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3QW-14976-77381

2 vaccinations 20 coded responses 26 check-ins 20 free-text entries 3 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
453 / OH
Registered
2021-03-11
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-11
    Registered in v-safe
  2. 2021-03-11
    Dose 1 — Moderna
  3. 2021-03-11
    Survey response — day 0, dose 1
    MedDRA: Dizziness — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Lightheaded and dizzy
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-12
    Survey response — days 1–6 daily, dose 1
    MedDRA: Fatigue — Feeling: Fair · Headache
    Free text: Fatigue
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-13
    Survey response — days 1–6 daily, dose 1
    MedDRA: Nausea, Pyrexia — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Yesterday evening had low-grade fever and nausea
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-14
    Survey response — days 1–6 daily, dose 1
    MedDRA: Asthma, Pre-existing disease — Feeling: Fair · Joint pains, Fatigue or tiredness
    Free text: Asthma has been MUCH worse since vaccination
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-15
    Survey response — days 1–6 daily, dose 1
    MedDRA: Arthralgia, Asthma, Insomnia — Feeling: Fair · Fever · Chills, Headache, Joint pains, Fatigue or tiredness
    Free text: Bad asthma , The joint pains and asthma keep me awake for hours at night.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-16
    Survey response — days 1–6 daily, dose 1
    MedDRA: Asthma — Feeling: Fair · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea
    Free text: Asthma ,my normal temperature is 97.6
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-17
    Survey response — days 1–6 daily, dose 1
    MedDRA: Arthralgia, Asthma, Sleep disorder — Feeling: Fair · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea
    Free text: Asthma ,knee joint pain and asthma kept me awake for hours
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-03-18
    Survey response — day 7, dose 1
    MedDRA: Asthma — Feeling: Fair · Fever · Chills, Headache, Joint pains, Nausea
    Free text: Asthma
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  11. 2021-03-25
    Survey response — day 14, dose 1
    MedDRA: Arthralgia, Dyspepsia, Malaise, Oesophageal pain, Pneumonia, Pneumonitis, Productive cough, Self-medication, Sinusitis, Sleep disorder — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: The inflammation in my lungs and sinuses infected. And made me very sick. I took ibuprofen for the joint pain and that caused burning in my stomach and esophagus. The lung infection Kept me awake coughing stuff up for hours.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-25
    Report sent to call center — day 14, dose 1
    Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional
    1 call case(s)
  13. 2021-04-01
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  14. 2021-04-08
    Dose 2 — Moderna
  15. 2021-04-08
    Survey response — day 0, dose 2
    MedDRA: Respiratory tract inflammation — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Respiratory inflammation
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-09
    Survey response — days 1–6 daily, dose 2
    MedDRA: Asthma, Pre-existing disease, Productive cough — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Free text: Increased asthma problems coughing up a lot of stuff
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-04-10
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cough, Gastritis, Secretion discharge — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Stomach inflammation. Extreme inflammation yes in my whole respiratory system. Coughing up volumes of mucus for several hours.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-10
    Report sent to call center — days 1–6 daily, 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)
  19. 2021-04-11
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cough, Discharge, Gastrointestinal inflammation, Inflammation, Respiratory symptom — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: Severe inflammation in whole respiratory system. Coughing up volumes of fluid for hours. Gastro intestinal inflammation.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-04-12
    Survey response — days 1–6 daily, dose 2
    MedDRA: Gastrointestinal inflammation, Insomnia, Productive cough, Radiculopathy — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Free text: Irritated nerves making my legs jump. Gastro intestinal inflammation. Severe respiratory inflammation. Coughing up volumes of stuff for hours and hours. Very little sleep happening.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-04-13
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cough, Inflammation — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to work
    Free text: Severe inflammation of respiratory system. Coughing lots of stuff up. Information of gastrointestinal system.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  22. 2021-04-14
    Survey response — days 1–6 daily, dose 2
    MedDRA: Cough, Gastrointestinal inflammation, Respiratory tract inflammation — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness
    Free text: Gastrointestinal inflammation. Respiratory system inflammation and coughing stuff up a lot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-04-15
    Survey response — day 7, dose 2
    MedDRA: Gastrointestinal inflammation, Productive cough, Respiratory tract inflammation — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Free text: Gastrointestinal inflammation. Respiratory inflammation, coughing up stuff for hours
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-04-23
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-04-29
    Survey response — day 21, dose 2
    MedDRA: Arthralgia, Dyspepsia, Fatigue, Pain in extremity, Pyrexia, Respiratory tract inflammation — Feeling: Fair · Be unable to work
    Free text: Burning stomach, joint pain, inflamed respiratory system, fever, arm pain and Fatigue
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-05-06
    Survey response — day 28, dose 2
    MedDRA: Nausea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: Nausea along with everything else, but not as severe
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  27. 2021-05-13
    Health check-in — day 35, dose 2
    Feeling: Fair
    Adult check-in
  28. 2021-05-21
    Health check-in — day 42, dose 2
    Feeling: Fair
    Adult check-in
  29. 2021-07-08
    Health check-in — 3 months, dose 2
    Feeling: Fair
    Adult check-in
  30. 2021-10-07
    Health check-in — 6 months, dose 2
    Feeling: Fair
    Adult check-in
  31. 2022-03-10
    Call successful
    Participant prefers to complete VAERS report online
  32. 2022-04-08
    Survey response — 12 months, dose 2
    MedDRA: Fall, Inflammation, Pain, Spinal operation — 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 · Hospitalization
    Free text: I had back surgery as a direct result of the inflammation I got in my back due to the Moderna booster. It caused great pain and caused me to fall backwards.
    MedDRA releases: 2024-11 · check-in free text available
  33. 2022-04-08
    Report sent to call center — 12 months, 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
    Hospitalization · 1 call case(s)
  34. 2022-04-12
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

