4S8-28783-53966

2 vaccinations 9 coded responses 24 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 954 / CA
Registered: 2020-12-30

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Survey response — day 0, dose 1
MedDRA: Paraesthesia — Feeling: Fair · Chills, Nausea

Free text: Left hand tingled for a few hrs (but injection was on Right arm)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache · Be unable to work

Adult check-in
2020-12-31
Report sent to call center — days 1–6 daily, dose 1
Be unable to work

1 call case(s)
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Diarrhea

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Fatigue or tiredness · Be unable to work

Adult check-in
2021-01-05
Report sent to call center — days 1–6 daily, dose 1
Be unable to work

1 call case(s)
2021-01-07
Survey response — day 7, dose 1
MedDRA: Chest discomfort, Cough — Feeling: Fair · Be unable to work

Free text: Cough, Chest Heaviness/Tightness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Report sent to call center — day 7, dose 1
Be unable to work

no matching call case
2021-01-13
Survey response — day 14, dose 1
MedDRA: Chest discomfort, Cough, Dysphonia, Ear discomfort, Headache, Oropharyngeal pain — Feeling: Fair · Be unable to work

Free text: Since 12/31, have had a combination of these: sore throat, headache, cough, hoarseness, chest tightness, plugged ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 14, dose 1
Be unable to work

1 call case(s)
2021-01-21
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-01-27
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-29
Dose 2 — Moderna
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Nausea

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain — Feeling: Poor · Site: Pain, Redness · Be unable to work, Be unable to do your normal daily activities

Free text: Bad lower back pain, but probably unrelated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Musculoskeletal stiffness — Feeling: Fair · Site: Pain, Redness · Fever · Be unable to work, Be unable to do your normal daily activities

Free text: Back pain & stiffness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — day 7, dose 2
MedDRA: Back pain — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-14
Survey response — day 42, dose 2
MedDRA: Dizziness, Nausea, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lightheadedness, nausea, sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-30
Survey response — 6 months, dose 2
MedDRA: Dyspepsia, Myalgia, Palpitations — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscle pains throughout body, heart palpitations, heartburn

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-01-29
Survey response — 12 months, dose 2
MedDRA: Heart rate irregular, Palpitations — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Heart Palpitations, irregular heart beats

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-01-31
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-29	Moderna

Call center

4 call center cases

1 successful · 3 priority 2/3 (triaged and no follow up)

1 check-in flagged for a call with no call center case on record

See the call center timeline

Free text

Release 1 — day 0, dose 1

2020-12-30

Systemic reaction (other): Left hand tingled for a few hrs (but injection was on Right arm)

Release 1 — day 7, dose 1

2021-01-07

Systemic reaction (other): Cough, Chest Heaviness/Tightness

Release 1 — day 14, dose 1

2021-01-13

Symptoms: Since 12/31, have had a combination of these: sore throat, headache, cough, hoarseness, chest tightness, plugged ears

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): Bad lower back pain, but probably unrelated

2021-02-04

Systemic reaction (other): Back pain & stiffness

Release 3 — day 7, dose 2

2021-02-05

Systemic reaction (other): Back pain

Release 5 — day 42, dose 2

2021-03-14

Symptoms: Lightheadedness, nausea, sore throat

Release 9 — 6 months, dose 2

2021-07-30

Symptoms: Muscle pains throughout body, heart palpitations, heartburn

Release 11 — 12 months, dose 2

2022-01-29

Symptoms: Heart Palpitations, irregular heart beats

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	Chest discomfort	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspepsia	✓	·	✓
SD	Dysphonia	✓	✓	✓
SD	Ear discomfort	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Heart rate irregular	·	·	✓
SD	Myalgia	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Palpitations	✓	·	✓
SRO	Back pain	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓

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