62G-25238-52350

4 vaccinations 14 coded responses 41 check-ins 14 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 985 / WA
Registered: 2021-02-03

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

2021-02-03
Registered in v-safe
2021-02-03
Dose 1 — Moderna
2021-02-03
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Mild-mod Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Self-medication — Feeling: Good · Site: Pain

Free text: Joint pain L hip today managed w/Tylenol+Ibuprofen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — day 7, dose 1
MedDRA: Arthralgia, Self-medication — Feeling: Good · Joint pains

Free text: L hip pain since vax. Tylenol+Ibuprofen needed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-05
Dose 2 — Moderna
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain, Oedema — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Swelling of tissue & tender node in armpit on side of injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral — Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Moderate swelling in right armpit on side of injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability, Lymph node pain — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tender node in right armpit, side vaccine injection. Plus general irritability

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 7, dose 2
MedDRA: Lymph node pain, Tendon discomfort — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tender node right armpit on side of injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 21, dose 2
MedDRA: Tendon pain — Feeling: Fair · Be unable to work

Free text: Left knee tendon pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — day 28, dose 2
MedDRA: Abdominal rigidity, Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Continued left knee pain, continued LLQ abdominal spasms. Didn't associate either with vaccine at 1st. Still unclear if either are Covid vaccine related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-24
Dose 3 — Moderna
Co-administered: Flu
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Rhinorrhoea, Sneezing — Feeling: Fair · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Sneezing alot & Runny nose

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Cough — Feeling: Good · Headache

Free text: Non productive coughing

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-07
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-14
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-21
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-28
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-23
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-28
Dose 4 — Moderna
2022-05-14
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-19
Survey response — day 21, dose 4
MedDRA: Respiratory tract congestion — Feeling: Fair

Free text: Chest congestion possibly due to heavy pollen load

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

Adult check-in
2022-06-02
Survey response — day 35, dose 4
MedDRA: Office visit, Respiratory tract congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Increased chest congestion. Chest x-ray done at clinic this week was normal

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Report sent to call center — day 35, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-03
Call 1 — Requested Callback
2022-06-03
Callback requested for
03:30PM ET
2022-06-03
Call successful
Does not wish to fill out VAERS report
2022-06-09
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-28
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-05	Moderna
3	2021-10-24	Moderna	Flu
4	2022-04-28	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): Mild-mod Brain fog

2021-02-05

Systemic reaction (other): Brain fog

2021-02-09

Systemic reaction (other): Joint pain L hip today managed w/Tylenol+Ibuprofen

Release 4 — day 7, dose 1

2021-02-11

Systemic reaction (other): L hip pain since vax. Tylenol+Ibuprofen needed

Release 5 — days 1–6 daily, dose 2

2021-03-08

Systemic reaction (other): Swelling of tissue & tender node in armpit on side of injection

2021-03-09

Systemic reaction (other): Moderate swelling in right armpit on side of injection

2021-03-11

Systemic reaction (other): Tender node in right armpit, side vaccine injection. Plus general irritability

Release 5 — day 7, dose 2

2021-03-12

Systemic reaction (other): Tender node right armpit on side of injection

Release 6 — day 21, dose 2

2021-03-26

Symptoms: Left knee tendon pain

Release 6 — day 28, dose 2

2021-04-03

Symptoms: Continued left knee pain, continued LLQ abdominal spasms. Didn't associate either with vaccine at 1st. Still unclear if either are Covid vaccine related

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Sneezing alot & Runny nose

2021-10-30

Systemic reaction (other): Non productive coughing

Release 11 — day 21, dose 4

2022-05-19

Symptoms: Chest congestion possibly due to heavy pollen load

Release 11 — day 35, dose 4

2022-06-02

Symptoms: Increased chest congestion. Chest x-ray done at clinic this week was normal

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 rigidity	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Office visit	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Tendon pain	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Oedema	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Self-medication	✓	✓	✓
SRO	Sneezing	·	·	✓
SRO	Tendon discomfort	✓	✓	○

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