5C8-27668-58918

3 vaccinations 10 coded responses 41 check-ins 10 free-text entries 6 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 531 / WI
Registered: 2021-03-13

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

2021-03-13
Registered in v-safe
2021-03-13
Dose 1 — Moderna
2021-03-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-20
Survey response — day 7, dose 1
MedDRA: Pruritus — Feeling: Fair · Site: Redness, Itching · Rash, not including the immediate area around the injection site

Free text: Itching started on day 6 and continues now on day 7. Moderna dose 1 received 7 days ago.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-10
Dose 2 — Moderna
2021-04-10
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-11
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 do your normal daily activities

Adult check-in
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Neck pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: Severe neck pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Neck pain — Feeling: Fair · Site: Pain · Headache

Free text: Neck pain - moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-17
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-24
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-01
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-15
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-10
Survey response — 3 months, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Very fatigued every day even with a full night sleep. Some days i have to take a nap, which is very not like me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-09
Survey response — 6 months, dose 2
MedDRA: Fatigue, Musculoskeletal chest pain, Painful respiration — 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 · Outpatient clinic or urgent care clinic visit

Free text: Chest wall pain, pain with deep breath. And extreme fatigue.

MedDRA releases: 2024-11 · check-in free text available
2021-10-09
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-14
Call 2 — Left Voicemail
2022-01-07
Dose 3 — Moderna
2022-01-07
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Swelling · Chills, Fatigue or tiredness

Adult check-in
2022-01-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-14
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2022-01-21
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-01-28
Survey response — day 21, dose 3
MedDRA: Arthralgia, Injection site pain, Mobility decreased, Sleep disorder — 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 · Telehealth, virtual health, or email health consultation

Free text: Pain from injection site has gotten worse and spread into the shoulder area resulting in limited movements and interrupted sleep.

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Report sent to call center — day 21, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-04
Survey response — day 28, dose 3
MedDRA: Arthralgia, Joint range of motion decreased, Periarthritis — 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: Continued pain in right shoulder (injection arm) limited range of motion and diagnosis is capsulitis. Now being referred to orthopedics.

MedDRA releases: 2024-11 · check-in free text available
2022-02-04
Report sent to call center — day 28, 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)
2022-02-04
Call 1 — Left Voicemail
2022-02-11
Survey response — day 35, dose 3
MedDRA: Arthralgia, Mobility decreased, Musculoskeletal stiffness — 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: Shoulder pain stiffness and limited mobility

MedDRA releases: 2024-11 · check-in free text available
2022-02-11
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-18
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-22
Call 1 — Left Voicemail
2022-04-11
Survey response — 3 months, dose 3
MedDRA: Arthralgia, Joint swelling, Office visit — 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: Continued shoulder pain with swelling. Was referred from primary and PT to orthopedics. Had to receive a MRI and cortisone injection. This is the shoulder I received my booster.

MedDRA releases: 2024-11 · check-in free text available
2022-04-11
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)
2022-04-12
Call 1 — Left Voicemail
2022-07-08
Survey response — 6 months, dose 3
MedDRA: Asthma, COVID-19, Respiratory disorder — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Caught Covid and and still have the asthma breathing issues 30 days post.

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-11
Call 1 — Left Voicemail
2022-07-11
Call 2 — Left Voicemail
2022-07-11
Call 1 — Left Voicemail
2022-07-11
Call 2 — Left Voicemail
2022-07-11
Call 2 — Left Voicemail
2022-07-11
Call 1 — Left Voicemail
2023-01-07
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Moderna
2	2021-04-10	Moderna
3	2022-01-07	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-09	Unsuccessful
2022-01-28	Unsuccessful
2022-02-04	Unsuccessful
2022-02-11	Unsuccessful
2022-04-11	Unsuccessful
2022-07-08	Unsuccessful

Free text

Release 6 — day 7, dose 1

2021-03-20

Systemic reaction (other): Itching started on day 6 and continues now on day 7. Moderna dose 1 received 7 days ago.

Release 7 — days 1–6 daily, dose 2

2021-04-12

Systemic reaction (other): Severe neck pain

2021-04-14

Systemic reaction (other): Neck pain - moderate

Release 9 — 3 months, dose 2

2021-07-10

Symptoms: Very fatigued every day even with a full night sleep. Some days i have to take a nap, which is very not like me.

Release 10 — 6 months, dose 2

2021-10-09

Symptoms: Chest wall pain, pain with deep breath. And extreme fatigue.

Release 11 — day 21, dose 3

2022-01-28

Symptoms: Pain from injection site has gotten worse and spread into the shoulder area resulting in limited movements and interrupted sleep.

Release 11 — day 28, dose 3

2022-02-04

Symptoms: Continued pain in right shoulder (injection arm) limited range of motion and diagnosis is capsulitis. Now being referred to orthopedics.

Release 11 — day 35, dose 3

2022-02-11

Symptoms: Shoulder pain stiffness and limited mobility

Release 11 — 3 months, dose 3

2022-04-11

Symptoms: Continued shoulder pain with swelling. Was referred from primary and PT to orthopedics. Had to receive a MRI and cortisone injection. This is the shoulder I received my booster.

Release 12 — 6 months, dose 3

2022-07-08

Symptoms: Caught Covid and and still have the asthma breathing issues 30 days post.

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	Arthralgia	·	·	✓
SD	Asthma	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Injection site pain	·	·	✓
SD	Joint range of motion decreased	·	·	✓
SD	Joint swelling	·	·	✓
SD	Mobility decreased	·	·	✓
SD	Musculoskeletal chest pain	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Office visit	·	·	✓
SD	Painful respiration	·	·	✓
SD	Periarthritis	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Sleep disorder	·	·	✓
SRO	Neck pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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