5R3-10907-13028

5 vaccinations 12 coded responses 25 check-ins 12 free-text entries 9 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 121 / NY
Registered: 2021-04-30

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

2021-04-08
Dose 1 — Moderna
2021-04-30
Registered in v-safe
2021-04-30
Survey response — day 21, dose 1
MedDRA: Blister, Flushing, Hot flush, Hyperhidrosis, Pruritus, Rash, Self-medication — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: 4/9 I developed a hot flush and mild rash on my arms and face, as well as a few blister like bumps on my forehead. Next night, it happened again, but this time I was all over itchy, flushed, and sweaty. I took another Benadryl and it went away again. · Healthcare visit (other): On-call doctor called and told me to take a Benadryl even though Id already taken Zyrtec.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Dose 2 — Moderna
2021-05-06
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-08
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: My left arm hurts and aches, but its manageable.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-15
Survey response — day 7, dose 2
MedDRA: Arthralgia, Burning sensation, Hypoaesthesia, Neck pain, Neuralgia, Pain in extremity, Paraesthesia — Feeling: Fair · Site: Pain · Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Systemic reaction (other): Ive been experiencing moderate to severe left neck, shoulder, arm nerve pain, tingling, numbness, and burning down my arm and into my fingertips the last week. I have two upcoming MD and Neuro appts for this new issue. · Healthcare visit (other): My left arm pain was so agonizing for hours that I sought medical treatment Thursday afternoon and again later that night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-20
Survey response — day 14, dose 2
MedDRA: Burning sensation, Hypoaesthesia, Neuralgia, Paraesthesia, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: My left arm, hand, and fingers have become a conduit for constant moderate to severe nerve pain, numbness, tingling, and burning · Healthcare visit (other): Primary care on Tuesday and PT appt tomorrow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-27
Survey response — day 21, dose 2
MedDRA: Burning sensation, Hypoaesthesia, Neuralgia, Pain in extremity, Paraesthesia, Peripheral coldness, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: My left arm nerve pain, numbness, burning, and tingling have gotten worse in the last week. I experience actual coldness to the touch in the forearm and left fingers due to constant nerve pain. · Healthcare visit (other): I had a spinal neurosurgery appt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-03
Survey response — day 28, dose 2
MedDRA: Hypoaesthesia, Neuralgia, Office visit, Paraesthesia, Peripheral coldness — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: My left arm nerve pain, numbness, tingling, and coldness in my fingers is still present and active. My MD increased my nerve pain meds and thats taken the edge off the pain from severe to moderate, so its more manageable. · Healthcare visit (other): MD neurology appt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-10
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-17
Survey response — day 42, dose 2
MedDRA: Hypoaesthesia, Neuralgia, Office visit, Pain in extremity, Paraesthesia, Peripheral coldness — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: My left arm nerve pain, tingling, numbness has gotten worse and my three fingers are constantly cold and numb. · Healthcare visit (other): I saw my Neurosurgeons PA

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-18
Call 2 — Left Voicemail
2021-08-05
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Hypoaesthesia, Nerve conduction studies abnormal, Office visit, Pain in extremity, Thoracic outlet syndrome — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: My left hand/arm/shoulder pain and numbness is from something called thoracic outlet syndrome. I just had a nerve conduction study done last week and he confirmed it. Im going to see a specialist at Albany Med Ctr later in August. · Healthcare visit (other): Neurologist and eventually a thoracic surgeon

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-10-13
Call 2 — Left Voicemail
2021-10-13
Call successful
Participant prefers to complete VAERS report online
2021-10-13
Call successful
Participant prefers to complete VAERS report online
2021-10-13
Call successful
Participant prefers to complete VAERS report online
2021-10-13
Call successful
Participant prefers to complete VAERS report online
2021-10-13
Call successful
Participant prefers to complete VAERS report online
2021-10-13
Call successful
Participant prefers to complete VAERS report online
2021-10-13
Call successful
Participant prefers to complete VAERS report online
2021-11-04
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-01
Dose 3 — Moderna
2022-04-25
Dose 4 — Moderna
2022-05-02
Health check-in — day 7, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-09
Survey response — day 14, dose 4
MedDRA: Pruritus, Rash, Self-medication — Feeling: Good

Free text: Several tiny bumps have erupted on my arms, which I thought may have been bug bites, but they didn't itch at all. Besides that, I've had a few days where I have felt itchy all over, so I took a few Benadryl and it went away.

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Survey response — day 21, dose 4
MedDRA: Back pain, Flank pain, Neuralgia, Pain, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I am sure it is not vaccine related. I had a lower spinal injection on Friday and I had severe radiating nerve pain on my left side and lower back over the last few days from my scar tissue surgical site.

MedDRA releases: 2024-11 · check-in free text available
2022-05-23
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-30
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-06
Survey response — day 42, dose 4
MedDRA: Burn infection, Office visit, Telemedicine — Feeling: Poor · 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: Symptoms: I am currently battling an infection from a burn that I accidentally received a few days ago on my breast. I went to an Urgent Care last night and I'm on a high powered antibiotic 4x a day. I'm sure I'll be fine in a few days. · Healthcare visit (other): I did a WellNow Urgent Care Telehealth appt first and she told me to go in-person Urgent Care

MedDRA releases: 2024-11 · check-in free text available
2022-06-06
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-07
Call 1 — Left Voicemail
2022-06-07
Call 1 — Left Voicemail
2022-06-07
Call 1 — Left Voicemail
2022-06-07
Call 1 — Left Voicemail
2022-06-07
Call 1 — Left Voicemail
2022-06-07
Call 1 — Left Voicemail
2022-06-07
Call 1 — Left Voicemail
2022-06-07
Call 1 — Left Voicemail
2022-06-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-27
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-09-11
Dose 5 — Moderna
Co-administered: Flu
2022-10-12
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-10-16
Survey response — day 35, dose 5
MedDRA: Feeling abnormal, Medical counselling, Neuralgia — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I'm sure it has nothing to do with my boosters. I'm feeling poorly because I've been battling an intractable severe spinal nerve pain in my lower back and legs for the last week and a half. · Healthcare visit (other): On Thursday, I called my Pain Management MD for guidance and I'm waiting to hear back from her.

