4MS-27210-57189

3 vaccinations 13 coded responses 30 check-ins 13 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 857 / AZ
Registered: 2021-03-04

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
Dose 1 — Moderna
2021-03-04
Registered in v-safe
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling jittery, Insomnia, Malaise — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Difficulty getting to sleep after the vax- normally easier for me. Felt jittery and unwell for several hours.

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: Fatigue, Feeling abnormal — Feeling: Fair · Site: Swelling · Fatigue or tiredness

Free text: Foggy head -strange fatigue

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: Nausea — Feeling: Fair · Fatigue or tiredness

Free text: Nausea after eating meals since the vaccine

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: Good · Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Survey response — day 14, dose 1
MedDRA: Fatigue, Nausea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Nausea and fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-03-31
Health check-in — day 0, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Dizzy when walking

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Bladder discomfort — Feeling: Fair · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Urinary discomfort for a few days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Survey response — day 14, dose 2
MedDRA: Balance disorder, Dizziness — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy in head feeling off balance

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 28, dose 2
Feeling: Good

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

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-08
Dose 3 — Moderna
2021-12-11
Survey response — days 1–6 daily, dose 3
MedDRA: Ageusia, Anosmia, Oropharyngeal pain, Unevaluable event — Feeling: Poor · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Sore throat, cannot taste or smell, · Healthcare visit (other): Set up appointment for covid test tomorrow

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Report sent to call center — days 1–6 daily, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-12
Survey response — days 1–6 daily, dose 3
MedDRA: Respiratory tract congestion, Sinus congestion — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Sinus and chest congestion

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Survey response — days 1–6 daily, dose 3
MedDRA: Sinusitis — Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sinus infection

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — days 1–6 daily, dose 3
MedDRA: Cough — Feeling: Fair · Fever · Headache, Fatigue or tiredness

Free text: Coughing

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Call successful
Participant prefers to complete VAERS report online
2021-12-15
Survey response — day 7, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Sore throat for 5 days running

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Survey response — day 14, dose 3
MedDRA: Nasopharyngitis, Oropharyngeal pain, SARS-CoV-2 test, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Very bad cold and sinus infection with sore throat. · Healthcare visit (other): Covid test

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Report sent to call center — day 14, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-23
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2021-12-08	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): Difficulty getting to sleep after the vax- normally easier for me. Felt jittery and unwell for several hours.

2021-03-05

Systemic reaction (other): Foggy head -strange fatigue

2021-03-06

Systemic reaction (other): Nausea after eating meals since the vaccine

Release 6 — day 14, dose 1

2021-03-20

Symptoms: Nausea and fatigue

Release 6 — days 1–6 daily, dose 2

2021-04-03

Systemic reaction (other): Dizzy when walking

2021-04-04

Systemic reaction (other): Urinary discomfort for a few days.

Release 7 — day 14, dose 2

2021-04-14

Symptoms: Dizzy in head feeling off balance

Release 10 — days 1–6 daily, dose 3

2021-12-11

Systemic reaction (other): Sore throat, cannot taste or smell,

Healthcare visit (other): Set up appointment for covid test tomorrow

2021-12-12

Systemic reaction (other): Sinus and chest congestion

2021-12-13

Systemic reaction (other): Sinus infection

2021-12-14

Systemic reaction (other): Coughing

Release 10 — day 7, dose 3

2021-12-15

Systemic reaction (other): Sore throat for 5 days running

Release 10 — day 14, dose 3

2021-12-22

Symptoms: Very bad cold and sinus infection with sore throat.

Healthcare visit (other): Covid test

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	SARS-CoV-2 test	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Balance disorder	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Ageusia	·	·	✓
SRO	Anosmia	·	·	✓
SRO	Bladder discomfort	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Feeling jittery	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Sinus congestion	·	·	✓
SRO	Sinusitis	·	·	✓

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