62H-33967-57449

3 vaccinations 16 coded responses 24 check-ins 16 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 481 / MI
Registered: 2021-04-08

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

2021-03-09
Dose 1 — Moderna
2021-04-06
Dose 2 — Moderna
2021-04-08
Registered in v-safe
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose increased, Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: dizziness, my sugar has increased a little

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Memory impairment, Oral herpes — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Problems with memory, fever blister on my lower lip

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Memory impairment — Feeling: Good · Chills, Muscle or body aches, Fatigue or tiredness

Free text: Having bad problems with my memory

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — day 7, dose 2
MedDRA: Disturbance in attention, Oral herpes — Feeling: Good · Headache, Muscle or body aches

Free text: Fever blister, concentration issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — day 14, dose 2
MedDRA: Headache — Feeling: Poor · Be unable to do your normal daily activities

Free text: Bad awful headaches and chest pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-04
Survey response — day 28, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-18
Survey response — day 42, dose 2
MedDRA: Back pain, Chest pain, Influenza like illness, Musculoskeletal chest pain, Urinary tract infection — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Uti, chest pain, rib pain, feels like i may have the flu even though i git the flu shit, back on both sides pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-06
Survey response — 3 months, dose 2
MedDRA: Chest pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Just chest hurts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-19
Call 1 — Left Voicemail
2021-10-05
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-27
Dose 3 — Moderna
2021-12-29
Survey response — days 1–6 daily, dose 3
MedDRA: Diabetes mellitus, Dry eye, Oropharyngeal pain, Pre-existing disease, Rhinorrhoea, Vision blurred — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Sugar up to 200 i have diabetes. I have dry eye and my eyes are blurring out no matter how many drops. Sore throat, runny nose

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Survey response — days 1–6 daily, dose 3
MedDRA: Chest pain, Feeling abnormal, Nasal congestion — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Nose plugged up, my chest is hurting, I feel awful

MedDRA releases: 2024-11 · check-in free text available
2022-01-01
Survey response — days 1–6 daily, dose 3
MedDRA: Blood glucose increased, Cough, Nasal congestion, Oropharyngeal pain — Feeling: Poor · Site: Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Throat hurts nose stuffed up my sugar is high i have a cough

MedDRA releases: 2024-11 · check-in free text available
2022-01-03
Survey response — day 7, dose 3
MedDRA: Migraine, Nasal congestion — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Migraine from hell, and nose is clogged up still. Dont know if this is still from the booster.

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Survey response — day 14, dose 3
MedDRA: Chills, Dizziness, Pain, Respiratory tract congestion, SARS-CoV-2 test positive, Vitreous floaters — Feeling: Poor · Be unable to do your normal daily activities

Free text: I tested positive for covid. I see black when I move around. I am congested, light headed, dizzy, chills, body aches. Have been sick since 12/28/21. Never got well after the booster. It took SIX days to get my results back.

MedDRA releases: 2024-11 · check-in free text available
2022-01-17
Survey response — day 21, dose 3
MedDRA: Ageusia, Anosmia, COVID-19, Diabetes mellitus inadequate control, Vision blurred — Feeling: Fair · Be unable to do your normal daily activities

Free text: My sugar is out on control. I was positive for covid. My eye sight is blurred. I cannot smell and taste still.

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-31
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-07
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-28
Survey response — 3 months, dose 3
MedDRA: Dizziness, Ear discomfort, Lower respiratory tract infection, Nasal congestion, Nausea, Office visit, Urinary tract infection — Feeling: Poor · 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: Chest infection nausea stuffed nose dizzy spells pressure behind my ears and an UTI. At urgent care right now.

MedDRA releases: 2024-11 · check-in free text available
2022-03-28
Report sent to call center — 3 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)
2022-03-29
Call successful
Does not wish to fill out VAERS report
2022-06-29
Survey response — 6 months, dose 3
MedDRA: Unevaluable event — Feeling: Good · Be unable to work or attend school

Free text: Nothing to do with covid

MedDRA releases: 2024-11 · check-in free text available
2022-12-29
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-06	Moderna
3	2021-12-27	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): dizziness, my sugar has increased a little

2021-04-11

Systemic reaction (other): Problems with memory, fever blister on my lower lip

2021-04-12

Systemic reaction (other): Having bad problems with my memory

Release 7 — day 7, dose 2

2021-04-13

Systemic reaction (other): Fever blister, concentration issues

Release 7 — day 14, dose 2

2021-04-20

Symptoms: Bad awful headaches and chest pain

Release 8 — day 28, dose 2

2021-05-04

Symptoms: Headaches

Release 8 — day 42, dose 2

2021-05-18

Symptoms: Uti, chest pain, rib pain, feels like i may have the flu even though i git the flu shit, back on both sides pain

Release 9 — 3 months, dose 2

2021-07-06

Symptoms: Just chest hurts

Release 10 — days 1–6 daily, dose 3

2021-12-29

Systemic reaction (other): Sugar up to 200 i have diabetes. I have dry eye and my eyes are blurring out no matter how many drops. Sore throat, runny nose

2021-12-31

Systemic reaction (other): Nose plugged up, my chest is hurting, I feel awful

2022-01-01

Systemic reaction (other): Throat hurts nose stuffed up my sugar is high i have a cough

Release 10 — day 7, dose 3

2022-01-03

Systemic reaction (other): Migraine from hell, and nose is clogged up still. Dont know if this is still from the booster.

Release 10 — day 14, dose 3

2022-01-10

Symptoms: I tested positive for covid. I see black when I move around. I am congested, light headed, dizzy, chills, body aches. Have been sick since 12/28/21. Never got well after the booster. It took SIX days to get my results back.

Release 10 — day 21, dose 3

2022-01-17

Symptoms: My sugar is out on control. I was positive for covid. My eye sight is blurred. I cannot smell and taste still.

Release 11 — 3 months, dose 3

2022-03-28

Symptoms: Chest infection nausea stuffed nose dizzy spells pressure behind my ears and an UTI. At urgent care right now.

Release 12 — 6 months, dose 3

2022-06-29

Symptoms: Nothing to do with covid

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	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Back pain	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Chills	·	·	✓
SD	COVID-19	·	·	✓
SD	Diabetes mellitus inadequate control	·	·	✓
SD	Dizziness	·	·	✓
SD	Ear discomfort	·	·	✓
SD	Headache	✓	✓	✓
SD	Influenza like illness	✓	✓	✓
SD	Lower respiratory tract infection	·	·	✓
SD	Musculoskeletal chest pain	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Nausea	·	·	✓
SD	Office visit	·	·	✓
SD	Pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Urinary tract infection	✓	✓	✓
SD	Vision blurred	·	·	✓
SD	Vitreous floaters	·	·	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Chest pain	·	·	✓
SRO	Cough	·	·	✓
SRO	Diabetes mellitus	·	·	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dry eye	·	·	✓
SRO	Feeling abnormal	·	·	✓
SRO	Memory impairment	✓	✓	✓
SRO	Migraine	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Oral herpes	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Vision blurred	·	·	✓

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