5CU-21594-00497

2 vaccinations 8 coded responses 20 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 628 / IL
Registered: 2021-01-11

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
Registered in v-safe
2021-01-11
Dose 1 — Moderna
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Office visit — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Get care from a doctor or other healthcare professional

Free text: Chiropractor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Paranasal sinus discomfort, Paranasal sinus hypersecretion — Feeling: Good

Free text: Increased sinus pressure and drainage for last 3 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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: Headache, Medical counselling — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: A severe headache for approx 72hrs · Healthcare visit (other): Fellow provider in my office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-08
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-09
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, 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: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Enlarged cervical lymph node on same side as injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Limb discomfort, Lymph node pain, Lymphoedema, Pain, Pain in extremity — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Right side cervical lymphedema with significant tenderness. Right arm is aching, heavy and hurts to use

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — day 7, dose 2
MedDRA: Arthralgia, Lymphadenopathy, Pain in extremity — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: Continued lymphadenopathy of right side. Arm continues to ache with significant joint pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-03
Call 1 — Left Voicemail
2021-03-11
Survey response — day 28, dose 2
MedDRA: Ear congestion, Ear discomfort, Oropharyngeal pain, Paranasal sinus hypersecretion, Sinus operation — Feeling: Fair

Free text: Sorethroat, sinus drainage, ear fullness,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 42, dose 2
MedDRA: Headache, Sinus congestion — 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: Sinus congestion with persistent headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-01
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-11	Moderna
2	2021-02-09	Moderna

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-13

Healthcare visit (other): Chiropractor

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): Increased sinus pressure and drainage for last 3 days

Release 2 — day 14, dose 1

2021-01-25

Symptoms: A severe headache for approx 72hrs

Healthcare visit (other): Fellow provider in my office

Release 4 — days 1–6 daily, dose 2

2021-02-14

Systemic reaction (other): Enlarged cervical lymph node on same side as injection

2021-02-15

Systemic reaction (other): Right side cervical lymphedema with significant tenderness. Right arm is aching, heavy and hurts to use

Release 4 — day 7, dose 2

2021-02-16

Systemic reaction (other): Continued lymphadenopathy of right side. Arm continues to ache with significant joint pain.

Release 5 — day 28, dose 2

2021-03-11

Symptoms: Sorethroat, sinus drainage, ear fullness,

Release 6 — day 42, dose 2

2021-03-23

Symptoms: Sinus congestion with persistent headache

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	Chiropractic	○	○	○
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Ear congestion	·	·	✓
SD	Ear discomfort	✓	✓	○
SD	Headache	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	Sinus congestion	✓	✓	✓
SD	Sinus operation	✓	✓	○
SRO	Arthralgia	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Lymphoedema	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Paranasal sinus discomfort	✓	✓	✓
SRO	Paranasal sinus hypersecretion	✓	✓	✓

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