5MT-29837-19833

3 vaccinations 7 coded responses 27 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 797 / TX
Registered: 2021-01-20

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

2020-12-28
Dose 1 — Moderna
2021-01-20
Registered in v-safe
2021-01-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-25
Dose 2 — Moderna
2021-01-25
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Not at this time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness · Fever · Headache

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Spinal pain — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Nausea

Free text: My spine has been sore senses night if 2nd injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-02-22
Survey response — day 28, dose 2
MedDRA: Feeling abnormal, Headache, Heart rate increased, Palpitations — Feeling: Poor

Free text: Headache are always there and a lot of palpitations. Some times feels like a rubber band is cutting off circulation. All the time now my heart rate is really high even just sitting here its 101bpm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-04-26
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Pfizer-BioNTech
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · 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

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
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

Adult check-in
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Back pain — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: My lower back hurts maybe kidneys ?

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-04
Survey response — day 7, dose 3
MedDRA: Back pain, Middle ear effusion — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Still some back pain, fluid in left ear

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-18
Survey response — day 21, dose 3
MedDRA: Headache, Muscle tightness, Tinnitus — Feeling: Fair

Free text: Tightness in neck and ringing in head with headaches.

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-09
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-27
Survey response — 3 months, dose 3
MedDRA: Diarrhoea, Headache, Muscle spasms, Palpitations, SARS-CoV-2 test positive, Sinus disorder, Vomiting — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: I had throwing up diarrhea horrible headaches sinus issues muscle cramping palpitations I ended up testing positive for Covid on January 21, 2022

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Report sent to call center — 3 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-31
Call 1 — Left Voicemail
2022-02-11
Call successful
Participant prefers to complete VAERS report online
2022-04-30
Health check-in — 6 months, dose 3
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-28	Moderna
2	2021-01-25	Moderna
3	2021-10-28	Pfizer-BioNTech	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — day 0, dose 2

2021-01-25

Systemic reaction (other): Not at this time

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): My spine has been sore senses night if 2nd injection

Release 4 — day 28, dose 2

2021-02-22

Symptoms: Headache are always there and a lot of palpitations. Some times feels like a rubber band is cutting off circulation. All the time now my heart rate is really high even just sitting here its 101bpm

Release 10 — days 1–6 daily, dose 3

2021-11-02

Systemic reaction (other): My lower back hurts maybe kidneys ?

Release 10 — day 7, dose 3

2021-11-04

Systemic reaction (other): Still some back pain, fluid in left ear

Release 10 — day 21, dose 3

2021-11-18

Symptoms: Tightness in neck and ringing in head with headaches.

Release 11 — 3 months, dose 3

2022-01-27

Symptoms: I had throwing up diarrhea horrible headaches sinus issues muscle cramping palpitations I ended up testing positive for Covid on January 21, 2022

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	Diarrhoea	·	·	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Heart rate increased	✓	✓	✓
SD	Muscle spasms	·	·	✓
SD	Muscle tightness	·	·	✓
SD	Palpitations	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sinus disorder	·	·	✓
SD	Tinnitus	·	·	✓
SD	Vomiting	·	·	✓
SRO	Back pain	·	·	✓
SRO	Middle ear effusion	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Spinal pain	✓	✓	✓

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