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4M5-17272-65600

5 vaccinations 35 coded responses 51 check-ins 34 free-text entries 4 call cases
Sex
Female
Age at first dose
61-65
ZIP prefix
440 / OH
Registered
2021-03-05
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-04
    Dose 1 — Moderna
  2. 2021-03-05
    Registered in v-safe
  3. 2021-03-05
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pre-existing disease — Feeling: Good · Site: Swelling · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Unidentifiable virus(es) since 4-17/2020
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-06
    Survey response — days 1–6 daily, dose 1
    MedDRA: Fatigue, Pre-existing disease — Feeling: Good · Site: Swelling · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Fatigue may be due to a virus Ive had since 4/20.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-07
    Survey response — days 1–6 daily, dose 1
    MedDRA: Unevaluable event — Feeling: Good · Site: Swelling · Fatigue or tiredness · Be unable to work
    Free text: May be due to illness since 4-2021
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-08
    Survey response — days 1–6 daily, dose 1
    MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Due to prior virus since 4-2020.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-09
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pre-existing disease — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Ill with virus since 4/2020.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-10
    Survey response — days 1–6 daily, dose 1
    MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: From virus Ive had since 4/2020.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-11
    Survey response — day 7, dose 1
    MedDRA: Unevaluable event — Feeling: Good · Site: Swelling, Itching · Fatigue or tiredness · Be unable to work
    Free text: Due to virus since 4/2020.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  10. 2021-03-18
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  11. 2021-03-25
    Survey response — day 21, dose 1
    MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities
    Free text: Symptoms from virus last 4/2020, not vaccine
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-01
    Dose 2 — Moderna
  13. 2021-04-01
    Survey response — day 0, dose 2
    MedDRA: Unevaluable event — Feeling: Good · Be unable to do your normal daily activities
    Free text: Might be from virus Ive had since 4/2020
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-04-02
    Survey response — days 1–6 daily, dose 2
    MedDRA: Adverse reaction — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness · Be unable to work
    Free text: May be from virus since 4/2020.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-04-03
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pre-existing disease — Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness · Be unable to work
    Free text: Due to virus had since 4/2020.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-04
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pre-existing disease, Viral infection — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: May be from a virus I had since4/2020
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-04-05
    Survey response — days 1–6 daily, dose 2
    MedDRA: Unevaluable event — Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: Maybe from previous virus 4/2020
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-06
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pre-existing disease — Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: Prob due to virus I had since 4/2020.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  19. 2021-04-07
    Survey response — days 1–6 daily, dose 2
    MedDRA: Pre-existing disease — Feeling: Fair · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Free text: From virus I have had since 4/2020.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-04-08
    Survey response — day 7, dose 2
    MedDRA: Unevaluable event — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Prob due to virus since 4/2020
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-04-15
    Health check-in — day 14, dose 2
    Feeling: Fair
    Adult check-in
  22. 2021-04-22
    Survey response — day 21, dose 2
    MedDRA: No adverse event, Pre-existing disease — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: From illness 4/2020 pain, mild to moderate fatigue, headaches. Ive been doing ok from the second vaccination and actually felt really good for two days afterwards
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  23. 2021-04-29
    Survey response — day 28, dose 2
    MedDRA: Fatigue, Headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: Continued extreme fatigue and other symptoms from virus I got 4/2020. I dont believe due to vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-05-06
    Survey response — day 35, dose 2
    MedDRA: Fatigue, Viral infection — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: Continued extreme fatigue and other symptoms from virus had since 4/2020. Nothing I attribute to vaccine.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  25. 2021-05-13
    Survey response — day 42, dose 2
    MedDRA: Fatigue, Myalgia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities
    Free text: Extreme fatigue and muscle pain from virus last April 2020 still. I did very well on both shots of my vaccine and am still well.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-07-01
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-09-30
    Survey response — 6 months, dose 2
    MedDRA: Early retirement, Office visit, Pre-existing disease — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit
    Free text: Symptoms: Ive had unidentified virus since April 2020, and they are very similar to long Covid. Was forced to retire 9/2020 age 62. I have had no exacerbated symptoms from my first two Moderna vaccines and look forward to Booster when able. · Healthcare visit (other): Family dr and specialists
    MedDRA releases: 2024-11 · check-in free text available
  28. 2021-09-30
    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
    Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
  29. 2021-10-01
    Call successful
    Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
