64T-49374-27902
3 vaccinations
8 coded responses
40 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 36-40
- ZIP prefix
- 549 / WI
- Registered
- 2021-02-01
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
P6L-32257-62525
Child or adolescent in my care · Female · 2021-11-30
SDC-10983-82561
Child or adolescent in my care · Male · 2022-01-13
Timeline
-
2021-02-01
Registered in v-safe
-
2021-02-01
Dose 1 — Moderna
- 2021-02-01
- 2021-02-02
- 2021-02-03
- 2021-02-04
- 2021-02-05
- 2021-02-06
- 2021-02-07
- 2021-02-08
-
2021-02-15
Survey response — day 14, dose 1MedDRA: Nausea — Feeling: GoodFree text: Slightly nauseous feeling that comes and goes. Not awful, but noticeable.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-02-22
-
2021-03-01
Dose 2 — Moderna
- 2021-03-01
-
2021-03-02
Survey response — days 1–6 daily, dose 2MedDRA: Hot flush — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activitiesFree text: Hot flashesMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-03-03
- 2021-03-04
- 2021-03-05
- 2021-03-06
- 2021-03-07
- 2021-03-08
- 2021-03-15
- 2021-03-22
- 2021-03-29
- 2021-04-05
- 2021-04-12
- 2021-05-31
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2021-08-30
Survey response — 6 months, dose 2MedDRA: Back pain, Gastrointestinal disorder, Office visit, Physiotherapy — Feeling: Fair · 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 visitFree text: Symptoms: Unknown lower back pain in the SI joint area. Dealing with it for past 4.5 months. Working with Drs to try to figure it out. Started 1.5 months after 2nd vaccine shot. Possibly from a gi illness I got about 1.25 months after the 2nd shot. · Healthcare visit (other): Physiatrist, PT, ChiropractorMedDRA releases: 2021-09,2024-11 · check-in free text available
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2021-08-30
Report sent to call center — 6 months, dose 2Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr1 call case(s)
- 2021-09-07
-
2021-11-17
Dose 3 — Moderna
- 2021-11-17
-
2021-11-18
Survey response — days 1–6 daily, dose 3MedDRA: Neuralgia — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activitiesFree text: My nerve pain in my lower lumbar facet joint flared upMedDRA releases: 2024-11 · check-in free text available
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2021-11-19
Health check-in — days 1–6 daily, dose 3Feeling: Good · Site: Pain · Muscle or body aches, NauseaAdult check-in
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2021-11-20
Survey response — days 1–6 daily, dose 3MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Site: Pain · Muscle or body aches · Be unable to do your normal daily activitiesFree text: The muscle pain is in my lower back. I've had issues there and the inflammation from the vaccine has increased the muscle ache there.MedDRA releases: 2024-11 · check-in free text available
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2021-11-21
Survey response — days 1–6 daily, dose 3MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activitiesFree text: The inflammation continues to have set off previous inflammation issuesMedDRA releases: 2024-11 · check-in free text available
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2021-11-22
Survey response — days 1–6 daily, dose 3MedDRA: Condition aggravated, Muscle disorder, Myositis, Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: My lower back muscles are still all inflamed and irritated. Which is causing my facet joint issue to increase in pain.MedDRA releases: 2024-11 · check-in free text available
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2021-11-23
Survey response — days 1–6 daily, dose 3MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: The booster also caused my husband's previous inflammation to flare up. It hasn't gone away yet either. He got the booster when I did.MedDRA releases: 2024-11 · check-in free text available
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2021-11-24
Health check-in — day 7, dose 3Feeling: Fair · Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesAdult check-in
- 2021-12-01
- 2021-12-08
- 2021-12-15
- 2021-12-22
- 2021-12-29
-
2022-01-19
Call successfulParticipant prefers to complete VAERS report online
- 2022-02-18
- 2022-05-18
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-02-01 | Moderna | |
| 2 | 2021-03-01 | Moderna | |
| 3 | 2021-11-17 | Moderna | No |
Call center
1 call center case
1 successful
Free text
Release 4 — day 14, dose 1
Symptoms: Slightly nauseous feeling that comes and goes. Not awful, but noticeable.
Release 4 — days 1–6 daily, dose 2
Systemic reaction (other): Hot flashes
Release 9 — 6 months, dose 2
Symptoms: Unknown lower back pain in the SI joint area. Dealing with it for past 4.5 months. Working with Drs to try to figure it out. Started 1.5 months after 2nd vaccine shot. Possibly from a gi illness I got about 1.25 months after the 2nd shot.
Healthcare visit (other): Physiatrist, PT, Chiropractor
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): My nerve pain in my lower lumbar facet joint flared up
Systemic reaction (other): The muscle pain is in my lower back. I've had issues there and the inflammation from the vaccine has increased the muscle ache there.
Systemic reaction (other): The inflammation continues to have set off previous inflammation issues
Systemic reaction (other): My lower back muscles are still all inflamed and irritated. Which is causing my facet joint issue to increase in pain.
Systemic reaction (other): The booster also caused my husband's previous inflammation to flare up. It hasn't gone away yet either. He got the booster when I did.
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 | Office visit | ✓ | · | ✓ |
| HCVO | Physiotherapy | ✓ | · | ✓ |
| SD | Back pain | ✓ | · | ✓ |
| SD | Gastrointestinal disorder | ✓ | · | ✓ |
| SD | Nausea | ✓ | ✓ | ✓ |
| SD | Office visit | ✓ | · | ✓ |
| SRO | Condition aggravated | · | · | ✓ |
| SRO | Hot flush | ✓ | ✓ | ✓ |
| SRO | Muscle disorder | · | · | ✓ |
| SRO | Myositis | · | · | ✓ |
| SRO | Neuralgia | · | · | ✓ |
| SRO | Pre-existing disease | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release