4RA-15738-97635

2 vaccinations 11 coded responses 18 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 479 / IN
Registered: 2021-01-18

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

2021-01-15
Dose 1 — Moderna
2021-01-18
Registered in v-safe
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-10
Dose 2 — Moderna
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain, Sinus operation — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Free text: Earache sinus drainage.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Fair · Site: Redness, Swelling · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Nasopharyngitis, Nausea — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Neusea last night feels like head cold

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Paranasal sinus hypersecretion — Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Free text: Coughing nazzel drainage

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Cough, Dyspnoea, Hypoaesthesia, Medical counselling, Neuralgia, Secretion discharge — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Coufh alot mucus center of back hurt siactic nerve bothering both legs. Lower back knees numbs short breath · Healthcare visit (other): Called her if not better by thursday to call call her back since alot of my symptoms is not from vaccination shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-17
Health check-in — day 7, dose 2
Feeling: Fair · None

Adult check-in
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-10
Survey response — day 28, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Get tired real easy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 35, dose 2
MedDRA: Computerised tomogram, Ear discomfort, Office visit, Sinus disorder — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Still have sinus and ear issues . · Healthcare visit (other): CT left ear neck scan

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Survey response — day 42, dose 2
MedDRA: Angular cheilitis, Erythema, Skin reaction — Feeling: Fair

Free text: Both big toes red and swollan. Both corners of my mouth sore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Get short of breath easier · Healthcare visit (other): Seen my COPD Lung specilist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-16
Call successful
Participant prefers to complete VAERS report online
2021-08-13
Survey response — 6 months, dose 2
MedDRA: Dyspnoea, Fatigue — Feeling: Fair

Free text: More short of breath and get tired quicker

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-13
Survey response — 12 months, dose 2
MedDRA: Anxiety, Asthenia, Cognitive disorder, Malaise, Pre-existing disease, Respiration abnormal, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school

Free text: Low energy beathing declined i already u derling conditions i have copd starting of emphysema more gastro issue i have pinched nerve main artery to pancreatic. More cognitive issues. Had alot of covid symptoms pcr negative. anxiety attacks worse.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-10	Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Earache sinus drainage.

2021-02-13

Systemic reaction (other): No

2021-02-14

Systemic reaction (other): Neusea last night feels like head cold

2021-02-15

Systemic reaction (other): Coughing nazzel drainage

2021-02-16

Systemic reaction (other): Coufh alot mucus center of back hurt siactic nerve bothering both legs. Lower back knees numbs short breath

Healthcare visit (other): Called her if not better by thursday to call call her back since alot of my symptoms is not from vaccination shot

Release 5 — day 28, dose 2

2021-03-10

Symptoms: Get tired real easy.

Release 5 — day 35, dose 2

2021-03-17

Symptoms: Still have sinus and ear issues .

Healthcare visit (other): CT left ear neck scan

Release 6 — day 42, dose 2

2021-03-24

Symptoms: Both big toes red and swollan. Both corners of my mouth sore.

Release 8 — 3 months, dose 2

2021-05-12

Symptoms: Get short of breath easier

Healthcare visit (other): Seen my COPD Lung specilist

Release 9 — 6 months, dose 2

2021-08-13

Symptoms: More short of breath and get tired quicker

Release 11 — 12 months, dose 2

2022-02-13

Symptoms: Low energy beathing declined i already u derling conditions i have copd starting of emphysema more gastro issue i have pinched nerve main artery to pancreatic. More cognitive issues. Had alot of covid symptoms pcr negative. anxiety attacks worse. cut off by CDC

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	Computerised tomogram	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Angular cheilitis	✓	✓	✓
SD	Anxiety	·	·	✓
SD	Asthenia	·	·	✓
SD	Cognitive disorder	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Ear discomfort	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Malaise	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiration abnormal	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus disorder	✓	✓	✓
SD	Skin reaction	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Paranasal sinus hypersecretion	✓	✓	✓
SRO	Secretion discharge	✓	✓	✓
SRO	Sinus operation	✓	✓	✓

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