52B-19138-56156

5 vaccinations 7 coded responses 43 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 302 / GA
Registered: 2021-01-13

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

2021-01-11
Dose 1 — Moderna
2021-01-13
Registered in v-safe
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Injection site rash, Injection site swelling — Feeling: Good

Free text: Red itchy rash & swelling on injection site 11 days after injection lasting 3 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-08
Dose 2 — Moderna
2021-02-08
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Fair · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-08-23
Dose 3 — Moderna
2021-08-23
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-08-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-08-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-08-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Itching · None

Adult check-in
2021-08-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-08-29
Survey response — days 1–6 daily, dose 3
MedDRA: Heart rate increased — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Elevated heart rate but still within resting range.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-30
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-09-06
Survey response — day 14, dose 3
MedDRA: Abdominal pain, Insomnia — Feeling: Good · Be unable to do your normal daily activities

Free text: Abdominal pain left side & difficulty sleeping for 3 nights. Those occurred 7 days after injection.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-09-21
Survey response — day 28, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Good

Free text: Lymph node on right side of head swollen & tender.

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-11-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-02-21
Survey response — 6 months, dose 3
MedDRA: Unevaluable event, Weight decreased — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Weight loss 7 lbs in 2 1/2 months after booster. · Healthcare visit (other): Scans, colonoscopy, endoscopy

MedDRA releases: 2024-11 · check-in free text available
2022-02-21
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-24
Call 1 — Could Not Reach Participant
2022-03-01
Call successful
Does not wish to fill out VAERS report
2022-04-02
Dose 4 — Moderna
2022-04-14
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-24
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-07
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-02
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-03
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-10-04
Dose 5 — Moderna
Co-administered: Flu
2022-10-13
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-18
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-01
Survey response — day 28, dose 5
MedDRA: Abdominal pain upper, Gastritis, Rash — Feeling: Good · Be unable to do your normal daily activities

Free text: Gastro severe pain& inflamation & late onset rash on inside lower arms

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-04-07
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-11	Moderna
2	2021-02-08	Moderna
3	2021-08-23	Moderna	No
4	2022-04-02	Moderna	No
5	2022-10-04	Moderna	Flu

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-25

Symptoms: Red itchy rash & swelling on injection site 11 days after injection lasting 3 days.

Release 3 — day 0, dose 2

2021-02-08

Systemic reaction (other): No

Release 9 — days 1–6 daily, dose 3

2021-08-29

Systemic reaction (other): Elevated heart rate but still within resting range.

Release 9 — day 14, dose 3

2021-09-06

Symptoms: Abdominal pain left side & difficulty sleeping for 3 nights. Those occurred 7 days after injection.

Release 9 — day 28, dose 3

2021-09-21

Symptoms: Lymph node on right side of head swollen & tender.

Release 11 — 6 months, dose 3

2022-02-21

Symptoms: Weight loss 7 lbs in 2 1/2 months after booster.

Healthcare visit (other): Scans, colonoscopy, endoscopy

Release 12 — day 28, dose 5

2022-11-01

Symptoms: Gastro severe pain& inflamation & late onset rash on inside lower arms

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	Unevaluable event	·	·	✓
SD	Abdominal pain	✓	·	✓
SD	Abdominal pain upper	·	·	✓
SD	Gastritis	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Insomnia	✓	·	✓
SD	Lymph node pain	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Rash	·	·	✓
SD	Weight decreased	·	·	✓
SRO	Heart rate increased	✓	·	✓
SRO	No adverse event	✓	✓	✓

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