3TM-33809-26496

3 vaccinations 4 coded responses 20 check-ins 4 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 957 / CA
Registered: 2020-12-23

Relationship: Self
Race: Native Hawaiian or other Pacific Islander
Ethnicity: Not Hispanic or Latino

Timeline

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

2020-12-23
Registered in v-safe
2020-12-23
Dose 1 — Moderna
2020-12-23
Survey response — day 0, dose 1
MedDRA: Injected limb mobility decreased, Pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Pain when lifting injected arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Chills, Fatigue or tiredness

Adult check-in
2020-12-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-30
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-20
Dose 2 — Moderna
2021-01-27
Survey response — day 7, dose 2
MedDRA: Asthenia, Chills, Diarrhoea, Fatigue, Feeling abnormal, Feeling cold, Headache, Nausea, Vomiting — Feeling: Fair · Fatigue or tiredness

Free text: On the 20th evening had chills went to bed with 3 blankets, woke at 2am felt splitting headache, nausea, vomiting, diarrhea.. felt like I was going to die. Weak, tired, fever, Metallic taste, no smell, loss of appetite, fever chills, headache next day. Lasted 5-6Days to totally heal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-10
Dose 3 — Moderna
2022-02-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-11
Survey response — 6 months, dose 3
MedDRA: Malaise, SARS-CoV-2 test negative, Vaccine positive rechallenge — Feeling: Good · 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, Emergency room or emergency department visit

Free text: Got very sick with COVID like symptoms for few weeks like never before Tested negative for COVID at home test and PCR Every COVID booster makes me very sick with COVID Like symptoms too

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-05-12
Call successful
Does not wish to fill out VAERS report
2022-11-13
Survey response — 12 months, dose 3
MedDRA: SARS-CoV-2 test negative, Viral infection — 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, Emergency room or emergency department visit

Free text: Viral infection x 3 weeks, still bad Negative COVID tests

MedDRA releases: 2024-11 · check-in free text available
2022-11-13
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-11-14
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-23	Moderna
2	2021-01-20	Moderna
3	2021-11-10	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 1 — day 0, dose 1

2020-12-23

Systemic reaction (other): Pain when lifting injected arm

Release 2 — day 7, dose 2

2021-01-27

Systemic reaction (other): On the 20th evening had chills went to bed with 3 blankets, woke at 2am felt splitting headache, nausea, vomiting, diarrhea.. felt like I was going to die. Weak, tired, fever, Metallic taste, no smell, loss of appetite, fever chills, headache next day. Lasted 5-6Days to totally heal

Release 11 — 6 months, dose 3

2022-05-11

Symptoms: Got very sick with COVID like symptoms for few weeks like never before Tested negative for COVID at home test and PCR Every COVID booster makes me very sick with COVID Like symptoms too

Release 12 — 12 months, dose 3

2022-11-13

Symptoms: Viral infection x 3 weeks, still bad Negative COVID tests

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	Malaise	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vaccine positive rechallenge	·	·	✓
SD	Viral infection	·	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injected limb mobility decreased	✓	✓	✓
SRO	Injection site pain	○	○	○
SRO	Nausea	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Vomiting	✓	✓	✓

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