443-22789-00903

2 vaccinations 9 coded responses 23 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 070 / NJ
Registered: 2021-03-22

Relationship: Self
Race: Other
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-22
Registered in v-safe
2021-03-22
Dose 1 — Moderna
2021-03-22
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Fair · Site: Pain

Free text: Arm Soreness 48 hours where I got the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Survey response — day 7, dose 1
MedDRA: Injection site nodule, Injection site reaction, Injection site swelling, Musculoskeletal stiffness — Feeling: Fair · Site: Pain, Swelling

Free text: My shot was 1 week ago. Now I have swelling, a knot and stiffness at the location of the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — day 14, dose 1
MedDRA: Erythema, Rash macular — Feeling: Good

Free text: I had red blotches reappear where i got the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-19
Dose 2 — Moderna
2021-04-19
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Ageusia, Back pain, Chills, Decreased appetite, Tremor — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Loss of appetite, loss of taste, Severe back pain shaking teeth chatter

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Myalgia — Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Free text: Mostly leg muscle and back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-24
Survey response — day 35, dose 2
MedDRA: Muscle strain — Feeling: Good · Be unable to do your normal daily activities

Free text: Right arm shoulder muscle feels like a sprain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-19
Survey response — 3 months, dose 2
MedDRA: Weight loss poor — Feeling: Good

Free text: Difficulty loosing weight

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
Survey response — 6 months, dose 2
MedDRA: Acute sinusitis, Menstrual disorder, Paranasal sinus inflammation — 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 · Outpatient clinic or urgent care clinic visit

Free text: Acute sinusitis and sinus inflammation, variation in menstral cycles

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
Report sent to call center — 6 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-22
Call 1 — Left Voicemail
2022-04-19
Survey response — 12 months, dose 2
MedDRA: COVID-19 — 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 · Outpatient clinic or urgent care clinic visit

Free text: I contracted COVID December 2021

MedDRA releases: 2024-11 · check-in free text available
2022-04-19
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-21
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-19	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-23

Systemic reaction (other): Arm Soreness 48 hours where I got the shot

Release 6 — day 7, dose 1

2021-03-29

Systemic reaction (other): My shot was 1 week ago. Now I have swelling, a knot and stiffness at the location of the shot

Release 7 — day 14, dose 1

2021-04-06

Symptoms: I had red blotches reappear where i got the shot

Release 7 — days 1–6 daily, dose 2

2021-04-20

Systemic reaction (other): Loss of appetite, loss of taste, Severe back pain shaking teeth chatter

2021-04-21

Systemic reaction (other): Mostly leg muscle and back pain

Release 8 — day 35, dose 2

2021-05-24

Symptoms: Right arm shoulder muscle feels like a sprain.

Release 9 — 3 months, dose 2

2021-07-19

Symptoms: Difficulty loosing weight

Release 10 — 6 months, dose 2

2021-10-20

Symptoms: Acute sinusitis and sinus inflammation, variation in menstral cycles

Release 11 — 12 months, dose 2

2022-04-19

Symptoms: I contracted COVID December 2021

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	Acute sinusitis	·	·	✓
SD	COVID-19	·	·	✓
SD	Erythema	✓	✓	✓
SD	Menstrual disorder	·	·	✓
SD	Muscle strain	✓	✓	✓
SD	Paranasal sinus inflammation	·	·	✓
SD	Rash macular	✓	✓	✓
SD	Weight loss poor	·	·	✓
SRO	Ageusia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Injection site nodule	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site reaction	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Tremor	✓	✓	✓

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