55F-22673-09180

2 vaccinations 12 coded responses 24 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 211 / MD
Registered: 2021-04-09

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

2021-04-08
Dose 1 — Moderna
2021-04-09
Registered in v-safe
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: Bone pain, Neck pain — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Pain in collar bone up into the neck some

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Bone pain, Neck pain — Feeling: Good · Site: Pain

Free text: Still some collarbone pain and a little neck pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 1
MedDRA: Discomfort — Feeling: Good

Free text: Slight discomfort in collar bone on both sides today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 1
MedDRA: Discomfort, Musculoskeletal discomfort — Feeling: Good · Fatigue or tiredness

Free text: Mild discomfort in shoulder and collarbone on the opposite side of injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — day 7, dose 1
Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-06
Dose 2 — Moderna
2021-05-06
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Heart rate increased, Mobility decreased, Muscle spasms — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Overnight I had severe dizziness and rapid heart beat to the point I could not lift my head or get out of bed for three hours. My upper legs had muscle spasms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: Still slight dizziness at times but hydrated more and that helped.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Dehydration, Dizziness — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Slight dizziness maybe still from dehydration?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness

Free text: Slight dizziness still

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Dizziness postural — Feeling: Good

Free text: Slight dizziness when standing in one place.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-23
Survey response — day 14, dose 2
MedDRA: Dizziness, Loss of consciousness, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Some extreme dizziness when taking a walk and even just standing still to the point I thought Id pass out and pain in my left side calf. The pain has subsided I believe.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-17
Survey response — day 42, dose 2
MedDRA: Rash, Rash pruritic — Feeling: Good

Free text: A rash with some itching appeared on my back last week. Its calmed down now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-05
Survey response — 3 months, dose 2
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · 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: Two week long severe cold in early July. I was tested for COVID both rapid nasal and PCR spit test and both were negative.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-24
Call successful
Does not wish to fill out VAERS report
2022-05-08
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-08	Moderna
2	2021-05-06	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-09

Systemic reaction (other): Pain in collar bone up into the neck some

2021-04-10

Systemic reaction (other): Still some collarbone pain and a little neck pain

2021-04-11

Systemic reaction (other): Slight discomfort in collar bone on both sides today.

2021-04-12

Systemic reaction (other): Mild discomfort in shoulder and collarbone on the opposite side of injection.

Release 8 — days 1–6 daily, dose 2

2021-05-07

Systemic reaction (other): Overnight I had severe dizziness and rapid heart beat to the point I could not lift my head or get out of bed for three hours. My upper legs had muscle spasms.

2021-05-08

Systemic reaction (other): Still slight dizziness at times but hydrated more and that helped.

2021-05-09

Systemic reaction (other): Slight dizziness maybe still from dehydration?

2021-05-11

Systemic reaction (other): Slight dizziness still

2021-05-12

Systemic reaction (other): Slight dizziness when standing in one place.

Release 8 — day 14, dose 2

2021-05-23

Symptoms: Some extreme dizziness when taking a walk and even just standing still to the point I thought Id pass out and pain in my left side calf. The pain has subsided I believe.

Release 9 — day 42, dose 2

2021-06-17

Symptoms: A rash with some itching appeared on my back last week. Its calmed down now.

Release 9 — 3 months, dose 2

2021-08-05

Symptoms: Two week long severe cold in early July. I was tested for COVID both rapid nasal and PCR spit test and both were negative.

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	Dizziness	✓	✓	✓
SD	Loss of consciousness	✓	✓	✓
SD	Nasopharyngitis	✓	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	·	✓
SRO	Bone pain	✓	✓	✓
SRO	Dehydration	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dizziness postural	·	·	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Musculoskeletal discomfort	✓	✓	✓
SRO	Neck pain	✓	✓	✓

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