5DC-13891-30249

3 vaccinations 11 coded responses 39 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 863 / AZ
Registered: 2021-05-02

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

2021-05-01
Dose 1 — Moderna
2021-05-02
Registered in v-safe
2021-05-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-05-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-05-08
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-05-15
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-22
Survey response — day 21, dose 1
MedDRA: Injection site bruising, Injection site swelling — Feeling: Good

Free text: Bruise at injection site is still there and slughtly swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Dose 2 — Moderna
2021-05-29
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-30
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain upper — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Stomach pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-06-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-06-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-06-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-06-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-06-05
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-06-14
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-07-03
Survey response — day 35, dose 2
MedDRA: Fatigue, Pain — Feeling: Fair

Free text: Body aches extreme fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-30
Survey response — 3 months, dose 2
MedDRA: Malaise — Feeling: Good · Be unable to do your normal daily activities

Free text: Similar to original c19 symptoms i had in january 2020, 3 weeks ago, assume it was Delra variant. Symptoms wrre MUCH milder than last year.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-29
Survey response — 6 months, dose 2
MedDRA: Diarrhoea, Fatigue, Nasopharyngitis, Oropharyngeal pain, Pyrexia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Severe diarrhea, separate time period mild c symptoms, sore throat, fatique, mild fever after hubby returned from flying to chicago.

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Dose 3 — Moderna
2022-01-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-01-22
Survey response — days 1–6 daily, dose 3
MedDRA: Malaise — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Have had c19 symptoms for 2 weeks, the booster intensified the symptoms. Testing was not available to me.

MedDRA releases: 2024-11 · check-in free text available
2022-01-23
Survey response — days 1–6 daily, dose 3
MedDRA: Adverse reaction, Ageusia, Anosmia, Axillary pain, Unevaluable event — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sense of taste and smell starting to return after 2 weeks of c symptoms. Left armpit hurts, arm injection was given

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Still loss of smell and taste after being sick before booster injection

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-27
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-02-06
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-02-11
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-02-17
Survey response — day 28, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-02-24
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-03-03
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-04-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-21
Survey response — 6 months, dose 3
MedDRA: Cardiomyopathy, Cardiovascular symptom, Hospitalisation — 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 · Emergency room or emergency department visit, Hospitalization

Free text: Cardiomyopathy with symptoms of heart attack requiring hospitalization.

MedDRA releases: 2024-11 · check-in free text available
2022-07-21
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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-07-22
Call successful
Participant prefers to complete VAERS report online
2023-01-20
Survey response — 12 months, dose 3
MedDRA: Cardiomyopathy — 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 · Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11
2023-01-20
Report sent to call center — 12 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2023-01-23
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-01	Moderna
2	2021-05-29	Moderna
3	2022-01-20	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 8 — day 21, dose 1

2021-05-22

Symptoms: Bruise at injection site is still there and slughtly swollen

Release 8 — days 1–6 daily, dose 2

2021-05-30

Systemic reaction (other): Stomach pain

Release 9 — day 35, dose 2

2021-07-03

Symptoms: Body aches extreme fatigue

Release 9 — 3 months, dose 2

2021-08-30

Symptoms: Similar to original c19 symptoms i had in january 2020, 3 weeks ago, assume it was Delra variant. Symptoms wrre MUCH milder than last year.

Release 10 — 6 months, dose 2

2021-11-29

Symptoms: Severe diarrhea, separate time period mild c symptoms, sore throat, fatique, mild fever after hubby returned from flying to chicago.

Release 11 — days 1–6 daily, dose 3

2022-01-22

Systemic reaction (other): Have had c19 symptoms for 2 weeks, the booster intensified the symptoms. Testing was not available to me.

2022-01-23

Systemic reaction (other): Sense of taste and smell starting to return after 2 weeks of c symptoms. Left armpit hurts, arm injection was given

2022-01-24

Systemic reaction (other): Still loss of smell and taste after being sick before booster injection

Release 11 — day 28, dose 3

2022-02-17

Symptoms: Sore throat

Release 12 — 6 months, dose 3

2022-07-21

Symptoms: Cardiomyopathy with symptoms of heart attack requiring hospitalization.

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	Cardiomyopathy	·	·	✓
SD	Cardiovascular symptom	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Hospitalisation	·	·	✓
SD	Injection site bruising	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Malaise	✓	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	·	·	✓
SRO	Abdominal pain upper	✓	✓	✓
SRO	Adverse reaction	·	·	✓
SRO	Ageusia	·	·	✓
SRO	Anosmia	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Malaise	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Unevaluable event	·	·	✓

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