6E7-11927-83468

6 vaccinations 26 coded responses 73 check-ins 22 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 208 / MD
Registered: 2021-03-10

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
2021-03-10
Registered in v-safe
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Dizziness

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

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Sinus congestion — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Sinus congestion and other symptoms that I associate with spring allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Respiratory tract congestion — Feeling: Good · Abdominal pain

Free text: Continued congestion and allergy symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Survey response — day 7, dose 1
MedDRA: Pre-existing disease, Respiratory tract congestion — Feeling: Good

Free text: Congestion typical of allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Survey response — day 21, dose 1
MedDRA: Abdominal discomfort, Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: More fatigue/tiredness as well as ongoing intestinal distress. Not sure where the intestinal problems are coming from, but I am trying not to eat/drink anything new.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Dose 2 — Moderna
2021-04-06
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Abdominal pain

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Self-medication — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: While my temp was 100.3, that was after taking a couple of Aleve throughout the day. My normal temperature range is 96.7 to 97.6.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Blood pressure normal, Decreased appetite, Feeling abnormal — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I consider 98.6 a fever since my normal temperature is 96.7 to 97.6. I have also been very weak today, very foggy-brained, and have almost no appetite.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Injection site erythema, Injection site swelling, Pyrexia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: 2 things: The swelling and redness that developed below the injection point is about 3 x 6 on day five. Second, I forgot to report that, during the three days I had a fever, I was having trouble breathing and had to use my asthma inhaler many times.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-13
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Itching · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-22
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-27
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-04
Survey response — day 28, dose 2
MedDRA: Arthralgia, Back pain, Musculoskeletal stiffness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Back, hip, and joint pain and stiffness. Some is quite severe. This may be a flare-up of a preexisting condition.

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

Adult check-in
2021-05-18
Survey response — day 42, dose 2
MedDRA: Migraine — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Lots of migraines

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-07
Survey response — 3 months, dose 2
MedDRA: Ear discomfort, Feeling abnormal, Headache, Nasal congestion, Office visit, Vertigo — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Continuing headaches, stuffy sinuses and ears, returned vertigo, overall feeling bad · Healthcare visit (other): Doctors office for vertigo

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

1 call case(s)
2021-07-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-05
Survey response — 6 months, dose 2
MedDRA: Gastrointestinal disorder, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities

Free text: Intestinal problems, possibly irritable bowel syndrome.

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Dose 3 — Moderna
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · Abdominal pain

Adult check-in
2021-11-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-16
Survey response — day 21, dose 3
MedDRA: Gastrointestinal disorder — Feeling: Good · Be unable to do your normal daily activities

Free text: Intestinal distress, could be IBS

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Survey response — day 35, dose 3
MedDRA: Abdominal discomfort, Neuralgia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Extreme nerve pain in lumbar region, hips, and legs and intestinal distress.

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-03
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-12-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-26
Survey response — 6 months, dose 3
MedDRA: Asthma, Condition aggravated, Gastrointestinal disorder, Inflammation, Nervous system disorder, Pre-existing disease, Self-medication — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: My Mast Cell Activation Disorder was kicked into overdrive by my three Covid vaccines, flu, and DPT vaccines. Results: inflammation affecting asthma, intestinal tract, and nerves in hips, back, legs, feet. Substantial antihistamines reduced symptoms.

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-27
Call successful
Participant prefers to complete VAERS report online
2022-06-04
Dose 4 — Moderna
2022-06-04
Survey response — day 0, dose 4
MedDRA: Unevaluable event — Feeling: Fair

Free text: I just had the shot one hour ago

MedDRA releases: 2024-11 · check-in free text available
2022-06-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-06-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Abdominal pain

Adult check-in
2022-06-07
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Abdominal pain

Adult check-in
2022-06-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Itching · Abdominal pain

Adult check-in
2022-06-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · Headache, Abdominal pain

Adult check-in
2022-06-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Abdominal pain

Adult check-in
2022-06-11
Health check-in — day 7, dose 4
Feeling: Good · Headache, Abdominal pain

Adult check-in
2022-06-18
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-06-25
Survey response — day 21, dose 4
MedDRA: Malaise, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Generally not feeling well. Most likely it was seasonal allergies.

MedDRA releases: 2024-11 · check-in free text available
2022-07-02
Survey response — day 28, dose 4
MedDRA: Oropharyngeal pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-07-02
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-05
Call 1 — Left Voicemail
2022-07-05
Call 1 — Left Voicemail
2022-07-05
Call 1 — Left Voicemail
2022-07-05
Call 1 — Left Voicemail
2022-07-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-16
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-03
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-09-27
Dose 5 — Moderna
2022-09-28
Survey response — days 1–6 daily, dose 5
MedDRA: Dizziness, Unevaluable event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Light headed east, dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2022-09-30
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-10-01
Survey response — days 1–6 daily, dose 5
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness, lightheadedness

MedDRA releases: 2024-11 · check-in free text available
2022-10-03
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Headache

Adult check-in
2022-10-04
Health check-in — day 7, dose 5
Feeling: Fair · Headache, Fatigue or tiredness

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

Adult check-in
2022-10-18
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-10-25
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-01
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-08
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-12-28
Survey response — 3 months, dose 5
MedDRA: Influenza — Feeling: Good · Be unable to do your normal daily activities

