4VK-77026-57936

3 vaccinations 19 coded responses 25 check-ins 19 free-text entries 10 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 982 / WA
Registered: 2021-02-23

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

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

2021-02-22
Dose 1 — Moderna
2021-02-23
Registered in v-safe
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-25
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal discomfort, Chest discomfort — Feeling: Fair · Muscle or body aches, Nausea, Abdominal pain

Free text: Discomfort in my chest and stomach.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Neck pain, Oropharyngeal pain — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: I have some coughing for the last two days and neck pain.sore throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Neck pain — Feeling: Fair · Site: Pain · Joint pains

Free text: Neck pain and cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Cough, Neck pain — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Neck pain radiates down to my shoulder blade its no joke Still some cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — day 7, dose 1
MedDRA: Fatigue, Neck pain — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Neck pain it is less but still hurts . And feeling tire .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — day 14, dose 1
MedDRA: Headache, Rash — Feeling: Good · Be unable to do your normal daily activities

Free text: I started with a headache really bad it lasted 3 plus days and a rash around the bottom of my nose. Still there .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — day 21, dose 1
MedDRA: Headache, Office visit, Rash — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Mild headache comes and goes. And nose rash still have it , I did go to the doctor.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-23
Dose 2 — Moderna
2021-03-23
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-24
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Fair · Site: Pain · Abdominal pain · Be unable to do your normal daily activities

Free text: Its pretty bad Ive have had it about 60 minutes its Cain of fading out.But still hurts .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit, Rash — Feeling: Good · Site: Pain · Chills, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): My nose rash is still not gone and spreading . · Healthcare visit (other): 2 weeks ago for nose rash , I was seen my a doctor , Refferal for a dermatologist.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-26
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Good · Headache

Free text: Rash on my nose .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): On my nose · Healthcare visit (other): Going to be see .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: On my nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-13
Survey response — day 21, dose 2
MedDRA: Eye infection, Fatigue — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Very tire . And infection on my eyes .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-20
Survey response — day 28, dose 2
MedDRA: Eye infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Eye infections on both

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-27
Survey response — day 35, dose 2
MedDRA: Eye infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Eye infection on left

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-04
Survey response — day 42, dose 2
MedDRA: Hordeolum — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Eye stys infection on left eye I was getting better, and 5-3-21 I start a new one eye hurts . Hu just had finish a round of antibiotics.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Survey response — 3 months, dose 2
MedDRA: Swelling — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: More body swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-22
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-29
Call successful
Participant prefers to complete VAERS report online
2021-11-29
Dose 3 — Moderna
2022-03-23
Survey response — 12 months, dose 2
MedDRA: Back pain, Fatigue, Heart rate increased, Palpitations — Feeling: Poor · Be unable to do your normal daily activities

Free text: Lots of pain between shoulder blades, palpitations, pulse racing, extremely tired.

MedDRA releases: 2024-11 · check-in free text available
2022-11-29
Survey response — 12 months, dose 3
MedDRA: Dry skin, Pain — 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

Free text: Skin dryness extrema on my fingers both hands . And many other things like more pain in my body .

MedDRA releases: 2024-11 · check-in free text available
2022-11-29
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-30
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-22	Moderna
2	2021-03-23	Moderna
3	2021-11-29	Moderna	No

Call center

10 call center cases

10 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-25

Systemic reaction (other): Discomfort in my chest and stomach.

2021-02-26

Systemic reaction (other): I have some coughing for the last two days and neck pain.sore throat.

2021-02-27

Systemic reaction (other): Neck pain and cough.

2021-02-28

Systemic reaction (other): Neck pain radiates down to my shoulder blade its no joke Still some cough.

Release 4 — day 7, dose 1

2021-03-01

Systemic reaction (other): Neck pain it is less but still hurts . And feeling tire .

Release 5 — day 14, dose 1

2021-03-08

Symptoms: I started with a headache really bad it lasted 3 plus days and a rash around the bottom of my nose. Still there .

Release 5 — day 21, dose 1

2021-03-15

Symptoms: Mild headache comes and goes. And nose rash still have it , I did go to the doctor.

Release 6 — days 1–6 daily, dose 2

2021-03-24

Systemic reaction (other): Its pretty bad Ive have had it about 60 minutes its Cain of fading out.But still hurts .

2021-03-25

Systemic reaction (other): My nose rash is still not gone and spreading .

Healthcare visit (other): 2 weeks ago for nose rash , I was seen my a doctor , Refferal for a dermatologist.

2021-03-26

Systemic reaction (other): Rash on my nose .

2021-03-27

Systemic reaction (other): On my nose

Healthcare visit (other): Going to be see .

2021-03-28

Systemic reaction (other): On my nose

Release 7 — day 21, dose 2

2021-04-13

Symptoms: Very tire . And infection on my eyes .

Release 7 — day 28, dose 2

2021-04-20

Symptoms: Eye infections on both

Release 8 — day 35, dose 2

2021-04-27

Symptoms: Eye infection on left

Release 8 — day 42, dose 2

2021-05-04

Symptoms: Eye stys infection on left eye I was getting better, and 5-3-21 I start a new one eye hurts . Hu just had finish a round of antibiotics.

Release 9 — 3 months, dose 2

2021-06-22

Symptoms: More body swollen

Release 11 — 12 months, dose 2

2022-03-23

Symptoms: Lots of pain between shoulder blades, palpitations, pulse racing, extremely tired.

Release 12 — 12 months, dose 3

2022-11-29

Symptoms: Skin dryness extrema on my fingers both hands . And many other things like more pain in my body .

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	✓	✓	✓
HCVO	Rash	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Back pain	·	·	✓
SD	Dry skin	·	·	✓
SD	Eye infection	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Heart rate increased	·	·	✓
SD	Hordeolum	✓	✓	✓
SD	Office visit	✓	·	✓
SD	Pain	·	·	✓
SD	Palpitations	·	·	✓
SD	Rash	✓	✓	✓
SD	Swelling	✓	✓	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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