4Y4-26938-93945

5 vaccinations 10 coded responses 43 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 943 / CA
Registered: 2021-03-13

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

2021-02-13
Dose 1 — Moderna
2021-03-13
Registered in v-safe
2021-03-13
Dose 2 — Moderna
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: Tenderness around injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Initial insomnia, Insomnia, Middle insomnia, Poor quality sleep — Feeling: Good

Free text: I just realized the first 2 nights were sleepless, waking up frequently with difficulty falling back to sleep. Last night only 1 short instance of this

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Good · Site: Redness · Diarrhea, Abdominal pain

Free text: Still some sleeplessness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-03
Survey response — day 21, dose 2
MedDRA: Back pain, Cough, Neck pain, Rhinorrhoea, Wheezing — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Neck and back soreness, runny nose and cough/rasping in chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-15
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-09-08
Dose 3 — Moderna
2021-09-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-11
Survey response — days 1–6 daily, dose 3
MedDRA: Body temperature increased — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: These were not today but Thursday, Friday I was good during day then 100 temp at night. Today Saturday all normal

MedDRA releases: 2024-11 · check-in free text available
2021-09-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-09-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Itching · Fatigue or tiredness

Adult check-in
2021-09-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-09-15
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-09-22
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-09-29
Survey response — day 21, dose 3
MedDRA: Abdominal discomfort — Feeling: Good · Be unable to do your normal daily activities

Free text: Stomach easily upset

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-13
Survey response — day 35, dose 3
MedDRA: Inflammation, Pre-existing disease, Tenderness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tender insides lower back and guts. Feels inflamed, doctor attributes this to the weight of the oxygenator I carry. Plus the coughing I live with.

MedDRA releases: 2024-11 · check-in free text available
2021-10-22
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-02-16
Dose 4 — Moderna
2022-03-09
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-08-17
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-10-05
Dose 5 — Moderna
2022-10-05
Health check-in — day 0, dose 5
Feeling: Good · None

Adult check-in
2022-10-06
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-10-07
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-08
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-10-09
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Diarrhea, Abdominal pain

Adult check-in
2022-10-10
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Diarrhea

Adult check-in
2022-10-11
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-12
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-19
Survey response — day 14, dose 5
MedDRA: Cough, Pneumonitis, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have more inflammation of my lungs, more coughing. However a dog is staying in my home and I am allergic.

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-16
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-04
Survey response — 3 months, dose 5
MedDRA: Cough, Sputum discoloured — 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

MedDRA releases: 2024-11
2023-01-04
Report sent to call center — 3 months, dose 5
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)
2023-01-05
Call 1 — Left Voicemail
2023-04-05
Survey response — 6 months, dose 5
MedDRA: Cardiac flutter, Cough, Dysphonia, Dyspnoea, Fatigue, Hypersensitivity pneumonitis, Interstitial lung disease, Lung disorder, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-05
Report sent to call center — 6 months, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-06
Call 2 — Requested Callback
2023-04-06
Call 1 — Requested Callback
2023-04-07
Callback requested for
03:00PM ET
2023-04-07
Call successful
Does not wish to fill out VAERS report
2023-04-07
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Moderna
2	2021-03-13	Moderna
3	2021-09-08	Moderna	No
4	2022-02-16	Moderna	No
5	2022-10-05	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): Tenderness around injection site

2021-03-16

Systemic reaction (other): I just realized the first 2 nights were sleepless, waking up frequently with difficulty falling back to sleep. Last night only 1 short instance of this

2021-03-17

Systemic reaction (other): Still some sleeplessness

Release 6 — day 21, dose 2

2021-04-03

Symptoms: Neck and back soreness, runny nose and cough/rasping in chest

Release 9 — days 1–6 daily, dose 3

2021-09-11

Systemic reaction (other): These were not today but Thursday, Friday I was good during day then 100 temp at night. Today Saturday all normal

Release 9 — day 21, dose 3

2021-09-29

Symptoms: Stomach easily upset

Release 10 — day 35, dose 3

2021-10-13

Symptoms: Tender insides lower back and guts. Feels inflamed, doctor attributes this to the weight of the oxygenator I carry. Plus the coughing I live with.

Release 12 — day 14, dose 5

2022-10-19

Symptoms: I have more inflammation of my lungs, more coughing. However a dog is staying in my home and I am allergic.

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	Abdominal discomfort	·	·	✓
SD	Back pain	✓	✓	✓
SD	Cardiac flutter	·	·	✓
SD	Cough	✓	✓	✓
SD	Dysphonia	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Hypersensitivity pneumonitis	·	·	✓
SD	Inflammation	·	·	✓
SD	Interstitial lung disease	·	·	✓
SD	Lung disorder	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pneumonitis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sputum discoloured	·	·	✓
SD	Tenderness	·	·	✓
SD	Wheezing	✓	✓	✓
SRO	Body temperature increased	·	·	✓
SRO	Initial insomnia	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Middle insomnia	✓	✓	✓
SRO	Poor quality sleep	✓	✓	✓

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