47A-15649-20637

2 vaccinations 8 coded responses 24 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 913 / CA
Registered: 2021-02-26

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

2021-02-26
Registered in v-safe
2021-02-26
Dose 1 — Moderna
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain

Free text: Pain is at the shot site and extends several inches below

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-05
Health check-in — day 7, dose 1
Feeling: Good · Headache, Abdominal pain

Adult check-in
2021-03-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-26
Dose 2 — Moderna
2021-03-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate irregular — Feeling: Good · Site: Pain · Headache

Free text: Irregular heart beats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

Adult check-in
2021-04-09
Survey response — day 14, dose 2
MedDRA: Anxiety, Hot flush, Insomnia — Feeling: Good

Free text: Im having a lot of hot flashes at night which wakes me up and then I have insomnia. Also getting anxiety attacks at night too.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-30
Survey response — day 35, dose 2
MedDRA: Hot flush — Feeling: Good

Free text: Night hot flashes are getting worse and wake up more

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — day 42, dose 2
MedDRA: Headache, Hot flush — Feeling: Good

Free text: Headache and hot flashes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Survey response — 3 months, dose 2
MedDRA: Clostridium difficile infection, Diverticulitis — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, Hospitalization

Free text: Diverticulitis and c diff

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Report sent to call center — 3 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

1 call case(s)
2021-07-02
Call 1 — Left Voicemail
2021-09-24
Survey response — 6 months, dose 2
MedDRA: Chest pain, Diverticulitis, Renal pain — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Pain in kidneys chest plus diverticulitis

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-10-12
Call 1 — Requested Callback
2021-10-12
Call successful
Other
2022-03-26
Survey response — 12 months, dose 2
MedDRA: Fatigue, Feeling abnormal, Gastrointestinal disorder, Gastrointestinal pain, Malaise, Nausea, Weight decreased — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Nauseous weak fatigued colon pain weight loss gut problems felt so poorly didn't know if I would pull through for two weeks still felling Ill

MedDRA releases: 2024-11 · check-in free text available
2022-03-26
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-30
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-26	Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-28

Systemic reaction (other): Pain is at the shot site and extends several inches below

Release 6 — days 1–6 daily, dose 2

2021-03-28

Systemic reaction (other): Irregular heart beats

Release 7 — day 14, dose 2

2021-04-09

Symptoms: Im having a lot of hot flashes at night which wakes me up and then I have insomnia. Also getting anxiety attacks at night too.

Release 8 — day 35, dose 2

2021-04-30

Symptoms: Night hot flashes are getting worse and wake up more

Release 8 — day 42, dose 2

2021-05-07

Symptoms: Headache and hot flashes

Release 9 — 3 months, dose 2

2021-06-25

Symptoms: Diverticulitis and c diff

Release 9 — 6 months, dose 2

2021-09-24

Symptoms: Pain in kidneys chest plus diverticulitis

Release 11 — 12 months, dose 2

2022-03-26

Symptoms: Nauseous weak fatigued colon pain weight loss gut problems felt so poorly didn't know if I would pull through for two weeks still felling Ill

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	Anxiety	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Clostridium difficile infection	✓	✓	✓
SD	Diverticulitis	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Feeling abnormal	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Gastrointestinal pain	·	·	✓
SD	Headache	✓	✓	✓
SD	Hot flush	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Malaise	·	·	✓
SD	Nausea	·	·	✓
SD	Renal pain	·	·	✓
SD	Weight decreased	·	·	✓
SRO	Heart rate irregular	✓	✓	✓
SRO	Injection site pain	✓	✓	✓

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