3RN-17595-34983

2 vaccinations 6 coded responses 25 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 802 / CO
Registered: 2021-02-13

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

2021-02-12
Dose 1 — Moderna
2021-02-13
Registered in v-safe
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Pyrexia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea

Free text: Fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Nausea

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Survey response — day 7, dose 1
MedDRA: Rhinorrhoea — Feeling: Good

Free text: Runny nose big time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-05
Survey response — day 21, dose 1
MedDRA: Pain in extremity — Feeling: Fair

Free text: My arm is hurting from my first shot again!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Dose 2 — Moderna
2021-03-11
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 7, dose 2
Feeling: Fair · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-22
Survey response — day 42, dose 2
MedDRA: Arthralgia, Blood pressure increased, Joint lock, Mobility decreased, Night sweats, Office visit, Pain, Pre-existing disease, Pyrexia, Rheumatoid arthritis, Systemic lupus erythematosus — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Night sweats, woke up to fiery pain in every joint, all joints also locked &impossible to move. Yesterday Doctor said my BP was 150/100, gave me 20 Prednisone pills. She did not know if this was my RA or Lupus. Last night i had a fever of 103+ · Healthcare visit (other): Doctor office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 42, 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)
2021-06-10
Survey response — 3 months, dose 2
MedDRA: Dehydration, Dizziness, Rash — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Dehydration, dizzy, rash

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-18
Call 1 — Left Voicemail
2021-06-21
Call 2 — Left Voicemail
2021-06-21
Call successful
Does not wish to fill out VAERS report
2021-09-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-13
Survey response — 12 months, dose 2
MedDRA: Hallucination, Malaise, Pyrexia, Rash, Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: Rashes and was VERY SICK FOR TWO DAYS AFTER MODERNA BOOSTER. 104 fever and hallucinating . Vomiting. Refuse to get another.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-11	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-13

Systemic reaction (other): Fever

Release 4 — day 7, dose 1

2021-02-19

Systemic reaction (other): Runny nose big time

Release 5 — day 21, dose 1

2021-03-05

Symptoms: My arm is hurting from my first shot again!

Release 7 — day 42, dose 2

2021-04-22

Symptoms: Night sweats, woke up to fiery pain in every joint, all joints also locked &impossible to move. Yesterday Doctor said my BP was 150/100, gave me 20 Prednisone pills. She did not know if this was my RA or Lupus. Last night i had a fever of 103+

Healthcare visit (other): Doctor office

Release 9 — 3 months, dose 2

2021-06-10

Symptoms: Dehydration, dizzy, rash

Release 11 — 12 months, dose 2

2022-03-13

Symptoms: Rashes and was VERY SICK FOR TWO DAYS AFTER MODERNA BOOSTER. 104 fever and hallucinating . Vomiting. Refuse to get another.

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	Office visit	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	Dehydration	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Hallucination	·	·	✓
SD	Joint lock	✓	✓	✓
SD	Malaise	·	·	✓
SD	Mobility decreased	✓	✓	✓
SD	Night sweats	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rheumatoid arthritis	✓	✓	✓
SD	Systemic lupus erythematosus	✓	✓	✓
SD	Vomiting	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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