52Q-77684-97425
5 vaccinations
8 coded responses
60 check-ins
7 free-text entries
4 call cases
- Sex
- Female
- Age at first dose
- 51-55
- ZIP prefix
- 494 / MI
- Registered
- 2021-03-11
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-11
Registered in v-safe
-
2021-03-11
Dose 1 — Moderna
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-15
- 2021-03-16
- 2021-03-17
- 2021-03-18
- 2021-03-25
- 2021-04-01
-
2021-04-08
Dose 2 — Moderna
-
2021-04-08
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-09
Health check-in — days 1–6 daily, dose 2Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2021-04-10
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2021-04-11
Health check-in — days 1–6 daily, dose 2Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2021-04-12
Survey response — days 1–6 daily, dose 2MedDRA: Migraine with aura — Feeling: Fair · Site: Pain · HeadacheFree text: Migraine aura, migraine visual disturbancesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-14
- 2021-04-15
- 2021-04-22
- 2021-04-29
-
2021-05-06
Survey response — day 28, dose 2MedDRA: Headache, Pain, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professionalFree text: Symptoms: Increased head and body aches. But I think its from MRIs with contrast more than the vaccine · Healthcare visit (other): Physical therapyMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
-
2021-05-06
Report sent to call center — day 28, dose 2Get care from a doctor or other healthcare professional1 call case(s)
- 2021-05-13
-
2021-05-20
Survey response — day 42, dose 2MedDRA: Dizziness, Headache, Pre-existing disease — Feeling: Fair · Be unable to work, Be unable to do your normal daily activitiesFree text: I have intracranial hypotension. Headache and dizziness are worse this weekMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-07-08
-
2021-10-07
Survey response — 6 months, dose 2MedDRA: Cerebrospinal fluid leakage, Neurosurgery — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · HospitalizationFree text: I had spinal neurosurgery for a spontaneous CSF leakMedDRA releases: 2024-11 · check-in free text available
-
2021-10-07
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare prHospitalization · 1 call case(s)
-
2021-10-08
Call successfulNot applicable - Accidental Reporting
-
2021-10-08
Call successfulNot applicable (accidental reporting or does not believe symptoms are related to vaccine)
-
2021-10-24
Dose 3 — Moderna
- 2021-10-29
- 2021-10-30
- 2021-10-31
- 2021-11-07
-
2021-11-14
Survey response — day 21, dose 3MedDRA: Temporomandibular joint syndrome — Feeling: FairFree text: Tight TMJ on same side as my boosterMedDRA releases: 2024-11 · check-in free text available
- 2021-11-21
- 2021-11-28
- 2021-12-05
- 2022-01-25
- 2022-04-24
-
2022-04-25
Dose 4 — Moderna
- 2022-04-25
- 2022-04-26
- 2022-04-27
-
2022-04-28
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activitiesAdult check-in
- 2022-04-29
- 2022-04-30
- 2022-05-01
- 2022-05-02
- 2022-05-09
- 2022-05-16
- 2022-05-23
- 2022-05-30
- 2022-06-06
- 2022-07-25
-
2022-09-22
Dose 5 — Moderna
-
2022-09-25
Health check-in — days 1–6 daily, dose 5Feeling: Poor · Site: Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesAdult check-in
-
2022-09-26
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Redness, Itching · Headache, Fatigue or tirednessAdult check-in
-
2022-09-27
Health check-in — days 1–6 daily, dose 5Feeling: Fair · Site: Pain, Redness, Itching · NoneAdult check-in
- 2022-09-28
- 2022-09-29
- 2022-10-06
-
2022-10-13
Survey response — day 21, dose 5MedDRA: Arthralgia, Pain, Pain in extremity, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activitiesFree text: pain flare in hips and legs (I have issues with my joints so it's probably not vaccine related)MedDRA releases: 2024-11 · check-in free text available
- 2022-10-20
- 2022-10-27
-
2022-11-05
Survey response — day 42, dose 5MedDRA: Arthralgia, Gastroenteritis viral — 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 visitFree text: Apparent stomach virus Hip painMedDRA releases: 2024-11 · check-in free text available
-
2022-11-05
Report sent to call center — day 42, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalOutpatient clinic or urgent care clinic visit · 1 call case(s)
- 2022-11-07
-
2022-11-07
Call successfulDoes not wish to fill out VAERS report
- 2022-12-24
-
2023-03-23
Survey response — 6 months, dose 5MedDRA: Cough, Viral infection — 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 consultationMedDRA releases: 2024-11
-
2023-03-23
Report sent to call center — 6 months, dose 5Be unable to do your normal daily activities · Get care from a doctor or other healthcare professionalTelehealth, virtual health, or email health consultation · 1 call case(s)
-
2023-03-24
Call successfulNot applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-11 | Moderna | |
| 2 | 2021-04-08 | Moderna | |
| 3 | 2021-10-24 | Moderna | No |
| 4 | 2022-04-25 | Moderna | No |
| 5 | 2022-09-22 | Moderna | No |
Call center
4 call center cases
4 successful
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): Migraine aura, migraine visual disturbances
Release 8 — day 28, dose 2
Symptoms: Increased head and body aches. But I think its from MRIs with contrast more than the vaccine
Healthcare visit (other): Physical therapy
Release 8 — day 42, dose 2
Symptoms: I have intracranial hypotension. Headache and dizziness are worse this week
Release 10 — 6 months, dose 2
Symptoms: I had spinal neurosurgery for a spontaneous CSF leak
Release 10 — day 21, dose 3
Symptoms: Tight TMJ on same side as my booster
Release 12 — day 21, dose 5
Symptoms: pain flare in hips and legs (I have issues with my joints so it's probably not vaccine related)
Release 12 — day 42, dose 5
Symptoms: Apparent stomach virus Hip pain
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 | Physiotherapy | ✓ | ✓ | ✓ |
| SD | Arthralgia | · | · | ✓ |
| SD | Cerebrospinal fluid leakage | · | · | ✓ |
| SD | Cough | · | · | ✓ |
| SD | Dizziness | ✓ | ✓ | ✓ |
| SD | Gastroenteritis viral | · | · | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Neurosurgery | · | · | ✓ |
| SD | Pain | ✓ | ✓ | ✓ |
| SD | Pain in extremity | · | · | ✓ |
| SD | Pre-existing disease | ✓ | ✓ | ✓ |
| SD | Temporomandibular joint syndrome | · | · | ✓ |
| SD | Viral infection | · | · | ✓ |
| SRO | Migraine with aura | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release