5RY-25756-43666

5 vaccinations 19 coded responses 47 check-ins 17 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 017 / MA
Registered: 2021-01-28

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Survey response — day 0, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Fatigue or tiredness

Free text: High heart rate with slow walking

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia — Feeling: Good

Free text: Waking up 2-3 times at night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-04
Survey response — day 7, dose 1
MedDRA: Sleep disorder — Feeling: Good

Free text: Sleep disturbance

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

Adult check-in
2021-02-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Influenza like illness — Feeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: I feel flu-ish

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Fatigue or tiredness

Free text: Sleeplessness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Fatigue or tiredness

Free text: Out of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sleeplessness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sleeplessness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 7, dose 2
MedDRA: Insomnia — Feeling: Good · Fatigue or tiredness

Free text: Sleeplessness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 14, dose 2
MedDRA: Breast pain, Fatigue, Pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Dull pain on left side below breast, new fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — day 14, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Fatigue, Food poisoning, Lyme disease, Nausea, Pyrexia — 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, Outpatient clinic or urgent care clinic visit

Free text: Nausea and fatigue from food poisonings; low grade fever from Lyme disease

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-27
Call successful
Does not wish to fill out VAERS report
2021-08-27
Call successful
Does not wish to fill out VAERS report
2021-11-02
Dose 3 — Moderna
2022-02-26
Survey response — 12 months, dose 2
MedDRA: Abdominal pain, Diarrhoea, Food poisoning, Vomiting — 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

Free text: food poisoning: vomiting, diarrhea, abdominal cramps

MedDRA releases: 2024-11 · check-in free text available
2022-02-26
Report sent to call center — 12 months, dose 2
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)
2022-03-02
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-02
Dose 4 — Moderna
2022-04-02
Survey response — day 0, dose 4
MedDRA: Heart rate increased — Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Rapid heart rate

MedDRA releases: 2024-11 · check-in free text available
2022-04-03
Survey response — days 1–6 daily, dose 4
MedDRA: Heart rate increased — Feeling: Fair · Fatigue or tiredness

Free text: fast heart rate

MedDRA releases: 2024-11 · check-in free text available
2022-04-04
Survey response — days 1–6 daily, dose 4
MedDRA: Heart rate increased — Feeling: Good

Free text: heart rate still a little high, better than yesterday

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-04-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-09
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-16
Survey response — day 14, dose 4
MedDRA: Fatigue, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme fatigue, mild nausea

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-07
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-04
Survey response — 3 months, dose 4
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-10-01
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-02
Survey response — 12 months, dose 4
MedDRA: Dyspnoea, Muscular weakness — Feeling: Poor · 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
2023-04-02
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)
2023-04-03
Call 1 — Left Voicemail
2023-04-26
Dose 5 — Moderna
2023-04-29
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2023-04-30
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2023-05-01
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2023-05-03
Health check-in — day 7, dose 5
Feeling: Fair · Fatigue or tiredness

Adult check-in
2023-05-12
Survey response — day 14, dose 5
MedDRA: Asthenia, Nausea — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-17
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2023-06-07
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-11-02	Moderna	No
4	2022-04-02	Moderna	No
5	2023-04-26	Moderna	No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-28

Systemic reaction (other): High heart rate with slow walking

Release 3 — days 1–6 daily, dose 1

2021-02-01

Systemic reaction (other): Waking up 2-3 times at night

Release 3 — day 7, dose 1

2021-02-04

Systemic reaction (other): Sleep disturbance

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): I feel flu-ish

2021-02-28

Systemic reaction (other): Sleeplessness

2021-03-01

Systemic reaction (other): Out of breath

2021-03-02

Systemic reaction (other): Sleeplessness

2021-03-03

Systemic reaction (other): Sleeplessness

Release 5 — day 7, dose 2

2021-03-04

Systemic reaction (other): Sleeplessness

Release 5 — day 14, dose 2

2021-03-11

Symptoms: Dull pain on left side below breast, new fatigue

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: Nausea and fatigue from food poisonings; low grade fever from Lyme disease

Release 11 — 12 months, dose 2

2022-02-26

Symptoms: food poisoning: vomiting, diarrhea, abdominal cramps

Release 11 — day 0, dose 4

2022-04-02

Systemic reaction (other): Rapid heart rate

Release 11 — days 1–6 daily, dose 4

2022-04-03

Systemic reaction (other): fast heart rate

2022-04-04

Systemic reaction (other): heart rate still a little high, better than yesterday

Release 11 — day 14, dose 4

2022-04-16

Symptoms: Extreme fatigue, mild nausea

Release 12 — 3 months, dose 4

2022-07-04

Symptoms: Fatigue

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	Abdominal pain	·	·	✓
SD	Asthenia	·	·	✓
SD	Breast pain	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Food poisoning	✓	·	✓
SD	Lyme disease	✓	·	✓
SD	Muscular weakness	·	·	✓
SD	Nausea	✓	·	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	✓	·	✓
SD	Vomiting	·	·	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Heart rate increased	·	·	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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