5SS-30230-29674

2 vaccinations 9 coded responses 15 check-ins 9 free-text entries 5 call cases

Sex: —
Age at first dose: 36-40
ZIP prefix: 631 / MO
Registered: 2021-02-02

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

2021-01-05
Dose 1 — Moderna
2021-02-02
Registered in v-safe
2021-02-02
Dose 2 — Moderna
2021-02-02
Health check-in — day 0, dose 2
Feeling: Poor · Site: Redness, Itching · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Adult check-in
2021-02-02
Report sent to call center — day 0, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Paraesthesia — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Tingling sensation in my back and neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Paraesthesia, Pruritus — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Itching and tingling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation, Pain, Paraesthesia — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Burning and tingling on the back of my neck. Woke up with a very strong pain in my right side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation, Paraesthesia — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Tingling and burning on the back of my neck by my spine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Paraesthesia, Peripheral swelling, Pruritus, Skin burning sensation — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Itching and burning on the back of my neck and in-between shoulder blades along with tingling and my right arm swollen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-09
Survey response — day 7, dose 2
MedDRA: Chest discomfort, Dyspnoea, Inhalation therapy — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Very hard time breathing. Felt very heavy and weighted on my chest · Healthcare visit (other): I called my doctor as I was having a hard time breathing and she prescribed me an inhaler and requesting my medical records from the hospital to see if they missed something

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-16
Survey response — day 14, dose 2
MedDRA: Dyspnoea, Medical counselling, Paraesthesia, Skin burning sensation — 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: I had a very hard time breathing. I called my doctor and she prescribed an Albuterol inhaler for me. I was still having tingling sensation and burning on my skin almost every day. Enough to put ice packs on it to deaden the symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
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)
2021-02-26
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-04
Survey response — day 28, dose 2
MedDRA: Burning sensation, Dyspnoea, Paraesthesia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: I'm still having tingling and burning all over my body. I also still have a hard time breathing. I'm really surprised that no one has contacted me from the CDC. This vaccine really did a number on me

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 35, dose 2
MedDRA: Dyspnoea, Fatigue, Pain, Throat irritation — Feeling: Poor · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Shortness of breath, itching and scratch ing in my throat, tired aches all over

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Report sent to call center — day 35, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-06-17
Call successful
Participant prefers to complete VAERS report online
2021-08-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-02	Moderna

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Tingling sensation in my back and neck

2021-02-05

Systemic reaction (other): Itching and tingling

2021-02-06

Systemic reaction (other): Burning and tingling on the back of my neck. Woke up with a very strong pain in my right side

2021-02-07

Systemic reaction (other): Tingling and burning on the back of my neck by my spine

2021-02-08

Systemic reaction (other): Itching and burning on the back of my neck and in-between shoulder blades along with tingling and my right arm swollen

Release 3 — day 7, dose 2

2021-02-09

Systemic reaction (other): Very hard time breathing. Felt very heavy and weighted on my chest

Healthcare visit (other): I called my doctor as I was having a hard time breathing and she prescribed me an inhaler and requesting my medical records from the hospital to see if they missed something

Release 4 — day 14, dose 2

2021-02-16

Symptoms: I had a very hard time breathing. I called my doctor and she prescribed an Albuterol inhaler for me. I was still having tingling sensation and burning on my skin almost every day. Enough to put ice packs on it to deaden the symptoms

Release 5 — day 28, dose 2

2021-03-04

Symptoms: I'm still having tingling and burning all over my body. I also still have a hard time breathing. I'm really surprised that no one has contacted me from the CDC. This vaccine really did a number on me

Release 5 — day 35, dose 2

2021-03-09

Symptoms: Shortness of breath, itching and scratch ing in my throat, tired aches all over

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	Dyspnoea	✓	✓	✓
HCVO	Inhalation therapy	✓	✓	✓
SD	Burning sensation	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Medical counselling	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Paraesthesia	✓	✓	✓
SD	Skin burning sensation	✓	✓	✓
SD	Throat irritation	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Skin burning sensation	✓	✓	✓

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