3U7-32092-95585

2 vaccinations 10 coded responses 26 check-ins 10 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 444 / OH
Registered: 2021-03-12

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

2021-03-12
Registered in v-safe
2021-03-12
Dose 1 — Moderna
2021-03-12
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lightheadedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Just mild soreness still at the injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Survey response — day 7, dose 1
MedDRA: Diarrhoea — Feeling: Good

Free text: Some loose stools

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-15
Dose 2 — Moderna
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: S

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Immediate post-injection reaction, Office visit, Palpitations, Tremor — Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Feeling shaky and unable to do much · Healthcare visit (other): I went to the Express Care in the same building where I had my shot. Immediately after the shot I felt my heart racing and lightheaded. The PA checked be there and vital signs and they were good. Just when I felt like I may have been getting better, I start to feel lightheaded and shaky. If I dont feel better, then Ill go to my physician or ER.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-22
Survey response — day 7, dose 2
MedDRA: Dyspnoea, Unevaluable event — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Sighing and need for deep breathe. · Healthcare visit (other): Appointment scheduled with PCP on 4/23/21.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 7, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Survey response — day 14, dose 2
MedDRA: Anxiety, Headache, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Anxiety , deep sighing , continued headache · Healthcare visit (other): Primary Care physician visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Survey response — day 21, dose 2
MedDRA: Anxiety — Feeling: Fair · Be unable to do your normal daily activities

Free text: Anxiety ; need for deep breaths

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — day 42, dose 2
MedDRA: Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Leg and foot pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-15
Survey response — 3 months, dose 2
MedDRA: Fall, Spinal operation, Surgery — Feeling: Poor · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: I had a fall in my landscaping and had yo have back surgery., · Healthcare visit (other): Surgery

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-15
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-22
Call successful
Does not wish to fill out VAERS report
2021-10-14
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-17
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Moderna
2	2021-04-15	Moderna

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-14

Systemic reaction (other): Lightheadedness

2021-03-16

Systemic reaction (other): Just mild soreness still at the injection site

Release 5 — day 7, dose 1

2021-03-19

Systemic reaction (other): Some loose stools

Release 7 — days 1–6 daily, dose 2

2021-04-19

Systemic reaction (other): S

2021-04-20

Systemic reaction (other): Feeling shaky and unable to do much

Healthcare visit (other): I went to the Express Care in the same building where I had my shot. Immediately after the shot I felt my heart racing and lightheaded. The PA checked be there and vital signs and they were good. Just when I felt like I may have been getting better, I start to feel lightheaded and shaky. If I dont feel better, then Ill go to my physician or ER.

Release 7 — day 7, dose 2

2021-04-22

Systemic reaction (other): Sighing and need for deep breathe.

Healthcare visit (other): Appointment scheduled with PCP on 4/23/21.

Release 8 — day 14, dose 2

2021-04-29

Symptoms: Anxiety , deep sighing , continued headache

Healthcare visit (other): Primary Care physician visit

Release 8 — day 21, dose 2

2021-05-06

Symptoms: Anxiety ; need for deep breaths

Release 8 — day 42, dose 2

2021-05-27

Symptoms: Leg and foot pain

Release 9 — 3 months, dose 2

2021-07-15

Symptoms: I had a fall in my landscaping and had yo have back surgery.,

Healthcare visit (other): Surgery

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	Dizziness	✓	✓	✓
HCVO	Immediate post-injection reaction	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Palpitations	✓	✓	✓
HCVO	Surgery	✓	·	✓
HCVO	Tremor	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Anxiety	✓	✓	✓
SD	Fall	✓	·	✓
SD	Headache	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Spinal operation	✓	·	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Tremor	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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