4C4-48579-53725

2 vaccinations 12 coded responses 28 check-ins 12 free-text entries 8 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 463 / IN
Registered: 2021-03-03

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Moderna
2021-03-03
Health check-in — day 0, dose 1
Feeling: Fair · Chills, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Nausea, Vomiting — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: I was vomiting last night. Not today. Just nauseous.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Pre-existing disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Headache is SEVERE! Hyponatremia related? Im concerned that my injection has worsened my chronic low blood sodium.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Depression, Depression suicidal, Suicidal ideation — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Extreme depression that is getting worse by the day. Its really bad. Even to the point of wishing I would die. I never heard of these side effects.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Disturbance in attention, Gait disturbance, Pre-existing disease — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: My pre-existing back issues are much worse since vaccine. I dont understand the connection. I just know that it is intolerable to walk.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-10
Survey response — day 7, dose 1
MedDRA: Neuralgia, Office visit, Pain — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Doctor appointment. Having a nerve burning for pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 7, dose 1
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)
2021-03-17
Survey response — day 14, dose 1
MedDRA: Apnoea, Arthralgia, Back pain, Chest discomfort, Hypertension, Hypopnoea, Unevaluable event — Feeling: Poor · 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, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: My back pain is so much worse than it was before. It hips now as well. I also have a tightness in my chest with pressure. My breathing is shallow. When laying on my back I catch myself not breathing. Its very scary. Blood pressure is high too. · Healthcare visit (other): Im happy a procedure next week on my back to burn nerves.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 14, dose 1
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)
2021-03-24
Survey response — day 21, dose 1
MedDRA: Arthralgia, Back pain, Pre-existing disease, Unevaluable event — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Intense pain in lower back across to the hips. Much more intense and painful than before I had COVID. · Healthcare visit (other): Im having surgery

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — day 21, dose 1
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)
2021-03-31
Survey response — day 28, dose 1
MedDRA: Asthenia, Chills, Diarrhoea, Dizziness, Headache, Hypopnoea, Respiratory rate increased, Unevaluable event, Vomiting — Feeling: Poor · 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: Symptoms: Non stop vomiting. Constant diarrhea. Chills. Headache. Extremely weak & light headed. Shallow rapid breathing My second Covid vaccine was originally scheduled for today but Meijers pharmacy called me and canceled. Now Im supposed to go April 9 · Healthcare visit (other): I was supposed to have a mammogram tomorrow. I had to cancel.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — day 28, dose 1
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)
2021-04-07
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-04-09
Dose 2 — Moderna
2021-04-09
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Back pain, Condition aggravated, Neck pain, Pain, Pain in extremity, Pre-existing disease — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): My fibromyalgia is extreme now. My knee, hips, full back, neck, arms, everything hurts really bad. · Healthcare visit (other): I am going on to see my doctor tomorrow. Ever since I had COVID-19 in January I hurt everywhere. Its extreme! I cant even stand to brush my teeth.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Report sent to call center — days 1–6 daily, 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)
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit, Pain — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Saw my doctor. Hes starting me on Cymbalta for body aches. Also ordered X-rays for knees and hips.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Report sent to call center — days 1–6 daily, 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)
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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

Adult check-in
2021-04-13
Report sent to call center — days 1–6 daily, 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)
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Depression, Vaccine positive rechallenge — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Extreme depression just like after first vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-23
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-30
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-08
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-27
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-10
Survey response — 12 months, dose 2
MedDRA: Anaemia, Aphasia, Brain fog, Dysphemia, Large intestinal haemorrhage, Memory impairment — 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, Emergency room or emergency department visit, Hospitalization

Free text: Hemorrhaging colon. Anemia. My brain isn't working right. I stutter and never had before. Forgetfulness in nearly every sentence. Unable to remember the most common names of things. I try to explaining what word I'm wanting to say and I'm blank.

MedDRA releases: 2024-11 · check-in free text available
2022-04-10
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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-11
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-04-09	Moderna

Call center

8 call center cases

8 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): I was vomiting last night. Not today. Just nauseous.

2021-03-05

Systemic reaction (other): Headache is SEVERE! Hyponatremia related? Im concerned that my injection has worsened my chronic low blood sodium.

2021-03-06

Systemic reaction (other): Extreme depression that is getting worse by the day. Its really bad. Even to the point of wishing I would die. I never heard of these side effects.

2021-03-08

Systemic reaction (other): My pre-existing back issues are much worse since vaccine. I dont understand the connection. I just know that it is intolerable to walk.

Release 5 — day 7, dose 1

2021-03-10

Healthcare visit (other): Doctor appointment. Having a nerve burning for pain

Release 5 — day 14, dose 1

2021-03-17

Symptoms: My back pain is so much worse than it was before. It hips now as well. I also have a tightness in my chest with pressure. My breathing is shallow. When laying on my back I catch myself not breathing. Its very scary. Blood pressure is high too.

Healthcare visit (other): Im happy a procedure next week on my back to burn nerves.

Release 6 — day 21, dose 1

2021-03-24

Symptoms: Intense pain in lower back across to the hips. Much more intense and painful than before I had COVID.

Healthcare visit (other): Im having surgery

Release 6 — day 28, dose 1

2021-03-31

Symptoms: Non stop vomiting. Constant diarrhea. Chills. Headache. Extremely weak & light headed. Shallow rapid breathing My second Covid vaccine was originally scheduled for today but Meijers pharmacy called me and canceled. Now Im supposed to go April 9

Healthcare visit (other): I was supposed to have a mammogram tomorrow. I had to cancel.

Release 7 — days 1–6 daily, dose 2

2021-04-11

Systemic reaction (other): My fibromyalgia is extreme now. My knee, hips, full back, neck, arms, everything hurts really bad.

Healthcare visit (other): I am going on to see my doctor tomorrow. Ever since I had COVID-19 in January I hurt everywhere. Its extreme! I cant even stand to brush my teeth.

2021-04-12

Healthcare visit (other): Saw my doctor. Hes starting me on Cymbalta for body aches. Also ordered X-rays for knees and hips.

2021-04-15

Systemic reaction (other): Extreme depression just like after first vaccination

Release 11 — 12 months, dose 2

2022-04-10

Symptoms: Hemorrhaging colon. Anemia. My brain isn't working right. I stutter and never had before. Forgetfulness in nearly every sentence. Unable to remember the most common names of things. I try to explaining what word I'm wanting to say and I'm blank.

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	Neuralgia	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Pain	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Anaemia	·	·	✓
SD	Aphasia	·	·	✓
SD	Apnoea	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Condition aggravated	○	○	○
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dysphemia	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Hypopnoea	✓	✓	✓
SD	Large intestinal haemorrhage	·	·	✓
SD	Memory impairment	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory rate increased	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Depression	✓	✓	✓
SRO	Depression suicidal	○	✓	○
SRO	Disturbance in attention	✓	✓	✓
SRO	Gait disturbance	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Suicidal ideation	✓	·	✓
SRO	Vaccine positive rechallenge	✓	✓	✓
SRO	Vomiting	✓	✓	✓

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