5GA-75271-27001

5 vaccinations 11 coded responses 55 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 787 / TX
Registered: 2021-01-15

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

2021-01-14
Dose 1 — Moderna
2021-01-15
Registered in v-safe
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Survey response — day 7, dose 1
MedDRA: Chills, Diarrhoea, Headache, Pyrexia — Feeling: Good · Headache

Free text: Two days ago I had a fever, chills, diarrhea, & a pounding headache for about 24 hours, and then it went away.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Survey response — day 0, dose 2
MedDRA: Injection site pain — Feeling: Fair · Site: Pain, Itching · Headache

Free text: Burning sensation at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pruritus, Pruritus — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Itching on hands & ears

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-13
Survey response — 3 months, dose 2
MedDRA: Abdominal pain upper — Feeling: Fair

Free text: Ongoing stomach ache for close to a week now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Diarrhea

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2021-10-30
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-13
Survey response — day 21, dose 3
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Significant joint pain in left knee & pain in left hip (no known reason, no injury).

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-24
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-06-25
Dose 4 — Moderna
2022-06-25
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2022-06-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-06-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2022-06-28
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain, Unevaluable event — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Sore throat · Healthcare visit (other): Went & got a PCR test at pharmacy

MedDRA releases: 2024-11 · check-in free text available
2022-06-28
Report sent to call center — days 1–6 daily, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-29
Survey response — days 1–6 daily, dose 4
MedDRA: Cough, Medical counselling, SARS-CoV-2 test positive — Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Constant cough. And? tested positive for Covid today. · Healthcare visit (other): Phone conversation with PA today, scheduled teledoc appt. with Dr. for tomorrow morning.

MedDRA releases: 2024-11 · check-in free text available
2022-06-29
Report sent to call center — days 1–6 daily, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-29
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-30
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-06-30
Call successful
Participant prefers to complete VAERS report online
2022-07-01
Survey response — days 1–6 daily, dose 4
MedDRA: Chills, Diarrhoea, Haematochezia, Malaise, Pyrexia, SARS-CoV-2 test positive — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Tested positive for Covid Tues. Started Paxlovid Thursday. Made me sick as a horse w/severe diarrhea, passing blood, high fever & chills

MedDRA releases: 2024-11 · check-in free text available
2022-07-02
Survey response — day 7, dose 4
MedDRA: Adverse drug reaction, COVID-19 — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Abdominal pain

Free text: Took Paxlovid on Thursday resulting in bloody diarrhea & severe abdominal pain. (I got my 2nd booster a week ago & then later tested + for Covid.)

MedDRA releases: 2024-11 · check-in free text available
2022-07-09
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-16
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-23
Survey response — day 28, dose 4
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extremely fatigued all the time for days on end.

MedDRA releases: 2024-11 · check-in free text available
2022-07-30
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-08-06
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-09-24
Survey response — 3 months, dose 4
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Continued extreme fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-12-25
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-03-23
Dose 5 — Moderna
2023-04-12
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2023-04-13
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2023-04-20
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2023-04-28
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2023-05-04
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-06-23
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna
3	2021-10-23	Moderna	No
4	2022-06-25	Moderna	No
5	2023-03-23	Moderna	No

Call center

3 call center cases

2 successful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — day 7, dose 1

2021-01-23

Systemic reaction (other): Two days ago I had a fever, chills, diarrhea, & a pounding headache for about 24 hours, and then it went away.

Release 4 — day 0, dose 2

2021-02-11

Systemic reaction (other): Burning sensation at injection site

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Itching on hands & ears

Release 8 — 3 months, dose 2

2021-05-13

Symptoms: Ongoing stomach ache for close to a week now.

Release 10 — day 21, dose 3

2021-11-13

Symptoms: Significant joint pain in left knee & pain in left hip (no known reason, no injury).

Release 12 — days 1–6 daily, dose 4

2022-06-28

Systemic reaction (other): Sore throat

Healthcare visit (other): Went & got a PCR test at pharmacy

2022-06-29

Systemic reaction (other): Constant cough. And? tested positive for Covid today.

Healthcare visit (other): Phone conversation with PA today, scheduled teledoc appt. with Dr. for tomorrow morning.

2022-07-01

Systemic reaction (other): Tested positive for Covid Tues. Started Paxlovid Thursday. Made me sick as a horse w/severe diarrhea, passing blood, high fever & chills

Release 12 — day 7, dose 4

2022-07-02

Systemic reaction (other): Took Paxlovid on Thursday resulting in bloody diarrhea & severe abdominal pain. (I got my 2nd booster a week ago & then later tested + for Covid.)

Release 12 — day 28, dose 4

2022-07-23

Symptoms: Extremely fatigued all the time for days on end.

Release 12 — 3 months, dose 4

2022-09-24

Symptoms: Continued extreme fatigue

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	Medical counselling	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Fatigue	·	·	✓
SRO	Adverse drug reaction	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Cough	·	·	✓
SRO	COVID-19	·	·	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Ear pruritus	✓	✓	✓
SRO	Haematochezia	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Malaise	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	SARS-CoV-2 test positive	·	·	✓

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