4HK-28939-46832

1 vaccination 7 coded responses 8 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 871 / NM
Registered: 2021-03-24

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

2021-03-16
Dose 1 — Moderna
2021-03-24
Registered in v-safe
2021-03-24
Survey response — day 7, dose 1
MedDRA: Vision blurred — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Blurred vision

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 14, dose 1
MedDRA: Depression, Fatigue, Vaccination site erythema, Vaccination site swelling — Feeling: Good · Be unable to do your normal daily activities

Free text: Strong sense of fatigue and some depression Days 9-12. Swelling and redness of the vaccine area continued until Day 8 and then finally disappeared and that is when the fatigue started.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 21, dose 1
MedDRA: Chills, Dyspnoea, Fatigue, Nausea, Respiratory tract congestion, SARS-CoV-2 test positive — Feeling: Good · 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: Chills, nausea, shortness of breath, a LOT of fatigue, congestion. So much that I went and had a COVID test.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
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)
2021-04-13
Survey response — day 28, dose 1
MedDRA: Back pain, Gait disturbance, Muscle spasms, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have had a lot of back pain and it has made it difficult to walk sometimes. I also have had some severe camps in my foot. Today and yesterday, my arm was sore again where the shot had been administered. It seems like exercise has been more difficul

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — day 35, dose 1
MedDRA: Back pain, Movement disorder, Office visit, Spinal pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Some very strange back pain and symptoms making it difficult for me to move in a downward motion whether sitting down or bending over. Feeling of low vertebrae being pulled apart. · Healthcare visit (other): My primary doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — day 35, 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)
2021-04-27
Health check-in — day 42, dose 1
Feeling: Good

Adult check-in
2021-06-16
Survey response — 3 months, dose 1
MedDRA: Bone pain, Dyspnoea, Fatigue, Headache, Myalgia, Office visit, Pre-existing disease, Rheumatoid arthritis — 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 · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Right after the vaccine, I had a bad flare up of rheumatoid arthritis. Deep pain in muscles and bones, a lot of fatigue and headache. The fatigue is continuing to plague me. Shortness of breath was intermittent and has progressed to intense recently. · Healthcare visit (other): Homeopathic consultation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Report sent to call center — 3 months, dose 1
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)
2021-06-18
Call successful
Participant prefers to complete VAERS report online
2021-09-14
Survey response — 6 months, dose 1
MedDRA: Arthralgia, Burning sensation, Hypoaesthesia, Unevaluable event — 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 visit

Free text: Symptoms: Pain in SI joint, causing intermittent numbness and burning all the way down my leg to my feet. · Healthcare visit (other): Still in treatment

MedDRA releases: 2024-11 · check-in free text available
2021-09-14
Report sent to call center — 6 months, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-16
Call 1 — Requested Callback
2021-09-28
Call 2 — Could Not Reach Participant
2021-09-28
Callback requested for
06:30PM ET

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Moderna

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 6 — day 7, dose 1

2021-03-24

Systemic reaction (other): Blurred vision

Release 6 — day 14, dose 1

2021-03-30

Symptoms: Strong sense of fatigue and some depression Days 9-12. Swelling and redness of the vaccine area continued until Day 8 and then finally disappeared and that is when the fatigue started.

Release 7 — day 21, dose 1

2021-04-07

Symptoms: Chills, nausea, shortness of breath, a LOT of fatigue, congestion. So much that I went and had a COVID test.

Release 7 — day 28, dose 1

2021-04-13

Symptoms: I have had a lot of back pain and it has made it difficult to walk sometimes. I also have had some severe camps in my foot. Today and yesterday, my arm was sore again where the shot had been administered. It seems like exercise has been more difficul cut off by CDC

Release 7 — day 35, dose 1

2021-04-20

Symptoms: Some very strange back pain and symptoms making it difficult for me to move in a downward motion whether sitting down or bending over. Feeling of low vertebrae being pulled apart.

Healthcare visit (other): My primary doctor

Release 9 — 3 months, dose 1

2021-06-16

Symptoms: Right after the vaccine, I had a bad flare up of rheumatoid arthritis. Deep pain in muscles and bones, a lot of fatigue and headache. The fatigue is continuing to plague me. Shortness of breath was intermittent and has progressed to intense recently. cut off by CDC

Healthcare visit (other): Homeopathic consultation

Release 9 — 6 months, dose 1

2021-09-14

Symptoms: Pain in SI joint, causing intermittent numbness and burning all the way down my leg to my feet.

Healthcare visit (other): Still in treatment

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	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	✓	✓	✓
SD	Bone pain	✓	✓	✓
SD	Burning sensation	·	·	✓
SD	Chills	✓	✓	✓
SD	Depression	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gait disturbance	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Movement disorder	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rheumatoid arthritis	✓	✓	✓
SD	SARS-CoV-2 test positive	✓	✓	✓
SD	Spinal pain	✓	✓	✓
SD	Vaccination site erythema	✓	✓	✓
SD	Vaccination site swelling	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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