	✓
SRO	Rash	✓	✓	✓

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