63B-15981-94668

5 vaccinations 25 coded responses 63 check-ins 23 free-text entries 4 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 944 / CA
Registered: 2021-02-02

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-01
Dose 1 — Moderna
2021-02-02
Registered in v-safe
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Self-medication — Feeling: Good · Site: Pain · Headache

Free text: I had slightly elevated temp (99.3) and chills. I run low in the 97 range.I had a headache but I had it before the vaccination, but waited to take Excedrin until about three hours after the vaccine yesterday 2/1

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-15
Survey response — day 14, dose 1
MedDRA: Diarrhoea, Insomnia, Nausea — Feeling: Fair

Free text: I woke up in the middle of the night with nausea, then I had trouble falling back to sleep. When I got up, I had to rush to the bathroom with loose bowels, then two more subsequent runny ones, but feeling better this afternoon

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-01
Dose 2 — Moderna
2021-03-01
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Nausea

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Blood glucose decreased, Pre-existing disease — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Abdominal pain

Free text: I have type II diabetes. I dont know if its connected in anyway to the vaccine, but my fasting blood sugar was 144, but 3 1/4 hours later, before lunch, I had a reading of 79 and 83 when I double checked. It has never been that low

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Body temperature increased, Oedema peripheral, Pain, Peripheral swelling, Tenderness — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness

Free text: My temp is normally under 98. Its 99.4 right now. Arm still a bit swollen and painful to touch or raise, but much better today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Diarrhea

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain, Nausea — Feeling: Fair · Fatigue or tiredness, Nausea, Abdominal pain

Free text: Abdominal pain and nausea was last night and into morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-08
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-15
Survey response — day 14, dose 2
MedDRA: Abdominal pain upper, Chills, Middle insomnia, Night sweats — Feeling: Good

Free text: The night after my last check in, I was having chills, then in the middle of the night, I woke up in a sweat. I have also been having stomach pains on and off since I received my second shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-05
Survey response — day 35, dose 2
MedDRA: Dyspepsia, Gastrooesophageal reflux disease, Rhinorrhoea, Sneezing — Feeling: Fair

Free text: I cant say whether its related to the vaccination, but I have been having digestive issues again, like heartburn/acid reflux. Also sneezing & runny nose-allergies?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-30
Survey response — 6 months, dose 2
MedDRA: Back pain, Fatigue, Poor quality sleep — Feeling: Fair

Free text: Fatigue, back pain in the right upper quadrant for a week so far, not sleeping well

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-27
Dose 3 — Moderna
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Pyrexia, Self-medication — Feeling: Fair · Site: Pain, Swelling · Fever · Fatigue or tiredness

Free text: After my check in yesterday, fever went up to 102Â° F before I took Excedrin, then it started to slowly go down

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Neck pain — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Nausea

Free text: Pain along both sides of my neck

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-03
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-10
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-17
Survey response — day 21, dose 3
MedDRA: Arthralgia, Back pain, Neck pain — Feeling: Good

Free text: I had joint pain and neck & low back pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Survey response — day 35, dose 3
MedDRA: Arthralgia, Fatigue — Feeling: Good

Free text: Fatigue, some joint pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-26
Survey response — 3 months, dose 3
MedDRA: Fatigue, Headache, Poor quality sleep, Upper-airway cough syndrome — Feeling: Fair

Free text: I have not been sleeping well and feeling fatigued, postnasal drip and headache almost every morning.

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Survey response — 6 months, dose 3
MedDRA: Abdominal pain upper, Chills, Headache, Nausea, Pyrexia, Unevaluable event, Vertigo — Feeling: Good · Be unable to do your normal daily activities

Free text: Vertigo, nausea, chills, headache, stomach pain below sternum the back, low grade fever

MedDRA releases: 2024-11 · check-in free text available
2022-07-01
Dose 4 — Moderna
2022-07-02
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-07-03
Survey response — days 1–6 daily, dose 4
MedDRA: Axillary pain — Feeling: Good · Site: Pain, Swelling

Free text: Pain in the armpit of the arm of the injection

MedDRA releases: 2024-11 · check-in free text available
2022-07-04
Survey response — days 1–6 daily, dose 4
MedDRA: Axillary pain — Feeling: Good · Site: Pain

