4V6-23819-79947

4 vaccinations 12 coded responses 43 check-ins 11 free-text entries 4 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 140 / NY
Registered: 2021-01-16

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

2021-01-13
Dose 1 — Moderna
2021-01-16
Registered in v-safe
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Extremely dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-22
Survey response — day 7, dose 1
MedDRA: Throat irritation — Feeling: Good · Site: Pain

Free text: Scratchy throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2021-02-16
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-09
Survey response — day 28, dose 2
MedDRA: Cough, Fatigue, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Ive had a cough and sore throat with fatigue for the last several days. A cold? Ive wondered if I should get a Covid test due to symptoms and exposure at work last week, but havent done so yet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — day 35, dose 2
MedDRA: Cough, Fatigue, Nasal congestion — Feeling: Fair

Free text: I continue to cough and have fatigue. Stuffy nose, etc.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-10
Survey response — 6 months, dose 2
MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain, Pyrexia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Had a bad sore throat, cough, low fever, and cold at the end of June/start of July. My son had the same and tested negative for Covid so I did not get tested. Ive been fine since. (It lasted about a week)

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-10
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-18
Call 1 — Left Voicemail
2021-10-23
Dose 3 — Moderna
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Asthenia, Chills, Fatigue, Headache, Nausea, Pain in extremity, Peripheral swelling — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: The day of the shot and day after the shot I had extreme arm pain and swelling, intense debilitating headache, chills, and nausea. Most if those feelings went away after about 24 hours after getting the shot. Now, I have minor pain in my arm, fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Fatigue, Tinnitus — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: I've had ringing in my ears since the shot but I was thinking it because I'm so tired. It isn't going way. Is that connected?

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Ringing in my ears

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — day 7, dose 3
MedDRA: Tinnitus — Feeling: Good · Fatigue or tiredness

Free text: Slight Ringing in ears

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-13
Survey response — day 21, dose 3
MedDRA: Office visit, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have had continued ringing in my ear and have been tested for hearing loss. I have no idea if the two are connected but it started shortly after my booster. · Healthcare visit (other): Saw my ENT doctor

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-16
Call successful
Participant prefers to complete VAERS report online
2021-11-20
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-14
Dose 4 — Moderna
2022-04-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-04-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-04-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-04-21
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-28
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-05
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-19
Survey response — day 35, dose 4
MedDRA: Fatigue, Malaise, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activities

Free text: I felt sick for two days. Very tired, sore throat, congested. I did a COVID home test but it was negative. That was yesterday. Today, I felt almost completely better.

MedDRA releases: 2024-11 · check-in free text available
2022-05-26
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-13
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-19
Survey response — 12 months, dose 4
MedDRA: COVID-19, Mammogram abnormal, Office visit, Ultrasound breast abnormal — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-04-19
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-04-20
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-09	Moderna
3	2021-10-23	Moderna	No
4	2022-04-14	Moderna	No

Call center

4 call center cases

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

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-16

Systemic reaction (other): Extremely dizzy

Release 2 — day 7, dose 1

2021-01-22

Systemic reaction (other): Scratchy throat.

Release 5 — day 28, dose 2

2021-03-09

Symptoms: Ive had a cough and sore throat with fatigue for the last several days. A cold? Ive wondered if I should get a Covid test due to symptoms and exposure at work last week, but havent done so yet.

Release 5 — day 35, dose 2

2021-03-16

Symptoms: I continue to cough and have fatigue. Stuffy nose, etc.

Release 9 — 6 months, dose 2

2021-08-10

Symptoms: Had a bad sore throat, cough, low fever, and cold at the end of June/start of July. My son had the same and tested negative for Covid so I did not get tested. Ive been fine since. (It lasted about a week)

Release 10 — days 1–6 daily, dose 3

2021-10-26

Systemic reaction (other): The day of the shot and day after the shot I had extreme arm pain and swelling, intense debilitating headache, chills, and nausea. Most if those feelings went away after about 24 hours after getting the shot. Now, I have minor pain in my arm, fatigue cut off by CDC

2021-10-28

Systemic reaction (other): I've had ringing in my ears since the shot but I was thinking it because I'm so tired. It isn't going way. Is that connected?

2021-10-29

Systemic reaction (other): Ringing in my ears

Release 10 — day 7, dose 3

2021-10-30

Systemic reaction (other): Slight Ringing in ears

Release 10 — day 21, dose 3

2021-11-13

Symptoms: I have had continued ringing in my ear and have been tested for hearing loss. I have no idea if the two are connected but it started shortly after my booster.

Healthcare visit (other): Saw my ENT doctor

Release 11 — day 35, dose 4

2022-05-19

Symptoms: I felt sick for two days. Very tired, sore throat, congested. I did a COVID home test but it was negative. That was yesterday. Today, I felt almost completely better.

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	·	·	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Malaise	·	·	✓
SD	Mammogram abnormal	·	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Nasopharyngitis	✓	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pyrexia	✓	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Tinnitus	·	·	✓
SD	Ultrasound breast abnormal	·	·	✓
SRO	Asthenia	·	·	✓
SRO	Chills	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Headache	·	·	✓
SRO	Nausea	·	·	✓
SRO	Pain in extremity	·	·	✓
SRO	Peripheral swelling	·	·	✓
SRO	Throat irritation	✓	✓	✓
SRO	Tinnitus	·	·	✓

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