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42Q-17727-43457

2 vaccinations 6 coded responses 23 check-ins 6 free-text entries 1 call case
Sex
Female
Age at first dose
46-50
ZIP prefix
128 / NY
Registered
2021-01-07
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-06
    Dose 1 — Moderna
  2. 2021-01-07
    Registered in v-safe
  3. 2021-01-07
    Survey response — days 1–6 daily, dose 1
    MedDRA: Heart rate increased — Feeling: Good · Site: Pain
    Free text: intermittent rapid heartbeat
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-01-08
    Survey response — days 1–6 daily, dose 1
    MedDRA: Heart rate increased, Hypoaesthesia — Feeling: Good · Site: Pain
    Free text: On the day of injection I did have some facial numbness on the contra lateral side for 2 hrs . Also elevated heart rate
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-01-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  6. 2021-01-12
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-01-13
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-21
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-01-27
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-02-03
    Dose 2 — Moderna
  11. 2021-02-03
    Survey response — day 0, dose 2
    MedDRA: Unevaluable event — Feeling: Good
    Free text: Just had shot 5 minutes ago
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-02-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Hypoaesthesia — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness
    Free text: Facial numbness last night
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-02-05
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · Headache, Muscle or body aches
    Adult check-in
  14. 2021-02-06
    Survey response — days 1–6 daily, dose 2
    MedDRA: Musculoskeletal stiffness — Feeling: Good
    Free text: Neck stiffness
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-07
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-02-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-02-09
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-02-10
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-02-17
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-02-24
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-03-03
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-10
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-17
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-05-07
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-08-04
    Survey response — 6 months, dose 2
    MedDRA: Incorrect route of product administration, Joint range of motion decreased, Musculoskeletal stiffness — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: Ive had left arm stiffness and now a limited range of motion since my vaccination . I think that the injection was up too high on my arm. I am entering physical therapy to address the ongoing issue.
    MedDRA releases: 2021-09,2024-11 · check-in free text available
  26. 2021-08-04
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  27. 2021-11-21
  28. 2022-02-05
    Health check-in — 12 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2022-02-18
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12021-01-06Moderna
22021-02-03Moderna

Call center

1 call center case

1 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-07

Systemic reaction (other): intermittent rapid heartbeat

2021-01-08

Systemic reaction (other): On the day of injection I did have some facial numbness on the contra lateral side for 2 hrs . Also elevated heart rate

Release 3 — day 0, dose 2

2021-02-03

Systemic reaction (other): Just had shot 5 minutes ago

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Facial numbness last night

2021-02-06

Systemic reaction (other): Neck stiffness

Release 9 — 6 months, dose 2

2021-08-04

Symptoms: Ive had left arm stiffness and now a limited range of motion since my vaccination . I think that the injection was up too high on my arm. I am entering physical therapy to address the ongoing issue.

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
SDIncorrect route of product administration ✓ · ✓
SDJoint range of motion decreased ✓ · ✓
SDMusculoskeletal stiffness ✓ · ✓
SROHeart rate increased ✓ ✓ ✓
SROHypoaesthesia ✓ ✓ ✓
SROMusculoskeletal stiffness ✓ ✓ ✓
SROUnevaluable event ✓ ✓ ✓

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

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