Free text: Soreness in the armpit of vax arm. Didn't have it with the other 3 vaccines

MedDRA releases: 2024-11 · check-in free text available
2022-07-05
Survey response — days 1–6 daily, dose 4
MedDRA: Axillary pain — Feeling: Good · Site: Pain

Free text: Soreness under the arm where the vaccine was given and also at the side of the vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-07-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-07-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-07-08
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-07-15
Survey response — day 14, dose 4
MedDRA: Cough, Fatigue, Headache, Influenza virus test negative, Oropharyngeal pain, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative, Sneezing, Throat irritation, Unevaluable event — 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

Free text: Starting 7/12, I got a headache, sore throat, sniffles & few sneezes. Took home test, neg. 7/13, all minus headache plus tired & 100.6 7/14 woke w/101.9, bad aches, scratchy throat, cough from irritation Test neg on NAAT C19 test & flu test better

MedDRA releases: 2024-11 · check-in free text available
2022-07-15
Report sent to call center — day 14, 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)
2022-07-18
Call 2 — Left Voicemail
2022-07-22
Survey response — day 21, dose 4
MedDRA: Fatigue, Rhinorrhoea — Feeling: Good

Free text: Sniffles, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-07-29
Survey response — day 28, dose 4
MedDRA: Diarrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-08-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-12
Survey response — day 42, dose 4
MedDRA: Diarrhoea, Fatigue, Gastrointestinal disorder — Feeling: Fair

Free text: Digestive issues, diarrhea Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Survey response — 3 months, dose 4
MedDRA: Fatigue, Headache, Nasopharyngitis, Paranasal sinus discomfort, Pyrexia — Feeling: Good · Be unable to do your normal daily activities

Free text: Mild cold symptoms, headache, sinus pressure, fatigue, low-grade fever

MedDRA releases: 2024-11 · check-in free text available
2022-10-27
Dose 5 — Pfizer-BioNTech
2022-10-28
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2022-10-29
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Abdominal pain

Adult check-in
2022-10-30
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-31
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-01
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Abdominal pain

Adult check-in
2022-11-02
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-03
Health check-in — day 7, dose 5
Feeling: Good · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2022-11-10
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-17
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-24
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-08
Survey response — day 42, dose 5
MedDRA: Burning sensation, Chest pain, Insomnia, Myalgia, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Burning sensation front of upper arms and across chest in the middle of the night. Insomnia, muscle soreness · Healthcare visit (other): Getting a stress test and an endoscopy. Not sure about the question whether vaccine caused symptoms on the next to last question

MedDRA releases: 2024-11 · check-in free text available
2022-12-08
Report sent to call center — day 42, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-12-09
Call 2 — Left Voicemail
2023-01-30
Survey response — 3 months, dose 5
MedDRA: Arthralgia, Fatigue, Headache, Muscular weakness, Pain, Ventricular extrasystoles — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-01-30
Report sent to call center — 3 months, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-01-31
Call 1 — Left Voicemail
2023-01-31
Call 1 — Left Voicemail
2023-01-31
Call 1 — Left Voicemail
2023-04-27
Survey response — 6 months, dose 5
MedDRA: Atrioventricular block, Coronary artery stenosis, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Hospitalization

MedDRA releases: 2024-11
2023-04-27
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2023-04-28
Call successful
Participant prefers to complete VAERS report online
2023-04-28
Call successful
Participant prefers to complete VAERS report online
2023-04-28
Call successful
Participant prefers to complete VAERS report online
2023-04-28
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-01	Moderna
2	2021-03-01	Moderna
3	2021-10-27	Moderna	No
4	2022-07-01	Moderna	No
5	2022-10-27	Pfizer-BioNTech	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-02

Systemic reaction (other): I had slightly elevated temp (99.3) and chills. I run low in the 97 range.I had a headache but I had it before the vaccination, but waited to take Excedrin until about three hours after the vaccine yesterday 2/1

Release 4 — day 14, dose 1

2021-02-15

Symptoms: I woke up in the middle of the night with nausea, then I had trouble falling back to sleep. When I got up, I had to rush to the bathroom with loose bowels, then two more subsequent runny ones, but feeling better this afternoon

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): I have type II diabetes. I dont know if its connected in anyway to the vaccine, but my fasting blood sugar was 144, but 3 1/4 hours later, before lunch, I had a reading of 79 and 83 when I double checked. It has never been that low

2021-03-04

Systemic reaction (other): My temp is normally under 98. Its 99.4 right now. Arm still a bit swollen and painful to touch or raise, but much better today.

