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5N5-33633-76994

3 vaccinations 4 coded responses 25 check-ins 4 free-text entries 1 call case
Sex
Female
Age at first dose
66+
ZIP prefix
327 / FL
Registered
2020-12-28
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2020-12-28
    Registered in v-safe
  2. 2020-12-28
    Dose 1 — Moderna
  3. 2020-12-28
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2020-12-29
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Redness · None
    Adult check-in
  5. 2020-12-30
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain, Redness · None
    Adult check-in
  6. 2020-12-31
    Survey response — days 1–6 daily, dose 1
    MedDRA: Pruritus — Feeling: Good · Site: Redness
    Free text: Mild Itchiness arms and legs
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-01-01
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-01-02
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  9. 2021-01-03
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-01-04
    Health check-in — day 7, dose 1
    Feeling: Good · Site: Itching · None
    Adult check-in
  11. 2021-01-20
    Survey response — day 21, dose 1
    MedDRA: Injection site erythema, Injection site rash, Injection site urticaria, Rash, Urticaria — Feeling: Good
    Free text: Had hives or rash on the whole upper left arm, same arm as injection. Started exactly 7 days after injection and lasted 2 or days. After rash or hives were gone, had light red patch for another 3 days.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-01-25
    Dose 2 — Moderna
  13. 2021-01-25
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  14. 2021-01-26
    Survey response — days 1–6 daily, dose 2
    MedDRA: Bone pain, Myalgia, Sleep disorder — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Could not sleep during the night as it felt like every bone and muscle in my body ached.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-01-27
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-01-28
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Headache, Nausea
    Adult check-in
  17. 2021-01-29
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  18. 2021-01-31
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Headache
    Adult check-in
  19. 2021-02-01
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-02-09
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-02-15
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-02-22
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-03-03
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-03-08
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-04-28
    Survey response — 3 months, dose 2
    MedDRA: Brain fog, Dizziness, Fatigue, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Dizziness, fatigue, brain fog, heavy feeling top of head · Healthcare visit (other): In-office doctor visit and MRI
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  26. 2021-04-28
    Report sent to call center — 3 months, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  27. 2021-07-26
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-08-26
    Dose 3 — Moderna
  29. 2021-11-25
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  30. 2022-02-27
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  31. 2022-04-12
  32. 2022-04-15
    Call successful
    Participant prefers to complete VAERS report online

Vaccinations

DoseDateManufacturerCo-administered
12020-12-28Moderna
22021-01-25Moderna
32021-08-26Moderna No

Call center

1 call center case

1 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): Mild Itchiness arms and legs

Release 2 — day 21, dose 1

2021-01-20

Symptoms: Had hives or rash on the whole upper left arm, same arm as injection. Started exactly 7 days after injection and lasted 2 or days. After rash or hives were gone, had light red patch for another 3 days.

Release 2 — days 1–6 daily, dose 2

2021-01-26

Systemic reaction (other): Could not sleep during the night as it felt like every bone and muscle in my body ached.

Release 8 — 3 months, dose 2

2021-04-28

Symptoms: Dizziness, fatigue, brain fog, heavy feeling top of head
Healthcare visit (other): In-office doctor visit and MRI

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit ✓ ✓ ✓
SDBrain fog ✓ ✓ ✓
SDDizziness ✓ ✓ ✓
SDFatigue ✓ ✓ ✓
SDInjection site erythema ✓ · ✓
SDInjection site rash ✓ · ✓
SDInjection site urticaria ✓ · ✓
SDRash ○ ✓ ○
SDUrticaria ○ ✓ ○
SROBone pain ✓ ✓ ✓
SROMyalgia ✓ ✓ ✓
SROPruritus ✓ ✓ ✓
SROSleep disorder ✓ ✓ ✓

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

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