4YB-10155-22317

3 vaccinations 21 coded responses 38 check-ins 21 free-text entries 4 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 980 / WA
Registered: 2021-04-22

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

2021-04-22
Registered in v-safe
2021-04-22
Dose 1 — Moderna
2021-04-22
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fever · None

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-06
Survey response — day 14, dose 1
MedDRA: Asthenia, Brain fog, Chills, Fatigue, Feeling hot, Headache, Injection site erythema, Injection site pruritus, Pain, Urticaria — Feeling: Fair · Be unable to do your normal daily activities

Free text: A 4 long red patch near the injection site, then a 2nd patch with an itchy hive in the center formed nearby. The 1st patch is lasting a week, the 2nd only lasted a few hours. Body aches, weakness, fatigue, headaches, brain fog, waking hot, chills.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-20
Dose 2 — Moderna
2021-05-20
Survey response — day 0, dose 2
MedDRA: Brain fog, Heart rate increased, Mood altered — Feeling: Good · Site: Pain, Swelling · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Foul mood, brain fog, fast heart rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Dysgeusia, Dyspnoea, Eczema, Electric shock sensation, Heart rate increased, Hyperhidrosis, Hypoaesthesia, Insomnia, Irritability, Oropharyngeal pain, Pre-existing disease — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Unable to sleep, sweating, electric pain & numbness (mostly left arm & hand), fast heart rate, short of breath, dizzy, irritable, sore throat, weird taste, pre-existing eczema flaring

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Oropharyngeal pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: shortness of breath, sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate increased — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: fast heart rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-24
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain, Induration, Lymphadenopathy — Feeling: Fair · Site: Redness, Swelling · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chest pains, sore & hard swollen neck lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-25
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Lymphadenopathy, Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Site: Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: sore hard swollen neck lymph nodes, sore throat, brain fog/confusion, some sense of smell impairment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Heart rate increased, Hyperhidrosis, Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Redness · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: sore swollen neck lymph nodes, fast heart rate, shortness of breath, still sweating profusely

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Survey response — day 7, dose 2
MedDRA: Brain fog, Confusional state, Dyspnoea, Heart rate increased, Lymph node pain, Lymphadenopathy, Oropharyngeal pain — Feeling: Fair · Site: Redness, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: sore swollen neck lymph nodes, fast heart rate, shortness of breath, brain fog/confusion, sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-06-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-01
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-18
Survey response — 6 months, dose 2
MedDRA: Asthma, Eczema, Pre-existing disease, Psoriasis — Feeling: Good

Free text: new = psoriasis worsened = eczema, asthma

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Dose 3 — Moderna
2021-12-09
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-12-10
Survey response — days 1–6 daily, dose 3
MedDRA: Brain fog, Gastrooesophageal reflux disease, Injection site hypoaesthesia, Insomnia, Lymph node pain — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: a little numbness at injection site, brain fog, couldn't sleep, sore lymph nodes in neck, GERD

MedDRA releases: 2024-11 · check-in free text available
2021-12-11
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Brain fog, Insomnia, Lymph node pain, Lymphadenopathy, Musculoskeletal chest pain, Neck pain, Pain, Pain in jaw — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: brain fog, little sleep, body aches especially being the ribs & shoulders & neck & jaw, sore & swollen lymph nodes in neck

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Survey response — days 1–6 daily, dose 3
MedDRA: Brain fog, Gastrooesophageal reflux disease, Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: some brain fog, sore/swollen lymph nodes in neck, some GERD

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Survey response — days 1–6 daily, dose 3
MedDRA: Brain fog, Gastrooesophageal reflux disease, Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: brain fog, sore/swollen lymph nodes in neck, GERD; all symptoms lessening

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — days 1–6 daily, dose 3
MedDRA: Brain fog, Gastrooesophageal reflux disease, Lymph node pain, Lymphadenopathy — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: some brain fog, sore/swollen lymph nodes in neck, GERD

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Survey response — days 1–6 daily, dose 3
MedDRA: Brain fog, Lymph node pain, Lymphadenopathy — Feeling: Fair · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: mild brain fog, mild sore/swollen lymph nodes in neck

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Survey response — day 7, dose 3
MedDRA: Gastrooesophageal reflux disease, Lymph node pain — Feeling: Good · Chills, Headache, Joint pains, Fatigue or tiredness

Free text: sore lymph nodes in neck, some GERD

MedDRA releases: 2024-11 · check-in free text available
2021-12-23
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-30
Survey response — day 21, dose 3
MedDRA: Arthritis, Condition aggravated, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: arthritis in my fingers flaring for the first time fibromyalgia flaring dermatitis flaring feverish (weird) · Healthcare visit (other): my pcp is too busy to schedule an appointment with me right now - I will discuss the arthritis with them as soon as possible

MedDRA releases: 2024-11 · check-in free text available
2021-12-30
Report sent to call center — day 21, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-06
Survey response — day 28, dose 3
MedDRA: Arthritis, Condition aggravated, Pre-existing disease, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: the new arthritis is continuing to progress, & the pre-existing dermatitis is continuing to flare more · Healthcare visit (other): (my pcp still doesn't have time to see me, but I did let them know that it's occurring & that I need to talk to them about it)