2021-03-06

Systemic reaction (other): Abdominal pain and nausea was last night and into morning

Release 5 — day 14, dose 2

2021-03-15

Symptoms: The night after my last check in, I was having chills, then in the middle of the night, I woke up in a sweat. I have also been having stomach pains on and off since I received my second shot.

Release 6 — day 35, dose 2

2021-04-05

Symptoms: I cant say whether its related to the vaccination, but I have been having digestive issues again, like heartburn/acid reflux. Also sneezing & runny nose-allergies?

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: Fatigue, back pain in the right upper quadrant for a week so far, not sleeping well

Release 10 — days 1–6 daily, dose 3

2021-10-29

Systemic reaction (other): After my check in yesterday, fever went up to 102Â° F before I took Excedrin, then it started to slowly go down

2021-10-30

Systemic reaction (other): Pain along both sides of my neck

Release 10 — day 21, dose 3

2021-11-17

Symptoms: I had joint pain and neck & low back pain

Release 10 — day 35, dose 3

2021-12-02

Symptoms: Fatigue, some joint pain

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: I have not been sleeping well and feeling fatigued, postnasal drip and headache almost every morning.

Release 11 — 6 months, dose 3

2022-04-27

Symptoms: Vertigo, nausea, chills, headache, stomach pain below sternum the back, low grade fever

Release 12 — days 1–6 daily, dose 4

2022-07-03

Systemic reaction (other): Pain in the armpit of the arm of the injection

2022-07-04

Systemic reaction (other): Soreness in the armpit of vax arm. Didn't have it with the other 3 vaccines

2022-07-05

Systemic reaction (other): Soreness under the arm where the vaccine was given and also at the side of the vaccine

Release 12 — day 14, dose 4

2022-07-15

Symptoms: Starting 7/12, I got a headache, sore throat, sniffles & few sneezes. Took home test, neg. 7/13, all minus headache plus tired & 100.6 7/14 woke w/101.9, bad aches, scratchy throat, cough from irritation Test neg on NAAT C19 test & flu test better cut off by CDC

Release 12 — day 21, dose 4

2022-07-22

Symptoms: Sniffles, fatigue

Release 12 — day 28, dose 4

2022-07-29

Symptoms: diarrhea

Release 12 — day 42, dose 4

2022-08-12

Symptoms: Digestive issues, diarrhea Fatigue

Release 12 — 3 months, dose 4

2022-09-30

Symptoms: Mild cold symptoms, headache, sinus pressure, fatigue, low-grade fever

Release 12 — day 42, dose 5

2022-12-08

Symptoms: Burning sensation front of upper arms and across chest in the middle of the night. Insomnia, muscle soreness

Healthcare visit (other): Getting a stress test and an endoscopy. Not sure about the question whether vaccine caused symptoms on the next to last question

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	Unevaluable event	·	·	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Atrioventricular block	·	·	✓
SD	Back pain	✓	·	✓
SD	Burning sensation	·	·	✓
SD	Chest pain	·	·	✓
SD	Chills	✓	✓	✓
SD	Coronary artery stenosis	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspepsia	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Headache	·	·	✓
SD	Influenza virus test negative	·	·	✓
SD	Insomnia	✓	✓	✓
SD	Middle insomnia	✓	✓	✓
SD	Muscular weakness	·	·	✓
SD	Myalgia	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	✓	✓
SD	Neck pain	·	·	✓
SD	Night sweats	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Poor quality sleep	✓	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sneezing	✓	✓	✓
SD	Throat irritation	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SD	Ventricular extrasystoles	·	·	✓
SD	Vertigo	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Blood glucose decreased	✓	✓	✓
SRO	Body temperature increased	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Neck pain	·	·	✓
SRO	Oedema peripheral	✓	✓	○
SRO	Pain	✓	✓	✓
SRO	Peripheral swelling	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	·	·	✓
SRO	Self-medication	✓	✓	✓
SRO	Tenderness	·	·	✓

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