  30. 2021-11-04
    Dose 3 — Moderna
  31. 2021-11-04
    Survey response — day 0, dose 3
    MedDRA: Dizziness, Emergency care, Immediate post-injection reaction, Medical counselling — 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
    Free text: Systemic reaction (other): Waited 30 min after test. While driving home got very woozy halfway home. Ended up going to fire dept to have them check me out before went home cuz live alone. Also called clinic where got booster n they said the symptom should pass and to take ben · Healthcare visit (other): EMT
    MedDRA releases: 2024-11 · check-in free text available
  32. 2021-11-04
    Report sent to call center — day 0, dose 3
    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)
  33. 2021-11-05
    Survey response — days 1–6 daily, dose 3
    MedDRA: Injection site pain, Self-medication, Sleep disorder — Feeling: Poor · Site: Pain · Muscle or body aches, Nausea
    Free text: Pain woke me up at injection site during last night. Tylenol arthritis strength and ice pack helped
    MedDRA releases: 2024-11 · check-in free text available
  34. 2021-11-05
  35. 2021-11-06
    Survey response — days 1–6 daily, dose 3
    MedDRA: Balance disorder, Muscular weakness — Feeling: Fair · Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Weak or woozy in legs and had reaction day of booster and missed calls from you to talk about it
    MedDRA releases: 2024-11 · check-in free text available
  36. 2021-11-07
    Health check-in — days 1–6 daily, dose 3
    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
    Adult check-in
  37. 2021-11-08
    Survey response — days 1–6 daily, dose 3
    MedDRA: Balance disorder, Muscular weakness — Feeling: Poor · Muscle or body aches, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Since booster I gave long periods where my legs feel weak n wobbly. Not good.
    MedDRA releases: 2024-11 · check-in free text available
  38. 2021-11-08
    Call successful
    Participant prefers to complete VAERS report online
  39. 2021-11-09
    Survey response — days 1–6 daily, dose 3
    MedDRA: Muscular weakness — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Weak legs like rubber or sea legs still
    MedDRA releases: 2024-11 · check-in free text available
  40. 2021-11-11
    Survey response — day 7, dose 3
    MedDRA: Balance disorder, Muscular weakness — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Since Booster my legs feel weak and wobbly including some of today and parts of every day
    MedDRA releases: 2024-11 · check-in free text available
  41. 2021-11-18
    Survey response — day 14, dose 3
    MedDRA: Balance disorder, Dizziness, Muscular weakness, Paraesthesia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Not new or worsening but still the dizziness, tingling and weskness in legs and feet and ankles, feel unstable at times. I filed report.
    MedDRA releases: 2024-11 · check-in free text available
  42. 2021-11-27
    Health check-in — day 21, dose 3
    Feeling: Fair
    Adult check-in
  43. 2021-12-02
    Health check-in — day 28, dose 3
    Feeling: Fair
    Adult check-in
  44. 2021-12-09
    Health check-in — day 35, dose 3
    Feeling: Fair
    Adult check-in
  45. 2021-12-16
    Health check-in — day 42, dose 3
    Feeling: Fair
    Adult check-in
  46. 2022-02-03
    Health check-in — 3 months, dose 3
    Feeling: Fair
    Adult check-in
  47. 2022-04-01
    Dose 4 — Moderna
  48. 2022-04-19
    Health check-in — day 14, dose 4
    Feeling: Poor
    Adult check-in
  49. 2022-04-22
    Survey response — day 21, dose 4
    MedDRA: Chest pain, Fatigue, Headache, Viral infection — Feeling: Poor · Be unable to do your normal daily activities
    Free text: Extreme fatigue n chest pains n headaches. Have had unidentified virus for two years.
    MedDRA releases: 2024-11 · check-in free text available
  50. 2022-04-30
    Health check-in — day 28, dose 4
    Feeling: Fair
    Adult check-in
  51. 2022-05-06
    Health check-in — day 35, dose 4
    Feeling: Fair
    Adult check-in
  52. 2022-05-13
    Health check-in — day 42, dose 4
    Feeling: Fair
    Adult check-in
  53. 2022-07-01
    Health check-in — 3 months, dose 4
    Feeling: Poor
    Adult check-in
  54. 2022-09-09
    Dose 5 — Moderna
  55. 2022-09-21
    Survey response — day 7, dose 5
    MedDRA: Pre-existing disease — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Have unidentified virus since 4/2020.
    MedDRA releases: 2024-11 · check-in free text available
  56. 2022-09-23
    Survey response — day 14, dose 5
    MedDRA: Fatigue, Viral infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Increased heavy fatigue. Have unidentified virus since 4/2020.
    MedDRA releases: 2024-11 · check-in free text available
  57. 2022-09-30
    Health check-in — day 21, dose 5
    Feeling: Fair
    Adult check-in
  58. 2022-10-08
    Survey response — day 28, dose 5
    MedDRA: Dyspnoea exertional, Fatigue, Somnolence — Feeling: Fair · Be unable to work or attend school
    Free text: Extreme fatigue and SOB on exertion. Couple times fell asleep without planning to when resting in chair.
    MedDRA releases: 2024-11 · check-in free text available
  59. 2022-10-14
    Survey response — day 35, dose 5
    MedDRA: Nasal congestion, Viral infection — Feeling: Fair
    Free text: Nasal congestion today. Continued unidentified virus since 4/2020.
    MedDRA releases: 2024-11 · check-in free text available
  60. 2022-10-22
    Health check-in — day 42, dose 5
    Feeling: Fair
    Adult check-in
  61. 2022-12-11
    Survey response — 3 months, dose 5
    MedDRA: Urinary tract infection, Viral infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: UTI treated, and continuing unidentified virus since 4/2020.
    MedDRA releases: 2024-11 · check-in free text available
  62. 2022-12-11
    Report sent to call center — 3 months, dose 5
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  63. 2022-12-13
  64. 2022-12-14
  65. 2022-12-14
    Call successful
    Does not wish to fill out VAERS report
  66. 2023-03-11
    Survey response — 6 months, dose 5
    MedDRA: Blood pressure inadequately controlled, Office visit — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  67. 2023-03-11
    Report sent to call center — 6 months, dose 5
    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 · 1 call case(s)
  68. 2023-03-13
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