Free text: 24 hour gastrointestinal "flu"

MedDRA releases: 2024-11 · check-in free text available
2023-03-29
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in
2023-05-07
Dose 6 — Moderna
2023-05-08
Survey response — days 1–6 daily, dose 6
MedDRA: Self-medication, Sleep disorder — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-09
Health check-in — days 1–6 daily, dose 6
Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2023-05-10
Health check-in — days 1–6 daily, dose 6
Feeling: Good · Site: Pain · None

Adult check-in
2023-05-11
Health check-in — days 1–6 daily, dose 6
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2023-05-12
Health check-in — days 1–6 daily, dose 6
Feeling: Good · None

Adult check-in
2023-05-13
Survey response — days 1–6 daily, dose 6
MedDRA: Migraine — Feeling: Fair · Headache, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-05-14
Health check-in — day 7, dose 6
Feeling: Good · None

Adult check-in
2023-05-21
Health check-in — day 14, dose 6
Feeling: Good

Adult check-in
2023-05-28
Health check-in — day 21, dose 6
Feeling: Good

Adult check-in
2023-06-04
Health check-in — day 28, dose 6
Feeling: Good

Adult check-in
2023-06-11
Survey response — day 35, dose 6
MedDRA: Incision site impaired healing, Injection site pruritus — Feeling: Fair

MedDRA releases: 2024-11
2023-06-18
Survey response — day 42, dose 6
MedDRA: Headache, Hypersensitivity, Respiratory tract congestion — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-06	Moderna
3	2021-10-26	Moderna	No
4	2022-06-04	Moderna	No
5	2022-09-27	Moderna	No
6	2023-05-07	Moderna	No

Call center

4 call center cases

4 successful

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Dizziness

2021-03-12

Systemic reaction (other): Sinus congestion and other symptoms that I associate with spring allergies

2021-03-14

Systemic reaction (other): Continued congestion and allergy symptoms

Release 5 — day 7, dose 1

2021-03-16

Systemic reaction (other): Congestion typical of allergies

Release 6 — day 21, dose 1

2021-03-30

Symptoms: More fatigue/tiredness as well as ongoing intestinal distress. Not sure where the intestinal problems are coming from, but I am trying not to eat/drink anything new.

Release 7 — day 0, dose 2

2021-04-06

Systemic reaction (other): Dizziness

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): While my temp was 100.3, that was after taking a couple of Aleve throughout the day. My normal temperature range is 96.7 to 97.6.

2021-04-08

Systemic reaction (other): I consider 98.6 a fever since my normal temperature is 96.7 to 97.6. I have also been very weak today, very foggy-brained, and have almost no appetite.

2021-04-10

Systemic reaction (other): 2 things: The swelling and redness that developed below the injection point is about 3 x 6 on day five. Second, I forgot to report that, during the three days I had a fever, I was having trouble breathing and had to use my asthma inhaler many times.

Release 8 — day 28, dose 2

2021-05-04

Symptoms: Back, hip, and joint pain and stiffness. Some is quite severe. This may be a flare-up of a preexisting condition.

Release 8 — day 42, dose 2

2021-05-18

Symptoms: Lots of migraines

Release 9 — 3 months, dose 2

2021-07-07

Symptoms: Continuing headaches, stuffy sinuses and ears, returned vertigo, overall feeling bad

Healthcare visit (other): Doctors office for vertigo

Release 10 — 6 months, dose 2

2021-10-05

Symptoms: Intestinal problems, possibly irritable bowel syndrome.

Release 10 — day 21, dose 3

2021-11-16

Symptoms: Intestinal distress, could be IBS

Release 10 — day 35, dose 3

2021-11-30

Symptoms: Extreme nerve pain in lumbar region, hips, and legs and intestinal distress.

Release 11 — 6 months, dose 3

2022-04-26

Symptoms: My Mast Cell Activation Disorder was kicked into overdrive by my three Covid vaccines, flu, and DPT vaccines. Results: inflammation affecting asthma, intestinal tract, and nerves in hips, back, legs, feet. Substantial antihistamines reduced symptoms. cut off by CDC

Release 11 — day 0, dose 4

2022-06-04

Systemic reaction (other): I just had the shot one hour ago

Release 12 — day 21, dose 4

2022-06-25

Symptoms: Generally not feeling well. Most likely it was seasonal allergies.

Release 12 — day 28, dose 4

2022-07-02

Symptoms: Sore throat

Release 12 — days 1–6 daily, dose 5

2022-09-28

Systemic reaction (other): Light headed east, dizziness

2022-10-01

Systemic reaction (other): Dizziness, lightheadedness

Release 12 — 3 months, dose 5

2022-12-28

Symptoms: 24 hour gastrointestinal "flu"

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	Vertigo	✓	✓	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Asthma	·	·	✓
SD	Back pain	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Ear discomfort	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypersensitivity	·	·	✓
SD	Incision site impaired healing	·	·	✓
SD	Inflammation	·	·	✓
SD	Influenza	·	·	✓
SD	Injection site pruritus	·	·	✓
SD	Malaise	·	·	✓
SD	Migraine	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Nervous system disorder	·	·	✓
SD	Neuralgia	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Self-medication	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Vertigo	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Blood pressure normal	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Migraine	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Sleep disorder	·	·	✓
SRO	Unevaluable event	·	·	✓

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