4HQ-27463-05448

4 vaccinations 8 coded responses 33 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 483 / MI
Registered: 2021-03-29

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

QLC-13887-45761 Child or adolescent in my care · Male · 2021-12-28

PAH-77147-25683 Child or adolescent in my care · Female · 2021-12-28

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-29
Registered in v-safe
2021-03-29
Dose 1 — Moderna
2021-03-29
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

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

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

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-27
Dose 2 — Moderna
2021-04-27
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Nausea

Adult check-in
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Dysgeusia — Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Metallic like taste in mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-04
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-05-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-08-02
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Exposure to SARS-CoV-2, Myalgia, SARS-CoV-2 test negative, Vaccine positive rechallenge — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Muscle and joint pains and aches like Joint and muscles pains experienced post second Covid Vaccine shot. Recently had exposure to Covid positive person, but my Covid PCR test (taken 5 days post exposure) was negative.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-02
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-13
Call successful
Participant prefers to complete VAERS report online
2021-10-31
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-26
Dose 3 — Moderna
2021-12-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-01-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-01-03
Survey response — day 7, dose 3
MedDRA: Glossodynia, Tongue disorder — Feeling: Good · Site: Pain

Free text: Painful Bump on end of tongue (happened a few days ago but forgot to report)

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Survey response — day 14, dose 3
MedDRA: Aphonia, COVID-19, Cough, Diarrhoea, Dyspnoea, Fatigue, Respiratory tract congestion — Feeling: Poor · Be unable to work or attend school

Free text: I have COVID: cough, no voice, congestion, breathing difficulties, fatigue, diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-01-16
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-01-24
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-30
Survey response — day 35, dose 3
MedDRA: Gastrointestinal disorder, Headache — Feeling: Fair · Be unable to work or attend school

Free text: GI issues (but only 1 day this last week), more headaches

MedDRA releases: 2024-11 · check-in free text available
2022-02-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-10-12
Dose 4 — Pfizer-BioNTech
2022-10-14
Survey response — days 1–6 daily, dose 4
MedDRA: Abdominal pain, Arthralgia, Chills, Fatigue, Hot flush, Myalgia, Nausea, Pyrexia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school

Free text: Previous day didn't report and wanted to report: had fever, chills, hot flashes, severe abdominal pain, muscle aches, joint pain, fatigue, & nausea

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-10-20
Survey response — day 7, dose 4
MedDRA: Dizziness — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Light headedness

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2023-01-11
Survey response — 3 months, dose 4
MedDRA: 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

MedDRA releases: 2024-11
2023-01-11
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-12
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-29	Moderna
2	2021-04-27	Moderna
3	2021-12-26	Moderna	No
4	2022-10-12	Pfizer-BioNTech	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 8 — days 1–6 daily, dose 2

2021-04-29

Systemic reaction (other): Metallic like taste in mouth

Release 9 — 3 months, dose 2

2021-08-02

Symptoms: Muscle and joint pains and aches like Joint and muscles pains experienced post second Covid Vaccine shot. Recently had exposure to Covid positive person, but my Covid PCR test (taken 5 days post exposure) was negative.

Release 10 — day 7, dose 3

2022-01-03

Systemic reaction (other): Painful Bump on end of tongue (happened a few days ago but forgot to report)

Release 10 — day 14, dose 3

2022-01-10

Symptoms: I have COVID: cough, no voice, congestion, breathing difficulties, fatigue, diarrhea

Release 11 — day 35, dose 3

2022-01-30

Symptoms: GI issues (but only 1 day this last week), more headaches

Release 12 — days 1–6 daily, dose 4

2022-10-14

Systemic reaction (other): Previous day didn't report and wanted to report: had fever, chills, hot flashes, severe abdominal pain, muscle aches, joint pain, fatigue, & nausea

Release 12 — day 7, dose 4

2022-10-20

Systemic reaction (other): Light headedness

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	Aphonia	·	·	✓
SD	Arthralgia	✓	·	✓
SD	Arthritis	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Exposure to SARS-CoV-2	✓	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	·	·	✓
SD	Myalgia	✓	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	✓	·	✓
SD	Vaccine positive rechallenge	✓	·	✓
SRO	Abdominal pain	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Chills	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Glossodynia	·	·	✓
SRO	Hot flush	·	·	✓
SRO	Myalgia	·	·	✓
SRO	Nausea	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Tongue disorder	·	·	✓

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