DoseDateManufacturerCo-administered
12021-03-04Moderna
22021-04-01Moderna
32021-11-04Moderna No
42022-04-01Moderna No
52022-09-09Moderna No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-05

Systemic reaction (other): Unidentifiable virus(es) since 4-17/2020

2021-03-06

Systemic reaction (other): Fatigue may be due to a virus Ive had since 4/20.

2021-03-07

Systemic reaction (other): May be due to illness since 4-2021

2021-03-08

Systemic reaction (other): Due to prior virus since 4-2020.

2021-03-09

Systemic reaction (other): Ill with virus since 4/2020.

2021-03-10

Systemic reaction (other): From virus Ive had since 4/2020.

Release 5 — day 7, dose 1

2021-03-11

Systemic reaction (other): Due to virus since 4/2020.

Release 6 — day 21, dose 1

2021-03-25

Symptoms: Symptoms from virus last 4/2020, not vaccine

Release 6 — day 0, dose 2

2021-04-01

Systemic reaction (other): Might be from virus Ive had since 4/2020

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): May be from virus since 4/2020.

2021-04-03

Systemic reaction (other): Due to virus had since 4/2020.

2021-04-04

Systemic reaction (other): May be from a virus I had since4/2020

2021-04-05

Systemic reaction (other): Maybe from previous virus 4/2020

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Prob due to virus I had since 4/2020.

2021-04-07

Systemic reaction (other): From virus I have had since 4/2020.

Release 7 — day 7, dose 2

2021-04-08

Systemic reaction (other): Prob due to virus since 4/2020

Release 7 — day 21, dose 2

2021-04-22

Symptoms: From illness 4/2020 pain, mild to moderate fatigue, headaches. Ive been doing ok from the second vaccination and actually felt really good for two days afterwards

Release 8 — day 28, dose 2

2021-04-29

Symptoms: Continued extreme fatigue and other symptoms from virus I got 4/2020. I dont believe due to vaccine.

