5SR-54183-24490

3 vaccinations 5 coded responses 41 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 26-30
ZIP prefix: 731 / OK
Registered: 2021-03-18

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

2021-03-18
Registered in v-safe
2021-03-18
Dose 1 — Moderna
2021-03-18
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-15
Dose 2 — Moderna
2021-04-15
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Coordination abnormal, Muscular weakness — Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Leg weakness, and coordination problems

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-29
Survey response — day 14, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Throat pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-14
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-16
Dose 3 — Moderna
Co-administered: Flu
2021-12-16
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-12-17
Survey response — days 1–6 daily, dose 3
MedDRA: Brain fog — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Brain fog

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-23
Health check-in — day 7, dose 3
Feeling: Fair · Headache

Adult check-in
2021-12-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-06
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-13
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-20
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-27
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-16
Survey response — 6 months, dose 3
MedDRA: Ear pain, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headaches and ear pain.

MedDRA releases: 2024-11 · check-in free text available
2022-12-16
Survey response — 12 months, dose 3
MedDRA: Brain fog, Cough, Fatigue, Respiratory tract infection, Vomiting — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Major fatigue, brain fog, dry cough causing vomiting, respiratory infection

MedDRA releases: 2024-11 · check-in free text available
2022-12-16
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-19
Call 1 — Left Voicemail
2022-12-20
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-15	Moderna
3	2021-12-16	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-12-16	Successful 2022-12-20	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-16

Systemic reaction (other): Leg weakness, and coordination problems

Release 8 — day 14, dose 2

2021-04-29

Symptoms: Throat pain

Release 10 — days 1–6 daily, dose 3

2021-12-17

Systemic reaction (other): Brain fog

Release 12 — 6 months, dose 3

2022-06-16

Symptoms: Headaches and ear pain.

Release 12 — 12 months, dose 3

2022-12-16

Symptoms: Major fatigue, brain fog, dry cough causing vomiting, respiratory 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	Brain fog	·	·	✓
SD	Cough	·	·	✓
SD	Ear pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Respiratory tract infection	·	·	✓
SD	Vomiting	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Coordination abnormal	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓

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