4LW-17790-72791

5 vaccinations 13 coded responses 47 check-ins 13 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 950 / CA
Registered: 2021-04-23

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

2021-03-21
Dose 1 — Moderna
2021-04-20
Dose 2 — Moderna
2021-04-23
Registered in v-safe
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Heart rate increased, Insomnia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness, Insomnia, and Increased Heart Rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I have Fibromyalgia and chronic pain, therefore it can sometimes take longer for me to recover from anything.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-28
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-05-04
Survey response — day 14, dose 2
MedDRA: Arthralgia, Fatigue, Pain, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: My overall pain levels have been elevated. I have chronic pain and I have no idea if the increased pain is from my existing health issues or from the vaccine.My joint pains and overall body aches are worse lately. I'm also much more tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-22
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-20
Survey response — 6 months, dose 2
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair

Free text: The glands on either side of my neck, under the jaw bone, are tender and enlarged.

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Dose 3 — Moderna
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-10
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-14
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-02
Survey response — 3 months, dose 3
MedDRA: Hip arthroplasty — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: I have had a Total Right Hip Replacement

MedDRA releases: 2024-11 · check-in free text available
2022-02-02
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-05-04
Survey response — 6 months, dose 3
MedDRA: Arthralgia, Arthritis infective, Central venous catheterisation, Erythema, Hip arthroplasty, Pre-existing disease, Surgery — Feeling: Poor · 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: I had a hip replacement surgery on 1/28/22, then my hip got infected and I had to have a partial revision surgery on my hip on 4/2/22. I have a PICC line installed and I am on IV antibiotics. My hip is healing, but is still very red and painful. · Healthcare visit (other): Surgery

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Report sent to call center — 6 months, dose 3
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 · 1 call case(s)
2022-06-08
Dose 4 — Moderna
2022-06-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-11
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-06-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-06-15
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-06-22
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-06
Survey response — day 28, dose 4
MedDRA: Condition aggravated, Office visit, Pain, Pain in extremity, Pre-existing disease, Surgery, Tenolysis — 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 · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I had trigger finger release surgery on my right hand on July 1, 2022. My whole body is achy and sore, in addition to my sore hand. All of my inflammatory conditions are aggravated. · Healthcare visit (other): In office surgery procedure.

MedDRA releases: 2024-11 · check-in free text available
2022-07-06
Report sent to call center — day 28, 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)
2022-07-13
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-07-20
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-09-07
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-09-08
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-09
Survey response — days 1–6 daily, dose 5
MedDRA: Lymphadenopathy, Oropharyngeal pain — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sore throat & swollen neck glands

MedDRA releases: 2024-11 · check-in free text available
2022-09-10
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-11
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-12
Survey response — days 1–6 daily, dose 5
MedDRA: Pruritus — Feeling: Fair · Fatigue or tiredness

Free text: Bodywide itching, not at the injection site. Been going on since the shot.

MedDRA releases: 2024-11 · check-in free text available
2022-09-14
Survey response — day 7, dose 5
MedDRA: Pruritus — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Bodywide itching

MedDRA releases: 2024-11 · check-in free text available
2022-09-21
Survey response — day 14, dose 5
MedDRA: Injection site pain — Feeling: Good

Free text: My right bicep hurts. I got my shot in the right arm. I don't know if it's regular muscle sore or not. It hurts on the lower, outside, of my bicep just above my elbow.

MedDRA releases: 2024-11 · check-in free text available
2022-09-28
Survey response — day 21, dose 5
MedDRA: Back pain — Feeling: Good

Free text: Backache

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-12
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-19
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-07
Survey response — 3 months, dose 5
MedDRA: Atrial fibrillation, Emergency care, Heart rate irregular — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: I had an AFib episode on 12/3/22. I was in the ER for 10 hours before it ended. My HR was all over the place, from 120 to 180, and very erratic.

MedDRA releases: 2024-11 · check-in free text available
2022-12-07
Report sent to call center — 3 months, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-12-08
Call 1 — Left Voicemail
2022-12-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-08
Call successful
Not applicable - Accidental Reporting
2022-12-09
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2023-03-08
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-21	Moderna
2	2021-04-20	Moderna
3	2021-11-02	Moderna	No
4	2022-06-08	Moderna	No
5	2022-09-07	Pfizer-BioNTech	Flu

Call center

4 call center cases

4 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-23

Systemic reaction (other): Dizziness, Insomnia, and Increased Heart Rate

2021-04-25

Systemic reaction (other): I have Fibromyalgia and chronic pain, therefore it can sometimes take longer for me to recover from anything.

Release 8 — day 14, dose 2

2021-05-04

Symptoms: My overall pain levels have been elevated. I have chronic pain and I have no idea if the increased pain is from my existing health issues or from the vaccine.My joint pains and overall body aches are worse lately. I'm also much more tired.

Release 10 — 6 months, dose 2

2021-10-20

Symptoms: The glands on either side of my neck, under the jaw bone, are tender and enlarged.

Release 11 — 3 months, dose 3

2022-02-02

Symptoms: I have had a Total Right Hip Replacement

Release 11 — 6 months, dose 3

2022-05-04

Symptoms: I had a hip replacement surgery on 1/28/22, then my hip got infected and I had to have a partial revision surgery on my hip on 4/2/22. I have a PICC line installed and I am on IV antibiotics. My hip is healing, but is still very red and painful.

Healthcare visit (other): Surgery

Release 12 — day 28, dose 4

2022-07-06

Symptoms: I had trigger finger release surgery on my right hand on July 1, 2022. My whole body is achy and sore, in addition to my sore hand. All of my inflammatory conditions are aggravated.

Healthcare visit (other): In office surgery procedure.

Release 12 — days 1–6 daily, dose 5

2022-09-09

Systemic reaction (other): Sore throat & swollen neck glands

2022-09-12

Systemic reaction (other): Bodywide itching, not at the injection site. Been going on since the shot.

Release 12 — day 7, dose 5

2022-09-14

Systemic reaction (other): Bodywide itching

Release 12 — day 14, dose 5

2022-09-21

Symptoms: My right bicep hurts. I got my shot in the right arm. I don't know if it's regular muscle sore or not. It hurts on the lower, outside, of my bicep just above my elbow.

Release 12 — day 21, dose 5

2022-09-28

Symptoms: Backache

Release 12 — 3 months, dose 5

2022-12-07

Symptoms: I had an AFib episode on 12/3/22. I was in the ER for 10 hours before it ended. My HR was all over the place, from 120 to 180, and very erratic.

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	Surgery	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Arthritis infective	·	·	✓
SD	Atrial fibrillation	·	·	✓
SD	Back pain	·	·	✓
SD	Central venous catheterisation	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Emergency care	·	·	✓
SD	Erythema	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Heart rate irregular	·	·	✓
SD	Hip arthroplasty	·	·	✓
SD	Injection site pain	·	·	✓
SD	Lymph node pain	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Tenolysis	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pruritus	·	·	✓

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