5JE-12027-78075

4 vaccinations 11 coded responses 28 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 947 / CA
Registered: 2021-02-12

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

2021-02-04
Dose 1 — Moderna
2021-02-12
Registered in v-safe
2021-02-12
Survey response — day 7, dose 1
MedDRA: Balance disorder, Fatigue, Headache — Feeling: Good · Site: Pain

Free text: Tired and slight headache day after. Felt like my walk was slightly unbalanced day or two after

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — day 14, dose 1
MedDRA: Rhinorrhoea — Feeling: Good

Free text: Runny nose, but probably pollen allergies.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — day 21, dose 1
MedDRA: Arthritis, Pre-existing disease — Feeling: Good

Free text: My arthritis has felt worse for the past week. Today is significantly better. I sure wish you could find a cure for arthritis!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Dose 2 — Moderna
2021-03-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Arthritis — Feeling: Good · Site: Pain · Joint pains

Free text: I have arthritis so its hard to differentiate, but the pain my neck joints seem worse today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Nausea — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Free text: Slight nausea after breakfast

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Nausea

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Survey response — day 7, dose 2
MedDRA: Decreased appetite — Feeling: Good

Free text: My appetite is slightly less than usual

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-25
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-29
Survey response — day 35, dose 3
MedDRA: Arthritis, Pre-existing disease — Feeling: Good

Free text: I have arthritis, so it may be all about that, but my body aches seem worse lately.

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-26
Survey response — 3 months, dose 3
MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Good

Free text: Sore throat, runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-04-25
Dose 4 — Moderna
2022-04-25
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-15
Survey response — day 14, dose 4
MedDRA: Diarrhoea, Rhinorrhoea — Feeling: Good

Free text: Runny nose, loose bowels

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Survey response — day 21, dose 4
MedDRA: Headache — Feeling: Good

Free text: Headache - mild

MedDRA releases: 2024-11 · check-in free text available
2022-07-25
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-26
Survey response — 12 months, dose 4
MedDRA: Ageusia, Anosmia, COVID-19, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-04-26
Report sent to call center — 12 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-04-27
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-04	Moderna
3	2021-10-25	Moderna	No
4	2022-04-25	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — day 7, dose 1

2021-02-12

Systemic reaction (other): Tired and slight headache day after. Felt like my walk was slightly unbalanced day or two after

Release 4 — day 14, dose 1

2021-02-18

Symptoms: Runny nose, but probably pollen allergies.

Release 4 — day 21, dose 1

2021-02-25

Symptoms: My arthritis has felt worse for the past week. Today is significantly better. I sure wish you could find a cure for arthritis!

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): I have arthritis so its hard to differentiate, but the pain my neck joints seem worse today.

2021-03-06

Systemic reaction (other): Slight nausea after breakfast

Release 5 — day 7, dose 2

2021-03-11

Systemic reaction (other): My appetite is slightly less than usual

Release 10 — day 35, dose 3

2021-11-29

Symptoms: I have arthritis, so it may be all about that, but my body aches seem worse lately.

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: Sore throat, runny nose

Release 11 — day 14, dose 4

2022-05-15

Symptoms: Runny nose, loose bowels

Release 11 — day 21, dose 4

2022-05-18

Symptoms: Headache - mild

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	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Arthritis	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Headache	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Balance disorder	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Nausea	✓	✓	✓

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