4AS-32444-78796

2 vaccinations 3 coded responses 17 check-ins 3 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 720 / AR
Registered: 2021-01-05

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Vomiting

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-12
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
2021-01-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-02
Dose 2 — Moderna
2021-02-09
Health check-in — day 7, dose 2
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-02-09
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-16
Survey response — day 14, dose 2
MedDRA: Bone pain, Fatigue, Headache, Pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fever bone pain aching and headache nausea severe fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-05-26
Call 1 — Could Not Reach Participant
2021-06-01
Call 2 — Could Not Reach Participant
2021-08-03
Survey response — 6 months, dose 2
MedDRA: Anxiety, Asthenia, Bone pain, Deep vein thrombosis, Hospitalisation, Impaired work ability, Thrombosis, Tremor — 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 · Emergency room or emergency department visit, Hospitalization

Free text: Dvt. Bilateral blood clots. Tremors. Bone pain extremities weakness getting worse Oxygen dependent. 2hospitalization.s. On Coumadin. This vaccine ruined my life I went from working 12-14 hours a day to unable to work at all. Worried about Gillian bu

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-03
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

1 call case(s)
2021-08-12
Call 1 — Could Not Reach Participant
2021-08-16
Call successful
Does not wish to fill out VAERS report
2022-02-02
Survey response — 12 months, dose 2
MedDRA: Amnesia, Arthralgia, Brain fog, Hemiparesis, Hypoaesthesia, Musculoskeletal disorder, Pain, Pulmonary thrombosis, Thrombosis — 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, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Pain multiple areas. Both shoulder. Right leg numb and doesn't want to work, left side weakness. Remains on oxygen, short term Memory loss and brain fog. · Healthcare visit (other): Blood clot in leg, and lungs

MedDRA releases: 2024-11 · check-in free text available
2022-02-02
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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-02-04
Call 1 — Could Not Reach Participant
2022-02-09
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-02	Moderna

Call center

4 call center cases

3 successful · 1 priority 2/3 (triaged and no follow up)

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — day 14, dose 2

2021-02-16

Symptoms: Fever bone pain aching and headache nausea severe fatigue

Release 9 — 6 months, dose 2

2021-08-03

Symptoms: Dvt. Bilateral blood clots. Tremors. Bone pain extremities weakness getting worse Oxygen dependent. 2hospitalization.s. On Coumadin. This vaccine ruined my life I went from working 12-14 hours a day to unable to work at all. Worried about Gillian bu cut off by CDC

Release 11 — 12 months, dose 2

2022-02-02

Symptoms: Pain multiple areas. Both shoulder. Right leg numb and doesn't want to work, left side weakness. Remains on oxygen, short term Memory loss and brain fog.

Healthcare visit (other): Blood clot in leg, and lungs

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	Pulmonary thrombosis	·	·	✓
HCVO	Thrombosis	·	·	✓
SD	Amnesia	·	·	✓
SD	Anxiety	✓	·	✓
SD	Arthralgia	·	·	✓
SD	Asthenia	✓	·	✓
SD	Bone pain	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Deep vein thrombosis	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hemiparesis	·	·	✓
SD	Hospitalisation	✓	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Impaired work ability	✓	·	✓
SD	Musculoskeletal disorder	·	·	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Thrombosis	✓	·	✓
SD	Tremor	✓	·	✓

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