MedDRA releases: 2024-11 · check-in free text available
2022-10-16
Report sent to call center — day 35, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-11
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-08	Moderna
2	2021-05-06	Moderna
3	2021-12-01	Moderna	No
4	2022-04-25	Moderna	No
5	2022-09-11	Moderna	Flu

Call center

9 call center cases

9 successful

5 waits over 3 months for a first call

See the call center timeline

Free text

Release 8 — day 21, dose 1

2021-04-30

Symptoms: 4/9 I developed a hot flush and mild rash on my arms and face, as well as a few blister like bumps on my forehead. Next night, it happened again, but this time I was all over itchy, flushed, and sweaty. I took another Benadryl and it went away again. cut off by CDC

Healthcare visit (other): On-call doctor called and told me to take a Benadryl even though Id already taken Zyrtec.

Release 8 — days 1–6 daily, dose 2

2021-05-08

Systemic reaction (other): My left arm hurts and aches, but its manageable.

Release 8 — day 7, dose 2

2021-05-15

Systemic reaction (other): Ive been experiencing moderate to severe left neck, shoulder, arm nerve pain, tingling, numbness, and burning down my arm and into my fingertips the last week. I have two upcoming MD and Neuro appts for this new issue.

Healthcare visit (other): My left arm pain was so agonizing for hours that I sought medical treatment Thursday afternoon and again later that night.

Release 8 — day 14, dose 2

2021-05-20

Symptoms: My left arm, hand, and fingers have become a conduit for constant moderate to severe nerve pain, numbness, tingling, and burning

Healthcare visit (other): Primary care on Tuesday and PT appt tomorrow

Release 8 — day 21, dose 2

2021-05-27

Symptoms: My left arm nerve pain, numbness, burning, and tingling have gotten worse in the last week. I experience actual coldness to the touch in the forearm and left fingers due to constant nerve pain.

Healthcare visit (other): I had a spinal neurosurgery appt

Release 8 — day 28, dose 2

2021-06-03

Symptoms: My left arm nerve pain, numbness, tingling, and coldness in my fingers is still present and active. My MD increased my nerve pain meds and thats taken the edge off the pain from severe to moderate, so its more manageable.

Healthcare visit (other): MD neurology appt

Release 9 — day 42, dose 2

2021-06-17

Symptoms: My left arm nerve pain, tingling, numbness has gotten worse and my three fingers are constantly cold and numb.

Healthcare visit (other): I saw my Neurosurgeons PA

Release 9 — 3 months, dose 2

2021-08-05

Symptoms: My left hand/arm/shoulder pain and numbness is from something called thoracic outlet syndrome. I just had a nerve conduction study done last week and he confirmed it. Im going to see a specialist at Albany Med Ctr later in August.

Healthcare visit (other): Neurologist and eventually a thoracic surgeon

Release 11 — day 14, dose 4

2022-05-09

Symptoms: Several tiny bumps have erupted on my arms, which I thought may have been bug bites, but they didn't itch at all. Besides that, I've had a few days where I have felt itchy all over, so I took a few Benadryl and it went away.

Release 11 — day 21, dose 4

2022-05-16

Symptoms: I am sure it is not vaccine related. I had a lower spinal injection on Friday and I had severe radiating nerve pain on my left side and lower back over the last few days from my scar tissue surgical site.

Release 11 — day 42, dose 4

2022-06-06

Symptoms: I am currently battling an infection from a burn that I accidentally received a few days ago on my breast. I went to an Urgent Care last night and I'm on a high powered antibiotic 4x a day. I'm sure I'll be fine in a few days.

Healthcare visit (other): I did a WellNow Urgent Care Telehealth appt first and she told me to go in-person Urgent Care

Release 12 — day 35, dose 5

2022-10-16

Symptoms: I'm sure it has nothing to do with my boosters. I'm feeling poorly because I've been battling an intractable severe spinal nerve pain in my lower back and legs for the last week and a half.

Healthcare visit (other): On Thursday, I called my Pain Management MD for guidance and I'm waiting to hear back from her.

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	Medical counselling	·	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Pain in extremity	✓	✓	✓
HCVO	Self-medication	✓	✓	✓
HCVO	Telemedicine	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	·	✓
SD	Back pain	·	·	✓
SD	Blister	✓	✓	✓
SD	Burn infection	·	·	✓
SD	Burning sensation	✓	✓	✓
SD	Feeling abnormal	·	·	✓
SD	Flank pain	·	·	✓
SD	Flushing	✓	✓	✓
SD	Hot flush	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Hypoaesthesia	✓	✓	✓
SD	Nerve conduction studies abnormal	✓	·	✓
SD	Neuralgia	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Peripheral coldness	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Thoracic outlet syndrome	✓	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓

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