668-16571-45656

2 vaccinations 6 coded responses 19 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 441 / OH
Registered: 2021-01-18

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

2021-01-15
Dose 1 — Moderna
2021-01-18
Registered in v-safe
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain — Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain

Free text: Had severe chest pain on Sunday but didnt last long.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-05
Survey response — day 21, dose 1
MedDRA: Pain in extremity — Feeling: Fair

Free text: My left arm still hurts. Although, I got the shot in my right arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Dose 2 — Moderna
2021-02-12
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 7, dose 2
Feeling: Fair · Chills, Fatigue or tiredness

Adult check-in
2021-03-07
Survey response — day 21, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Be unable to work

Free text: Sarcoidosis was in remission until I got the second shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 28, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Since I got the 2nd shot my sarcoidosis is very active and I have to be outback on meds. It hasnt been active for 6 years.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-28
Survey response — day 42, dose 2
MedDRA: Decreased appetite, Hypoxia, Medical counselling, Office visit, Sarcoidosis — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Sarcoidosis is active and had to get back on meds. Also not enough oxygen is going thru my blood stream. · Healthcare visit (other): Also seen two different dictors

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-13
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-25
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-12
Survey response — 12 months, dose 2
MedDRA: COVID-19, Malaise — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: I have been sick since 12/25/2021. Diagnosed with Covid early January and have been sick since!

MedDRA releases: 2024-11 · check-in free text available
2022-02-12
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-02-15
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-12	Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-19

Systemic reaction (other): Had severe chest pain on Sunday but didnt last long.

Release 3 — day 21, dose 1

2021-02-05

Symptoms: My left arm still hurts. Although, I got the shot in my right arm.

Release 5 — day 21, dose 2

2021-03-07

Symptoms: Sarcoidosis was in remission until I got the second shot

Release 5 — day 28, dose 2

2021-03-12

Symptoms: Since I got the 2nd shot my sarcoidosis is very active and I have to be outback on meds. It hasnt been active for 6 years.

Release 6 — day 42, dose 2

2021-03-28

Symptoms: Sarcoidosis is active and had to get back on meds. Also not enough oxygen is going thru my blood stream.

Healthcare visit (other): Also seen two different dictors

Release 11 — 12 months, dose 2

2022-02-12

Symptoms: I have been sick since 12/25/2021. Diagnosed with Covid early January and have been sick since!

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	Medical counselling	○	✓	○
HCVO	Office visit	✓	·	✓
SD	Condition aggravated	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Decreased appetite	○	✓	○
SD	Hypoxia	✓	·	✓
SD	Malaise	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sarcoidosis	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Chest pain	✓	✓	✓

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