5J5-14084-29849

5 vaccinations 28 coded responses 58 check-ins 28 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 451 / OH
Registered: 2021-03-08

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

2021-03-08
Registered in v-safe
2021-03-08
Dose 1 — Moderna
2021-03-08
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Free text: Bp 140/90 dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site mass — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Large lump where vaccine was given

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Neck pain, Oedema peripheral, Peripheral swelling — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Swelling of arm and neck pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-12
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, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspepsia — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Heartburn

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspepsia — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Heartburn,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — day 7, dose 1
MedDRA: Body temperature decreased, Dyspepsia, Feeling hot — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Heartburn, I feel hot but low temperature

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-29
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-05
Dose 2 — Moderna
2021-04-05
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
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

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Immunisation reaction, Neck pain, Urine output increased — Feeling: Fair · 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: Covid arm and neck & back ache. Urine output increase.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Neck pain — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Neck & shoulder pain

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

Adult check-in
2021-04-12
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-26
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-10
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-17
Survey response — day 42, dose 2
MedDRA: Abdominal distension, Constipation — Feeling: Fair

Free text: Bloating and Constipation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-04
Survey response — 6 months, dose 2
MedDRA: Aortic aneurysm, Osteopenia, Pain in jaw — Feeling: Fair · Be unable to do your normal daily activities

Free text: Jaw pain and osteopenia. Enlarge aorta arch...

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Dose 3 — Moderna
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Eye pain — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Eye pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Eye pain, Paraesthesia — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Eye pain and tingling in fingers n thumb

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-08
Survey response — days 1–6 daily, dose 3
MedDRA: Brain fog — Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Brain Fog

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Survey response — days 1–6 daily, dose 3
MedDRA: Irritability, Neck pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Left side Neck pain, irritable

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Survey response — day 7, dose 3
MedDRA: Agitation — Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Agitated

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Survey response — day 14, dose 3
MedDRA: Back pain — Feeling: Fair

Free text: Back pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Survey response — day 21, dose 3
MedDRA: Alopecia, Fatigue, Irritability — Feeling: Fair

Free text: Notice lately hair loss, more fatigue and aggravation.

MedDRA releases: 2024-11 · check-in free text available
2021-12-02
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-11
Survey response — day 35, dose 3
MedDRA: Back pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Back pain, uterine biopsy

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-03
Survey response — 3 months, dose 3
MedDRA: Gastrointestinal disorder, Osteopenia — Feeling: Fair

Free text: Osteopenia, stomach issues

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Dose 4 — Moderna
2022-04-20
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain, Swelling · Headache

Adult check-in
2022-04-21
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia, Neck pain — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shoulder and neck pains.

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia, Neck pain — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Shoulder and neck pains

MedDRA releases: 2024-11 · check-in free text available
2022-04-23
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-04-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-04-26
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-04-27
Survey response — day 7, dose 4
MedDRA: Dizziness, Vertigo — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness/vertigo/BP 150/100

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Survey response — day 14, dose 4
MedDRA: Arthralgia, Dizziness, Neck pain — Feeling: Fair

Free text: Shoulder, neck pain and dizziness.

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Survey response — day 21, dose 4
MedDRA: Arthralgia, Fatigue, Myalgia — Feeling: Good

Free text: Joint, muscle pains and fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Survey response — day 28, dose 4
MedDRA: Abdominal pain upper, Diarrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe stomach pains all over and diarrhea.

MedDRA releases: 2024-11 · check-in free text available
2022-05-27
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-11
Dose 5 — Moderna
2022-09-12
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-16
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2022-09-17
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2022-09-18
Survey response — day 7, dose 5
MedDRA: Paranasal sinus hypersecretion — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: Clear muscus from sinuses

MedDRA releases: 2024-11 · check-in free text available
2022-09-25
Survey response — day 14, dose 5
MedDRA: Abdominal pain upper, Diarrhoea, Headache, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Diarrhea, loose stool, stomach pains and headache. · Healthcare visit (other): Gastroenterology

MedDRA releases: 2024-11 · check-in free text available
2022-09-25
Report sent to call center — day 14, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2022-09-26
Call 1 — Left Voicemail
2022-10-02
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-10-09
Survey response — day 28, dose 5
MedDRA: Non-alcoholic fatty liver, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Non alcoholic Fatty liver · Healthcare visit (other): Ultrasound and upcoming fibroscan