Release 8 — day 35, dose 2

2021-05-06

Symptoms: Continued extreme fatigue and other symptoms from virus had since 4/2020. Nothing I attribute to vaccine.

Release 8 — day 42, dose 2

2021-05-13

Symptoms: Extreme fatigue and muscle pain from virus last April 2020 still. I did very well on both shots of my vaccine and am still well.

Release 9 — 6 months, dose 2

2021-09-30

Symptoms: Ive had unidentified virus since April 2020, and they are very similar to long Covid. Was forced to retire 9/2020 age 62. I have had no exacerbated symptoms from my first two Moderna vaccines and look forward to Booster when able.
Healthcare visit (other): Family dr and specialists

Release 10 — day 0, dose 3

2021-11-04

Systemic reaction (other): Waited 30 min after test. While driving home got very woozy halfway home. Ended up going to fire dept to have them check me out before went home cuz live alone. Also called clinic where got booster n they said the symptom should pass and to take ben cut off by CDC
Healthcare visit (other): EMT

Release 10 — days 1–6 daily, dose 3

2021-11-05

Systemic reaction (other): Pain woke me up at injection site during last night. Tylenol arthritis strength and ice pack helped

2021-11-06

Systemic reaction (other): Weak or woozy in legs and had reaction day of booster and missed calls from you to talk about it

2021-11-08

Systemic reaction (other): Since booster I gave long periods where my legs feel weak n wobbly. Not good.

2021-11-09

Systemic reaction (other): Weak legs like rubber or sea legs still

Release 10 — day 7, dose 3

2021-11-11

Systemic reaction (other): Since Booster my legs feel weak and wobbly including some of today and parts of every day

Release 10 — day 14, dose 3

2021-11-18

Symptoms: Not new or worsening but still the dizziness, tingling and weskness in legs and feet and ankles, feel unstable at times. I filed report.

Release 11 — day 21, dose 4

2022-04-22

Symptoms: Extreme fatigue n chest pains n headaches. Have had unidentified virus for two years.

Release 12 — day 7, dose 5

2022-09-21

Systemic reaction (other): Have unidentified virus since 4/2020.

Release 12 — day 14, dose 5

2022-09-23

Symptoms: Increased heavy fatigue. Have unidentified virus since 4/2020.

Release 12 — day 28, dose 5

2022-10-08

Symptoms: Extreme fatigue and SOB on exertion. Couple times fell asleep without planning to when resting in chair.

Release 12 — day 35, dose 5

2022-10-14

Symptoms: Nasal congestion today. Continued unidentified virus since 4/2020.

Release 12 — 3 months, dose 5

2022-12-11

Symptoms: UTI treated, and continuing unidentified virus since 4/2020.

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

FieldPreferred term2021-092023-042024-11
HCVOEmergency care · · ✓
HCVOOffice visit · · ✓
SDBalance disorder · · ✓
SDBlood pressure inadequately controlled · · ✓
SDChest pain · · ✓
SDDizziness · · ✓
SDDyspnoea exertional · · ✓
SDEarly retirement · · ✓
SDFatigue ✓ ✓ ✓
SDHeadache ✓ ✓ ✓
SDMuscular weakness · · ✓
SDMyalgia ✓ ✓ ✓
SDNasal congestion · · ✓
SDNo adverse event ✓ ✓ ✓
SDParaesthesia · · ✓
SDPre-existing disease ✓ ✓ ✓
SDSomnolence · · ✓
SDUrinary tract infection · · ✓
SDViral infection · · ✓
SROAdverse reaction ✓ ✓ ✓
SROBalance disorder · · ✓
SRODizziness · · ✓
SROEmergency care · · ✓
SROFatigue ✓ ✓ ✓
SROImmediate post-injection reaction · · ✓
SROInjection site pain · · ✓
SROMedical counselling · · ✓
SROMuscular weakness · · ✓
SROPre-existing disease ✓ ✓ ✓
SROSelf-medication · · ✓
SROSleep disorder · · ✓
SROUnevaluable event ✓ ✓ ✓
SROViral infection ✓ ✓ ✓

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

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