5S8-33307-68370

3 vaccinations 3 coded responses 36 check-ins 3 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 936 / CA
Registered: 2020-12-28

Relationship: Self
Race: Native Hawaiian or other Pacific Islander
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-27
Dose 1 — Moderna
2020-12-28
Registered in v-safe
2020-12-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-01-03
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Survey response — day 21, dose 1
MedDRA: Arthralgia, Carpal tunnel syndrome, Injection site rash, Pain, Rash papular — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Small, raised rash appeared at injection site, with minor pain radiating down to wrist. Feeling similar to carpal tunnel. Didnt impede activities, but felt like a nuisance.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-24
Dose 2 — Moderna
2021-01-24
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

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

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-01
Survey response — day 35, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: Arm is sore at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-03-23
Call 1 — Left Voicemail
2021-04-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-24
Survey response — 3 months, dose 3
MedDRA: COVID-19 — Feeling: Fair · 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: COVID-18 infection

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
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
2022-01-31
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-27
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-27	Moderna
2	2021-01-24	Moderna
3	2021-10-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-19	Unsuccessful
2022-01-24	Successful 2022-01-31	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 2 — day 21, dose 1

2021-01-19

Symptoms: Small, raised rash appeared at injection site, with minor pain radiating down to wrist. Feeling similar to carpal tunnel. Didnt impede activities, but felt like a nuisance.

Release 4 — day 35, dose 2

2021-03-01

Symptoms: Arm is sore at injection site

Release 11 — 3 months, dose 3

2022-01-24

Symptoms: COVID-18 infection

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	Arthralgia	✓	✓	✓
SD	Carpal tunnel syndrome	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Rash papular	✓	✓	✓

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