MedDRA releases: 2024-11 · check-in free text available
2022-10-09
Report sent to call center — day 28, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-11
Call successful
Does not wish to fill out VAERS report
2022-10-11
Call successful
Does not wish to fill out VAERS report
2022-10-16
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna
2	2021-04-05	Moderna
3	2021-11-04	Moderna	No
4	2022-04-20	Moderna	No
5	2022-09-11	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-08

Systemic reaction (other): Bp 140/90 dizzy

Release 5 — days 1–6 daily, dose 1

2021-03-09

Systemic reaction (other): Large lump where vaccine was given

2021-03-10

Systemic reaction (other): Swelling of arm and neck pain

2021-03-13

Systemic reaction (other): Heartburn

2021-03-14

Systemic reaction (other): Heartburn,

Release 5 — day 7, dose 1

2021-03-15

Systemic reaction (other): Heartburn, I feel hot but low temperature

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Covid arm and neck & back ache. Urine output increase.

2021-04-10

Systemic reaction (other): Neck & shoulder pain

Release 8 — day 42, dose 2

2021-05-17

Symptoms: Bloating and Constipation

Release 10 — 6 months, dose 2

2021-10-04

Symptoms: Jaw pain and osteopenia. Enlarge aorta arch...

Release 10 — days 1–6 daily, dose 3

2021-11-05

Systemic reaction (other): Eye pain

2021-11-06

Systemic reaction (other): Eye pain and tingling in fingers n thumb

2021-11-08

Systemic reaction (other): Brain Fog

2021-11-09

Systemic reaction (other): Left side Neck pain, irritable

Release 10 — day 7, dose 3

2021-11-11

Systemic reaction (other): Agitated

Release 10 — day 14, dose 3

2021-11-18

Symptoms: Back pain

Release 10 — day 21, dose 3

2021-11-25

Symptoms: Notice lately hair loss, more fatigue and aggravation.

Release 10 — day 35, dose 3

2021-12-11

Symptoms: Back pain, uterine biopsy

Release 11 — 3 months, dose 3

2022-02-03

Symptoms: Osteopenia, stomach issues

Release 11 — days 1–6 daily, dose 4

2022-04-21

Systemic reaction (other): Shoulder and neck pains.

2022-04-22

Systemic reaction (other): Shoulder and neck pains

Release 11 — day 7, dose 4

2022-04-27

Systemic reaction (other): Dizziness/vertigo/BP 150/100

Release 11 — day 14, dose 4

2022-05-04

Symptoms: Shoulder, neck pain and dizziness.

Release 11 — day 21, dose 4

2022-05-11

Symptoms: Joint, muscle pains and fatigue

Release 11 — day 28, dose 4

2022-05-18

Symptoms: Severe stomach pains all over and diarrhea.

Release 12 — day 7, dose 5

2022-09-18

Systemic reaction (other): Clear muscus from sinuses

Release 12 — day 14, dose 5

2022-09-25

Symptoms: Diarrhea, loose stool, stomach pains and headache.

Healthcare visit (other): Gastroenterology

Release 12 — day 28, dose 5

2022-10-09

Symptoms: Non alcoholic Fatty liver

Healthcare visit (other): Ultrasound and upcoming fibroscan

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	Office visit	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abdominal distension	✓	✓	✓
SD	Abdominal pain upper	·	·	✓
SD	Alopecia	·	·	✓
SD	Aortic aneurysm	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Constipation	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	·	·	✓
SD	Irritability	·	·	✓
SD	Myalgia	·	·	✓
SD	Neck pain	·	·	✓
SD	Non-alcoholic fatty liver	·	·	✓
SD	Osteopenia	·	·	✓
SD	Pain in jaw	·	·	✓
SRO	Agitation	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Body temperature decreased	○	✓	○
SRO	Brain fog	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Eye pain	·	·	✓
SRO	Feeling hot	✓	·	✓
SRO	Immunisation reaction	✓	✓	✓
SRO	Injection site mass	✓	✓	✓
SRO	Irritability	·	·	✓
SRO	Neck pain	✓	✓	✓
SRO	Oedema peripheral	✓	✓	○
SRO	Paraesthesia	·	·	✓
SRO	Paranasal sinus hypersecretion	·	·	✓
SRO	Peripheral swelling	·	·	✓
SRO	Urine output increased	✓	✓	✓
SRO	Vertigo	·	·	✓

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