44B-19407-71403

3 vaccinations 7 coded responses 28 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 039 / ME
Registered: 2021-01-07

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Diarrhea

Adult check-in
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Breast pain, Injection site pain, Lymph node pain, Pain — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: The pain from injection site radiates from arm/ shoulder area to side of breast( lymph node area). Very sore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Diarrhea

Adult check-in
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Nasal congestion — Feeling: Good · Headache

Free text: Stuffy nose. Headache was moderate then became mild mid day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-28
Survey response — day 21, dose 1
MedDRA: Abdominal discomfort, Dizziness — Feeling: Poor

Free text: Dizzy, upset stomach

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-05
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness · Joint pains, Fatigue or tiredness, Nausea

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Poor · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Headache has been fairly consistent since receiving 2nd vaccine. Also, sinus pressure. No nasal discharge. No post nasal drip. No sneezing. No school or an of cold

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 7, dose 2
Feeling: Poor · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Survey response — day 14, dose 2
MedDRA: Sinusitis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sinus infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Report sent to call center — day 14, 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)
2021-02-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-20
Survey response — day 42, dose 2
MedDRA: Abdominal discomfort, Migraine — Feeling: Poor · Be unable to do your normal daily activities

Free text: Gi upsetIncreased migraines

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-07
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-08-17
Call 1 — Left Voicemail
2022-01-28
Dose 3 — Moderna
2022-02-05
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-02-05
Health check-in — day 7, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2022-02-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-19
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-03-05
Survey response — day 35, dose 3
MedDRA: Arthralgia, Back pain, Pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Body aches. Joints. And back

MedDRA releases: 2024-11 · check-in free text available
2022-03-05
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-07
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-05	Moderna
3	2022-01-28	Moderna	No

Call center

2 call center cases

2 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

2021-01-09

Systemic reaction (other): The pain from injection site radiates from arm/ shoulder area to side of breast( lymph node area). Very sore.

2021-01-13

Systemic reaction (other): Stuffy nose. Headache was moderate then became mild mid day.

Release 2 — day 21, dose 1

2021-01-28

Symptoms: Dizzy, upset stomach

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Headache has been fairly consistent since receiving 2nd vaccine. Also, sinus pressure. No nasal discharge. No post nasal drip. No sneezing. No school or an of cold

Release 4 — day 14, dose 2

2021-02-21

Symptoms: Sinus infection

Release 6 — day 42, dose 2

2021-03-20

Symptoms: Gi upsetIncreased migraines

Release 11 — day 35, dose 3

2022-03-05

Symptoms: Body aches. Joints. And back

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	Abdominal discomfort	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Pain	·	·	✓
SD	Sinusitis	✓	✓	✓
SRO	Breast pain	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Pain	✓	✓	✓

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