5FQ-20869-39422

5 vaccinations 9 coded responses 56 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 972 / OR
Registered: 2021-01-26

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

2021-01-26
Registered in v-safe
2021-01-26
Dose 1 — Moderna
2021-01-26
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: Slight dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Hot flush — Feeling: Good · Site: Pain · Joint pains

Free text: Hot flashes - started ~8hrs after shot and lasted for a few hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-23
Dose 2 — Moderna
2021-02-23
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Tinnitus — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness, ringing in ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Anger, Anhedonia, Irritability, Mood altered — Feeling: Good · Site: Pain, Redness · Joint pains

Free text: Mood changes - feeling irritable, short tempered, and disinterested in anything

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — day 7, dose 2
MedDRA: Apathy, Irritability — Feeling: Good · Site: Itching · Joint pains

Free text: Feeling Irritable, and in an indifferent mood

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-10
Dose 3 — Moderna
2021-10-25
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-13
Survey response — 6 months, dose 3
MedDRA: Acupuncture, Arthralgia, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Increased joint pain · Healthcare visit (other): In person visit- cortisone injection, acupuncture, chiropractic adjustment

MedDRA releases: 2024-11 · check-in free text available
2022-03-13
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-16
Call 1 — Left Voicemail
2022-03-16
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-09
Dose 4 — Moderna
2022-05-09
Survey response — day 0, dose 4
MedDRA: Dry throat, Thirst — Feeling: Good · Site: Pain, Redness · Joint pains, Fatigue or tiredness

Free text: Thirst, dry throat

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-11
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-05-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2022-05-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2022-05-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2022-05-15
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2022-05-16
Health check-in — day 7, dose 4
Feeling: Good · Site: Swelling · None

Adult check-in
2022-05-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-13
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-08
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-23
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-09-24
Survey response — days 1–6 daily, dose 5
MedDRA: Ocular discomfort, Paranasal sinus discomfort — Feeling: Fair · Site: Pain, Swelling · 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: Sinus and eye pressure

MedDRA releases: 2024-11 · check-in free text available
2022-09-25
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-09-26
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains

Adult check-in
2022-09-27
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2022-09-29
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Swelling · None

Adult check-in
2022-09-30
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-07
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-14
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-21
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-28
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-04
Survey response — day 42, dose 5
MedDRA: Lymphadenitis, Neck pain, Self-medication — 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: Symptoms: Lymph node inflammation near left ear. Caused severe neck pain. No other symptoms other than severe neck pain near ear. · Healthcare visit (other): Was prescribed steroid drops for ear in combo with ibuprofen.

MedDRA releases: 2024-11 · check-in free text available
2022-11-04
Report sent to call center — day 42, dose 5
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)
2022-11-07
Call 1 — Left Voicemail
2022-11-07
Call successful
Participant prefers to complete VAERS report online
2022-12-23
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-24
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Moderna
2	2021-02-23	Moderna
3	2021-09-10	Moderna	No
4	2022-05-09	Moderna	No
5	2022-09-23	Pfizer-BioNTech	Flu

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-26

Systemic reaction (other): Slight dizziness

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): Hot flashes - started ~8hrs after shot and lasted for a few hours.

Release 4 — days 1–6 daily, dose 2

2021-02-24

Systemic reaction (other): Dizziness, ringing in ears

2021-03-01

Systemic reaction (other): Mood changes - feeling irritable, short tempered, and disinterested in anything

Release 4 — day 7, dose 2

2021-03-02

Systemic reaction (other): Feeling Irritable, and in an indifferent mood

Release 11 — 6 months, dose 3

2022-03-13

Symptoms: Increased joint pain

Healthcare visit (other): In person visit- cortisone injection, acupuncture, chiropractic adjustment

Release 11 — day 0, dose 4

2022-05-09

Systemic reaction (other): Thirst, dry throat

Release 12 — days 1–6 daily, dose 5

2022-09-24

Systemic reaction (other): Sinus and eye pressure

Release 12 — day 42, dose 5

2022-11-04

Symptoms: Lymph node inflammation near left ear. Caused severe neck pain. No other symptoms other than severe neck pain near ear.

Healthcare visit (other): Was prescribed steroid drops for ear in combo with ibuprofen.

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	Acupuncture	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Self-medication	·	·	✓
SD	Arthralgia	·	·	✓
SD	Lymphadenitis	·	·	✓
SD	Neck pain	·	·	✓
SRO	Anger	✓	✓	✓
SRO	Anhedonia	✓	✓	✓
SRO	Apathy	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dry throat	·	·	✓
SRO	Hot flush	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Mood altered	✓	·	✓
SRO	Ocular discomfort	·	·	✓
SRO	Paranasal sinus discomfort	·	·	✓
SRO	Thirst	·	·	✓
SRO	Tinnitus	✓	✓	✓

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