4A2-65125-89771

5 vaccinations 9 coded responses 48 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 731 / OK
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: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-08
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Pyrexia, Self-medication — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: My normal temp varies between 96 and 97 so I've had significant fever even with high doses of Tylenol.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-04
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, 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 · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Survey response — day 35, dose 2
MedDRA: Cough, Fatigue, Pre-existing disease, Rheumatoid arthritis — Feeling: Fair · Be unable to do your normal daily activities

Free text: I take monthly infusions for rheumatoid arthritis and it seems like my arthritis has worsened since the vaccinations and I cant seem to shake a cough or tiredness since the first dose in January.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-05
Survey response — 6 months, dose 2
MedDRA: Immunosuppression, Surgery — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I had surgery and was tested for antibodies to the vaccine, twice, and both tests were negative. I am immunosuppressive and the vaccine didnt work for me.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-09
Call 1 — Left Voicemail
2021-08-09
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-02
Dose 3 — Moderna
2021-09-25
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-14
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-03
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-03-24
Dose 4 — Moderna
2022-04-16
Survey response — day 21, dose 4
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extremely tired since

MedDRA releases: 2024-11 · check-in free text available
2022-04-21
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-04-28
Survey response — day 35, dose 4
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tired

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-06-25
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-09-22
Survey response — 6 months, dose 4
MedDRA: COVID-19, Malaise — Feeling: Fair · 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: I got Covid and was very sick for several weeks and still feel sick.

MedDRA releases: 2024-11 · check-in free text available
2022-09-22
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-09-23
Call successful
Does not wish to fill out VAERS report
2022-11-21
Dose 5 — Moderna
2022-11-22
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-23
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-24
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2022-11-25
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-26
Survey response — days 1–6 daily, dose 5
MedDRA: Chest pain — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chest pain

MedDRA releases: 2024-11 · check-in free text available
2022-11-27
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-11-28
Health check-in — day 7, dose 5
Feeling: Fair · Site: Pain · None

Adult check-in
2022-12-07
Survey response — day 14, dose 5
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-12-12
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-12-19
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-12-30
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2023-01-02
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-02-22
Survey response — 3 months, dose 5
MedDRA: Corneal dystrophy — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-22
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2021-09-02	Moderna	No
4	2022-03-24	Moderna	No
5	2022-11-21	Moderna	No

Call center

4 call center cases

2 successful · 2 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): My normal temp varies between 96 and 97 so I've had significant fever even with high doses of Tylenol.

Release 5 — day 35, dose 2

2021-03-11

Symptoms: I take monthly infusions for rheumatoid arthritis and it seems like my arthritis has worsened since the vaccinations and I cant seem to shake a cough or tiredness since the first dose in January.

Release 9 — 6 months, dose 2

2021-08-05

Symptoms: I had surgery and was tested for antibodies to the vaccine, twice, and both tests were negative. I am immunosuppressive and the vaccine didnt work for me.

Release 11 — day 21, dose 4

2022-04-16

Symptoms: Extremely tired since

Release 11 — day 35, dose 4

2022-04-28

Symptoms: Tired

Release 12 — 6 months, dose 4

2022-09-22

Symptoms: I got Covid and was very sick for several weeks and still feel sick.

Release 12 — days 1–6 daily, dose 5

2022-11-26

Systemic reaction (other): Chest pain

Release 12 — day 14, dose 5

2022-12-07

Symptoms: Fatigue

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	Corneal dystrophy	·	·	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Immunosuppression	✓	·	✓
SD	Malaise	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rheumatoid arthritis	✓	✓	✓
SD	Surgery	✓	·	✓
SRO	Chest pain	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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