5PL-33897-64686

2 vaccinations 6 coded responses 22 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 997 / AK
Registered: 2020-12-28

Relationship: Self
Race: Multiracial
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
Registered in v-safe
2020-12-28
Dose 1 — Moderna
2020-12-28
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-29
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Joint range of motion decreased, Pre-existing disease, Sleep disorder — Feeling: Fair · Site: Pain · Joint pains, Nausea · Be unable to do your normal daily activities

Free text: My shoulder is very painful and has limited range of motion, I had trouble sleeping due to the pain. I also history of torn rotator cuff in the same arm I received the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-29
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-30
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain

Free text: Mental health note- I feel so happy and grateful to have access to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-22
Dose 2 — Moderna
2021-01-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Headache

Adult check-in
2021-01-26
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Immunisation, Insomnia — Feeling: Good · Fever · Headache, Diarrhea

Free text: Trouble sleeping since getting the 2nd shot. I wish I could provide my first 3 days after getting the shot, because I felt very poorly.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Good

Free text: Lack of hunger, trouble sleeping

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-12
Survey response — day 21, dose 2
MedDRA: Abdominal pain, Back pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Left sided Abdominal and left sided back pain, possibly kidney related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-05-20
Call 1 — Left Voicemail
2021-07-23
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-22
Survey response — 12 months, dose 2
MedDRA: Diarrhoea, Nasal congestion, Office visit, Pregnancy, Rhinorrhoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Became pregnant after 2nd Covid vaccine, then got booster. Nasal congestion/runny nose for x7 weeks Recent diarrhea · Healthcare visit (other): In-person

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-25
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-28	Moderna
2	2021-01-22	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2020-12-29	priority 2/3
2021-02-12	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-22	Successful 2022-01-25	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-29

Systemic reaction (other): My shoulder is very painful and has limited range of motion, I had trouble sleeping due to the pain. I also history of torn rotator cuff in the same arm I received the vaccine.

2020-12-30

Systemic reaction (other): Mental health note- I feel so happy and grateful to have access to the vaccine.

Release 2 — days 1–6 daily, dose 2

2021-01-26

Systemic reaction (other): Trouble sleeping since getting the 2nd shot. I wish I could provide my first 3 days after getting the shot, because I felt very poorly.

Release 3 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): Lack of hunger, trouble sleeping

Release 4 — day 21, dose 2

2021-02-12

Symptoms: Left sided Abdominal and left sided back pain, possibly kidney related.

Release 11 — 12 months, dose 2

2022-01-22

Symptoms: Became pregnant after 2nd Covid vaccine, then got booster. Nasal congestion/runny nose for x7 weeks Recent diarrhea

Healthcare visit (other): In-person

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	·	·	✓
SD	Abdominal pain	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Pregnancy	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Immunisation	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Joint range of motion decreased	✓	✓	✓
SRO	Mobility decreased	○	○	○
SRO	Pre-existing disease	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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