MedDRA releases: 2024-11 · check-in free text available
2022-01-06
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-06
Call 1 — Left Voicemail
2022-01-07
Call successful
Participant prefers to complete VAERS report online
2022-01-13
Survey response — day 35, dose 3
MedDRA: Arthralgia, Arthritis, Asthenia, Oedema, Somnolence, Swelling, Unevaluable event, Visual impairment — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: the new arthritis is progressing (including more swelling & edema, pain, increasing bone on finger joints, & it also seems my eyesight may be affected) (sleeping a lot & staying in bed 14-16 hours, but still drained) · Healthcare visit (other): still waiting for my pcp & me to have time to schedule an appointment for me

MedDRA releases: 2024-11 · check-in free text available
2022-01-13
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-14
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-20
Survey response — day 42, dose 3
MedDRA: Arthritis, Office visit, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: progression of arthritis · Healthcare visit (other): need help from psychologist, pcp, & rheumotologist

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-22
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-22	Moderna
2	2021-05-20	Moderna
3	2021-12-09	Moderna	No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 8 — day 14, dose 1

2021-05-06

Symptoms: A 4 long red patch near the injection site, then a 2nd patch with an itchy hive in the center formed nearby. The 1st patch is lasting a week, the 2nd only lasted a few hours. Body aches, weakness, fatigue, headaches, brain fog, waking hot, chills.

Release 8 — day 0, dose 2

2021-05-20

Systemic reaction (other): Foul mood, brain fog, fast heart rate

Release 8 — days 1–6 daily, dose 2

2021-05-21

Systemic reaction (other): Unable to sleep, sweating, electric pain & numbness (mostly left arm & hand), fast heart rate, short of breath, dizzy, irritable, sore throat, weird taste, pre-existing eczema flaring

2021-05-22

Systemic reaction (other): shortness of breath, sore throat

2021-05-23

Systemic reaction (other): fast heart rate

2021-05-24

Systemic reaction (other): Chest pains, sore & hard swollen neck lymph nodes

2021-05-25

Systemic reaction (other): sore hard swollen neck lymph nodes, sore throat, brain fog/confusion, some sense of smell impairment

2021-05-26

Systemic reaction (other): sore swollen neck lymph nodes, fast heart rate, shortness of breath, still sweating profusely

Release 8 — day 7, dose 2

2021-05-27

Systemic reaction (other): sore swollen neck lymph nodes, fast heart rate, shortness of breath, brain fog/confusion, sore throat

Release 10 — 6 months, dose 2

2021-11-18

Symptoms: new = psoriasis worsened = eczema, asthma

Release 10 — days 1–6 daily, dose 3

2021-12-10

Systemic reaction (other): a little numbness at injection site, brain fog, couldn't sleep, sore lymph nodes in neck, GERD

2021-12-11

Systemic reaction (other): brain fog, little sleep, body aches especially being the ribs & shoulders & neck & jaw, sore & swollen lymph nodes in neck

2021-12-12

Systemic reaction (other): some brain fog, sore/swollen lymph nodes in neck, some GERD

2021-12-13

Systemic reaction (other): brain fog, sore/swollen lymph nodes in neck, GERD; all symptoms lessening

2021-12-14

Systemic reaction (other): some brain fog, sore/swollen lymph nodes in neck, GERD

2021-12-15

Systemic reaction (other): mild brain fog, mild sore/swollen lymph nodes in neck

Release 10 — day 7, dose 3

2021-12-16

Systemic reaction (other): sore lymph nodes in neck, some GERD

Release 10 — day 21, dose 3

2021-12-30

Symptoms: arthritis in my fingers flaring for the first time fibromyalgia flaring dermatitis flaring feverish (weird)

Healthcare visit (other): my pcp is too busy to schedule an appointment with me right now - I will discuss the arthritis with them as soon as possible

Release 10 — day 28, dose 3

2022-01-06

Symptoms: the new arthritis is continuing to progress, & the pre-existing dermatitis is continuing to flare more

Healthcare visit (other): (my pcp still doesn't have time to see me, but I did let them know that it's occurring & that I need to talk to them about it)

Release 10 — day 35, dose 3

2022-01-13

Symptoms: the new arthritis is progressing (including more swelling & edema, pain, increasing bone on finger joints, & it also seems my eyesight may be affected) (sleeping a lot & staying in bed 14-16 hours, but still drained)

Healthcare visit (other): still waiting for my pcp & me to have time to schedule an appointment for me

Release 10 — day 42, dose 3

2022-01-20

Symptoms: progression of arthritis

Healthcare visit (other): need help from psychologist, pcp, & rheumotologist

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	Arthritis	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	·	·	✓
SD	Arthritis	·	·	✓
SD	Asthenia	✓	✓	✓
SD	Asthma	·	·	✓
SD	Brain fog	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Eczema	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Oedema	·	·	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Psoriasis	·	·	✓
SD	Somnolence	·	·	✓
SD	Swelling	·	·	✓
SD	Urticaria	✓	✓	✓
SD	Visual impairment	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Brain fog	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Confusional state	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Eczema	✓	✓	✓
SRO	Electric shock sensation	✓	✓	✓
SRO	Gastrooesophageal reflux disease	·	·	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Induration	✓	✓	✓
SRO	Injection site hypoaesthesia	·	·	✓
SRO	Insomnia	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Mood altered	✓	✓	✓
SRO	Musculoskeletal chest pain	·	·	✓
SRO	Neck pain	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Pain in jaw	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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