5BL-24416-01256

3 vaccinations 5 coded responses 14 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 425 / KY
Registered: 2020-12-28

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

2020-12-28
Registered in v-safe
2020-12-28
Dose 1 — Moderna
2020-12-28
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Chills, Headache

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Chills, Headache

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Dose 2 — Moderna
2021-01-27
Health check-in — day 0, dose 2
Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Breast pain, Ear pain, Neck pain — Feeling: Fair · Site: Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness

Free text: Soreness in armpit, breast, neck, and right ear which are all on the side of injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 42, dose 2
MedDRA: Mammogram abnormal, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Abnormal mammogram · Healthcare visit (other): 2nd mammogram and ultrasound done, no results yet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-28
Survey response — 3 months, dose 2
MedDRA: Axillary pain, Mammogram abnormal, Oedema peripheral, Office visit, Supraclavicular fossa pain, Swelling, Ultrasound breast abnormal — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Another bad mammogram and ultrasound of the right breast. Soreness and swelling of the right arm pit area and collar bone area. Another mammogram and ultrasound scheduled in a few months. · Healthcare visit (other): Women's clinic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-01
Dose 3 — Moderna
2021-10-25
Survey response — day 21, dose 3
MedDRA: Amnesia, Anxiety, Confusional state, Mood swings, Office visit, Tremor — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Hands shaking, confusion, memory loss, anxiety, mood swings · Healthcare visit (other): Ongoing medical treatment with my healthcare provider, seeing therapists and doing memory exercises

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
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)
2021-10-26
Call 1 — Left Voicemail
2022-01-02
Survey response — 3 months, dose 3
MedDRA: Amnesia, Office visit, Personality change, Tremor — 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

Free text: Symptoms: Still have shaking mainly in left side, memory loss, personality change · Healthcare visit (other): Family doctor numerous times, brain MRI, Psychiatrist

MedDRA releases: 2024-11 · check-in free text available
2022-01-02
Report sent to call center — 3 months, dose 3
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)
2022-01-04
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-28	Moderna
2	2021-01-27	Moderna
3	2021-10-01	Moderna	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): Soreness in armpit, breast, neck, and right ear which are all on the side of injection site

Release 5 — day 42, dose 2

2021-03-12

Symptoms: Abnormal mammogram

Healthcare visit (other): 2nd mammogram and ultrasound done, no results yet

Release 8 — 3 months, dose 2

2021-04-28

Symptoms: Another bad mammogram and ultrasound of the right breast. Soreness and swelling of the right arm pit area and collar bone area. Another mammogram and ultrasound scheduled in a few months.

Healthcare visit (other): Women's clinic

Release 10 — day 21, dose 3

2021-10-25

Symptoms: Hands shaking, confusion, memory loss, anxiety, mood swings

Healthcare visit (other): Ongoing medical treatment with my healthcare provider, seeing therapists and doing memory exercises

Release 10 — 3 months, dose 3

2022-01-02

Symptoms: Still have shaking mainly in left side, memory loss, personality change

Healthcare visit (other): Family doctor numerous times, brain MRI, Psychiatrist

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	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Amnesia	·	·	✓
SD	Anxiety	·	·	✓
SD	Axillary pain	✓	✓	✓
SD	Confusional state	·	·	✓
SD	Mammogram abnormal	✓	✓	✓
SD	Mood swings	·	·	✓
SD	Oedema peripheral	✓	✓	✓
SD	Personality change	·	·	✓
SD	Supraclavicular fossa pain	✓	✓	✓
SD	Swelling	✓	✓	✓
SD	Tremor	·	·	✓
SD	Ultrasound breast abnormal	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Breast pain	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Neck pain	✓	✓	✓

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