DoseDateManufacturerCo-administered
12021-03-11Moderna
22021-04-08Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-11

Systemic reaction (other): Lightheaded and dizzy

Release 5 — days 1–6 daily, dose 1

2021-03-12

Systemic reaction (other): Fatigue

2021-03-13

Systemic reaction (other): Yesterday evening had low-grade fever and nausea

2021-03-14

Systemic reaction (other): Asthma has been MUCH worse since vaccination

2021-03-15

Systemic reaction (other): Bad asthma , The joint pains and asthma keep me awake for hours at night.

2021-03-16

Systemic reaction (other): Asthma ,my normal temperature is 97.6

2021-03-17

Systemic reaction (other): Asthma ,knee joint pain and asthma kept me awake for hours

Release 5 — day 7, dose 1

2021-03-18

Systemic reaction (other): Asthma

Release 6 — day 14, dose 1

2021-03-25

Symptoms: The inflammation in my lungs and sinuses infected. And made me very sick. I took ibuprofen for the joint pain and that caused burning in my stomach and esophagus. The lung infection Kept me awake coughing stuff up for hours.

Release 7 — day 0, dose 2

2021-04-08

Systemic reaction (other): Respiratory inflammation

Release 7 — days 1–6 daily, dose 2

2021-04-09

Systemic reaction (other): Increased asthma problems coughing up a lot of stuff

2021-04-10

Systemic reaction (other): Stomach inflammation. Extreme inflammation yes in my whole respiratory system. Coughing up volumes of mucus for several hours.

2021-04-11

Systemic reaction (other): Severe inflammation in whole respiratory system. Coughing up volumes of fluid for hours. Gastro intestinal inflammation.

2021-04-12

Systemic reaction (other): Irritated nerves making my legs jump. Gastro intestinal inflammation. Severe respiratory inflammation. Coughing up volumes of stuff for hours and hours. Very little sleep happening.

2021-04-13

Systemic reaction (other): Severe inflammation of respiratory system. Coughing lots of stuff up. Information of gastrointestinal system.

2021-04-14

Systemic reaction (other): Gastrointestinal inflammation. Respiratory system inflammation and coughing stuff up a lot.

Release 7 — day 7, dose 2

2021-04-15

Systemic reaction (other): Gastrointestinal inflammation. Respiratory inflammation, coughing up stuff for hours

Release 8 — day 21, dose 2

2021-04-29

Symptoms: Burning stomach, joint pain, inflamed respiratory system, fever, arm pain and Fatigue

Release 8 — day 28, dose 2

2021-05-06

Symptoms: Nausea along with everything else, but not as severe

Release 11 — 12 months, dose 2

2022-04-08

Symptoms: I had back surgery as a direct result of the inflammation I got in my back due to the Moderna booster. It caused great pain and caused me to fall backwards.

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

FieldPreferred term2021-092023-042024-11
SDArthralgia ✓ ✓ ✓
SDDyspepsia ✓ ✓ ✓
SDFall · · ✓
SDFatigue ✓ ✓ ✓
SDInflammation · · ✓
SDMalaise ✓ ✓ ✓
SDNausea ✓ ✓ ✓
SDOesophageal pain ✓ ✓ ✓
SDPain · · ✓
SDPain in extremity ✓ ✓ ✓
SDPneumonia ✓ ✓ ✓
SDPneumonitis ✓ ✓ ✓
SDProductive cough ✓ ✓ ✓
SDPyrexia ✓ ✓ ✓
SDRespiratory tract inflammation ✓ ✓ ✓
SDSelf-medication ✓ ✓ ✓
SDSinusitis ✓ ✓ ✓
SDSleep disorder ✓ ✓ ✓
SDSpinal operation · · ✓
SROArthralgia ✓ ✓ ✓
SROAsthma ✓ ✓ ✓
SROCough ✓ ✓ ✓
SRODischarge ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROGastritis ✓ ✓ ✓
SROGastrointestinal inflammation ✓ ✓ ✓
SROInflammation ✓ ✓ ✓
SROInsomnia ✓ ✓ ✓
SRONausea ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROProductive cough ✓ ✓ ✓
SROPyrexia ✓ ✓ ✓
SRORadiculopathy ✓ ✓ ✓
SRORespiratory symptom ✓ ✓ ✓
SRORespiratory tract inflammation ✓ ✓ ✓
SROSecretion discharge ✓ ✓ ✓
SROSleep disorder ✓ ✓ ✓

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

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