638-15187-02687

4 vaccinations 13 coded responses 29 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 995 / AK
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-13
Health check-in — day 0, dose 1
Feeling: Fair · Headache

Adult check-in
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Migraine with aura — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Migraine aura

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-20
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-01-27
Survey response — day 14, dose 1
MedDRA: Injection site bruising, Peripheral swelling, Rash pruritic — Feeling: Fair

Free text: I developed an itchy rash approximately 1 - 2 inches below the injection site, it began 9 days after the vaccination. My arm also became swollen coincident with the rash. The rash is still there today. The bruise at the injection site returned.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — day 21, dose 1
MedDRA: Anxiety, Arthralgia, Headache, Injection site erythema, Injection site pruritus, Injection site swelling, Myalgia, Pain — Feeling: Fair

Free text: Continuing itching, swelling and redness below injection site, heightened anxiety, headaches, muscle and joint aches and pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Dose 2 — Moderna
2021-02-20
Survey response — day 7, dose 2
MedDRA: Sinus congestion — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sinus congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — day 14, dose 2
MedDRA: Arthralgia, Migraine, Migraine with aura, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Moderately severe migraine-type headache with aura, runny nose, joint pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — day 21, dose 2
MedDRA: Headache, Pruritus — Feeling: Poor · Be unable to do your normal daily activities

Free text: Headache today. Headaches have continued off and on with varying intensity since receiving the first and second doses of the vaccine. Also still have some itching below the injection site that comes and goes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-17
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-24
Survey response — day 42, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-11
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-02
Dose 3 — Moderna
2022-02-10
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-11-01
Dose 4 — Moderna
2022-11-04
Survey response — days 1–6 daily, dose 4
MedDRA: Anxiety — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Anxiety

MedDRA releases: 2024-11 · check-in free text available
2022-11-05
Survey response — days 1–6 daily, dose 4
MedDRA: Anxiety, Insomnia — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Increased anxiety, insomnia

MedDRA releases: 2024-11 · check-in free text available
2022-11-06
Survey response — days 1–6 daily, dose 4
MedDRA: Anxiety — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Anxiety

MedDRA releases: 2024-11 · check-in free text available
2022-11-08
Survey response — day 7, dose 4
MedDRA: Anxiety, Insomnia — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Insomnia, anxiety

MedDRA releases: 2024-11 · check-in free text available
2022-11-15
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-11-22
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-11-29
Survey response — day 28, dose 4
MedDRA: Blood pressure increased — Feeling: Fair

Free text: Higher blood pressure

MedDRA releases: 2024-11 · check-in free text available
2022-12-06
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-12-13
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-02-01
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-05-02
Survey response — 6 months, dose 4
MedDRA: Alopecia, Migraine with aura — 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

MedDRA releases: 2024-11
2023-05-02
Report sent to call center — 6 months, dose 4
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)
2023-05-03
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna
3	2021-11-02	Moderna	No
4	2022-11-01	Moderna	No

Call center

2 call center cases

1 successful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): Migraine aura

Release 2 — day 14, dose 1

2021-01-27

Symptoms: I developed an itchy rash approximately 1 - 2 inches below the injection site, it began 9 days after the vaccination. My arm also became swollen coincident with the rash. The rash is still there today. The bruise at the injection site returned.

Release 3 — day 21, dose 1

2021-02-03

Symptoms: Continuing itching, swelling and redness below injection site, heightened anxiety, headaches, muscle and joint aches and pain

Release 4 — day 7, dose 2

2021-02-20

Systemic reaction (other): Sinus congestion

Release 4 — day 14, dose 2

2021-02-24

Symptoms: Moderately severe migraine-type headache with aura, runny nose, joint pain

Release 5 — day 21, dose 2

2021-03-03

Symptoms: Headache today. Headaches have continued off and on with varying intensity since receiving the first and second doses of the vaccine. Also still have some itching below the injection site that comes and goes.

Release 6 — day 42, dose 2

2021-03-24

Symptoms: Fatigue

Release 12 — days 1–6 daily, dose 4

2022-11-04

Systemic reaction (other): Anxiety

2022-11-05

Systemic reaction (other): Increased anxiety, insomnia

2022-11-06

Systemic reaction (other): Anxiety

Release 12 — day 7, dose 4

2022-11-08

Systemic reaction (other): Insomnia, anxiety

Release 12 — day 28, dose 4

2022-11-29

Symptoms: Higher blood pressure

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	Alopecia	·	·	✓
SD	Anxiety	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Blood pressure increased	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site bruising	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Migraine	✓	·	✓
SD	Migraine with aura	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SRO	Anxiety	·	·	✓
SRO	Insomnia	·	·	✓
SRO	Migraine with aura	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓

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