479-18195-71470
5 vaccinations
12 coded responses
39 check-ins
11 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 66+
- ZIP prefix
- 342 / FL
- Registered
- 2021-01-19
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-01-19
Registered in v-safe
-
2021-01-19
Dose 1 — Moderna
- 2021-01-21
-
2021-01-22
Survey response — days 1–6 daily, dose 1MedDRA: No adverse event — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activitiesFree text: NoMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-01-23
- 2021-01-24
- 2021-01-25
- 2021-01-26
-
2021-02-02
Survey response — day 14, dose 1MedDRA: Abdominal pain, Flatulence, Insomnia, Muscle spasms — Feeling: Poor · Be unable to do your normal daily activitiesFree text: AB pain, cramping, gas, insomniaMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-09
-
2021-02-16
Dose 2 — Moderna
- 2021-02-16
- 2021-02-17
- 2021-02-18
- 2021-02-19
- 2021-02-20
- 2021-02-21
- 2021-02-22
- 2021-02-23
- 2021-03-02
-
2021-03-09
Survey response — day 21, dose 2MedDRA: Adverse drug reaction, Arthralgia, Myalgia, Pyrexia, Sensory loss — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Serious adverse reaction to Macrid. Lost feeling in arms & legs, fever, then pain in every muscle & joint. DK if this could have been affected by the CoVID shots.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-09
Report sent to call center — day 21, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
-
2021-03-16
Survey response — day 28, dose 2MedDRA: Hepatomegaly — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visitFree text: Enlarged liver. Due to Macrobid?MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-03-16
Report sent to call center — day 28, dose 2Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional1 call case(s)
- 2021-03-23
- 2021-03-30
- 2021-05-18
-
2021-08-17
Survey response — 6 months, dose 2MedDRA: Coccydynia, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalFree text: Symptoms: Coccydynia · Healthcare visit (other): Drs ofcMedDRA releases: 2021-09,2024-11 · check-in free text available
-
2021-08-17
Report sent to call center — 6 months, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-08-19
- 2021-08-20
- 2021-08-24
-
2021-08-24
Call successfulParticipant prefers to complete VAERS report online
-
2021-11-11
Dose 3 — Moderna
- 2022-02-16
-
2022-04-16
Dose 4 — Moderna
-
2022-04-16
Survey response — day 0, dose 4MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2022-04-17
Survey response — days 1–6 daily, dose 4MedDRA: No adverse event — Feeling: GoodFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2022-04-19
Survey response — days 1–6 daily, dose 4MedDRA: Joint swelling — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Swollen ankles ( prob not related)MedDRA releases: 2024-11 · check-in free text available
-
2022-04-20
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesAdult check-in
- 2022-04-21
-
2022-04-22
Survey response — days 1–6 daily, dose 4MedDRA: Arthralgia, Emergency care, Oedema, Peripheral venous disease, SARS-CoV-2 test negative — Feeling: GoodFree text: No. Went to the ER on 04/20 & the edema & joint pain was diagnosed as Chronic Venal Insufficiency. Had nothing to do with the COVID booster. They tested for COVID. Negative.MedDRA releases: 2024-11 · check-in free text available
-
2022-04-23
Survey response — day 7, dose 4MedDRA: No adverse event — Feeling: Fair · Diarrhea, Abdominal pain · Be unable to do your normal daily activitiesFree text: NoMedDRA releases: 2024-11 · check-in free text available
-
2022-04-30
Survey response — day 14, dose 4MedDRA: Diarrhoea, Dizziness, Headache, Muscle spasms — Feeling: Fair · Be unable to do your normal daily activitiesFree text: Headache, cramps, diarrhea, light headedness.MedDRA releases: 2024-11 · check-in free text available
- 2022-05-07
- 2022-05-14
- 2022-05-21
- 2022-05-28
- 2022-07-16
- 2022-10-15
-
2022-10-30
Dose 5 — Moderna
-
2023-04-30
Survey response — 6 months, dose 5MedDRA: Arthritis, Asthenia, Office visit — Feeling: Good · Get care from a doctor or other healthcare professionalMedDRA releases: 2024-11
-
2023-04-30
Report sent to call center — 6 months, dose 5Get care from a doctor or other healthcare professional1 call case(s)
- 2023-05-02
-
2023-05-09
Call successfulParticipant prefers to complete VAERS report online
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-01-19 | Moderna | |
| 2 | 2021-02-16 | Moderna | |
| 3 | 2021-11-11 | Moderna | No |
| 4 | 2022-04-16 | Moderna | No |
| 5 | 2022-10-30 | Moderna | No |
Call center
4 call center cases
4 successful
Free text
Release 2 — days 1–6 daily, dose 1
Systemic reaction (other): No
Release 3 — day 14, dose 1
Symptoms: AB pain, cramping, gas, insomnia
Release 5 — day 21, dose 2
Symptoms: Serious adverse reaction to Macrid. Lost feeling in arms & legs, fever, then pain in every muscle & joint. DK if this could have been affected by the CoVID shots.
Release 5 — day 28, dose 2
Symptoms: Enlarged liver. Due to Macrobid?
Release 9 — 6 months, dose 2
Release 11 — day 0, dose 4
Systemic reaction (other): No
Release 11 — days 1–6 daily, dose 4
Systemic reaction (other): No
Systemic reaction (other): Swollen ankles ( prob not related)
Systemic reaction (other): No. Went to the ER on 04/20 & the edema & joint pain was diagnosed as Chronic Venal Insufficiency. Had nothing to do with the COVID booster. They tested for COVID. Negative.
Release 11 — day 7, dose 4
Systemic reaction (other): No
Release 11 — day 14, dose 4
Symptoms: Headache, cramps, diarrhea, light headedness.
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 | Office visit | ✓ | · | ✓ |
| SD | Abdominal pain | ✓ | ✓ | ✓ |
| SD | Adverse drug reaction | ✓ | ✓ | ✓ |
| SD | Arthralgia | ✓ | ✓ | ✓ |
| SD | Arthritis | · | · | ✓ |
| SD | Asthenia | · | · | ✓ |
| SD | Coccydynia | ✓ | · | ✓ |
| SD | Diarrhoea | · | · | ✓ |
| SD | Dizziness | · | · | ✓ |
| SD | Flatulence | ✓ | ✓ | ✓ |
| SD | Headache | · | · | ✓ |
| SD | Hepatomegaly | ✓ | ✓ | ✓ |
| SD | Insomnia | ✓ | ✓ | ✓ |
| SD | Muscle spasms | ✓ | ✓ | ✓ |
| SD | Myalgia | ✓ | ✓ | ✓ |
| SD | Pyrexia | ✓ | ✓ | ✓ |
| SD | Sensory loss | ✓ | ✓ | ✓ |
| SRO | Arthralgia | · | · | ✓ |
| SRO | Emergency care | · | · | ✓ |
| SRO | Joint swelling | · | · | ✓ |
| SRO | No adverse event | ✓ | ✓ | ✓ |
| SRO | Oedema | · | · | ✓ |
| SRO | Peripheral venous disease | · | · | ✓ |
| SRO | SARS-CoV-2 test negative | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release