5XM-99653-92526

5 vaccinations 14 coded responses 33 check-ins 13 free-text entries 5 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 503 / IA
Registered: 2021-04-21

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

2021-04-01
Dose 1 — Moderna
2021-04-21
Registered in v-safe
2021-04-21
Survey response — day 14, dose 1
MedDRA: Fatigue, Headache, Injection site bruising, Injection site erythema, Night sweats — Feeling: Good · Be unable to work

Free text: Night sweats, headache, tired, large purple bruise at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-29
Dose 2 — Moderna
2021-04-29
Survey response — day 0, dose 2
MedDRA: Hypoaesthesia — Feeling: Good · Site: Pain

Free text: Numbness in tips of fingers on hand of injection site side.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Brain fog, Hyperhidrosis — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Sweating more than usual. Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-13
Survey response — day 14, dose 2
MedDRA: Depression — Feeling: Fair · Be unable to work

Free text: Depression

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Survey response — day 21, dose 2
MedDRA: Brain fog, Memory impairment — Feeling: Fair

Free text: Brain fog and memory issues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Survey response — day 28, dose 2
MedDRA: Brain fog, Cough, Depression, Fatigue, Oropharyngeal pain — Feeling: Poor · Be unable to work

Free text: Brain fog and depression with severe fatigue. Cough and sore throat 5-26 & 5-27.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Survey response — day 35, dose 2
MedDRA: Oropharyngeal pain, Productive cough — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Wet productive cough. Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-03
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-10
Survey response — day 42, dose 2
MedDRA: Bronchitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Bronchitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-21
Call 1 — Left Voicemail
2021-07-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-31
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Brain fog — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Brain fog again but not as bad as my second Moderna.

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Health check-in — day 7, dose 3
Feeling: Fair · Headache

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

Adult check-in
2021-11-21
Survey response — day 21, dose 3
MedDRA: Back pain, Musculoskeletal stiffness, Myalgia, Neck pain, Pain in extremity — Feeling: Fair

Free text: Achy muscles aches and pains legs back neck. Stiffness.

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 35, dose 3
Feeling: Fair

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

Adult check-in
2022-01-30
Survey response — 3 months, dose 3
MedDRA: Hypertension — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: High blood pressure

MedDRA releases: 2024-11 · check-in free text available
2022-01-30
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-02
Call 1 — Left Voicemail
2022-05-01
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-21
Dose 4 — Pfizer-BioNTech
2022-10-15
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-10-18
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-10-21
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2022-10-22
Health check-in — day 7, dose 5
Feeling: Good · Site: Itching · None

Adult check-in
2022-10-29
Survey response — day 14, dose 5
MedDRA: Fatigue — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Extreme fatigue but not sure if it's depression or from Covid shot

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Report sent to call center — day 14, dose 5
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-31
Call 1 — Left Voicemail
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 1 — Left Voicemail
2022-11-03
Call successful
Not applicable - Accidental Reporting
2022-11-03
Call successful
Not applicable - Accidental Reporting
2022-11-03
Call successful
Not applicable - Accidental Reporting
2022-11-03
Call successful
Does not wish to fill out VAERS report
2022-11-05
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-12
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-28
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-01-14
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-20
Survey response — 6 months, dose 5
MedDRA: Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative — 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

MedDRA releases: 2024-11
2023-04-20
Report sent to call center — 6 months, dose 5
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Moderna
2	2021-04-29	Moderna
3	2021-10-31	Pfizer-BioNTech	Flu
4	2022-05-21	Pfizer-BioNTech	No
5	2022-10-15	Pfizer-BioNTech	Flu

Call center

5 call center cases

4 successful · 1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 7 — day 14, dose 1

2021-04-21

Symptoms: Night sweats, headache, tired, large purple bruise at injection site

Release 8 — day 0, dose 2

2021-04-29

Systemic reaction (other): Numbness in tips of fingers on hand of injection site side.

Release 8 — days 1–6 daily, dose 2

2021-04-30

Systemic reaction (other): Headache

2021-05-02

Systemic reaction (other): Sweating more than usual. Brain fog

Release 8 — day 14, dose 2

2021-05-13

Symptoms: Depression

Release 8 — day 21, dose 2

2021-05-23

Symptoms: Brain fog and memory issues.

Release 8 — day 28, dose 2

2021-05-27

Symptoms: Brain fog and depression with severe fatigue. Cough and sore throat 5-26 & 5-27.

Release 8 — day 35, dose 2

2021-06-03

Symptoms: Wet productive cough. Sore throat

Release 9 — day 42, dose 2

2021-06-10

Symptoms: Bronchitis

Release 10 — days 1–6 daily, dose 3

2021-11-05

Systemic reaction (other): Brain fog again but not as bad as my second Moderna.

Release 10 — day 21, dose 3

2021-11-21

Symptoms: Achy muscles aches and pains legs back neck. Stiffness.

Release 11 — 3 months, dose 3

2022-01-30

Symptoms: High blood pressure

Release 12 — day 14, dose 5

2022-10-29

Symptoms: Extreme fatigue but not sure if it's depression or from Covid shot

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	Back pain	·	·	✓
SD	Brain fog	✓	✓	✓
SD	Bronchitis	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Depression	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypertension	·	·	✓
SD	Injection site bruising	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Memory impairment	✓	✓	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Myalgia	·	·	✓
SD	Neck pain	·	·	✓
SD	Night sweats	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Productive cough	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Brain fog	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓

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