6EJ-56392-93802

4 vaccinations 12 coded responses 48 check-ins 12 free-text entries 6 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 488 / MI
Registered: 2021-04-22

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

2021-04-22
Registered in v-safe
2021-04-22
Dose 1 — Moderna
2021-04-22
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-20
Dose 2 — Moderna
2021-05-20
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-05-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache

Adult check-in
2021-05-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-05-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-05-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-05-27
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-17
Survey response — day 28, dose 2
MedDRA: Dyspnoea — 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: Shortness of breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-24
Survey response — day 35, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-28
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-07-01
Survey response — day 42, dose 2
MedDRA: Headache — Feeling: Good

Free text: Headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-10
Dose 3 — Moderna
2021-11-18
Survey response — 6 months, dose 2
MedDRA: Medical counselling, Renal stone removal — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: I had large kidney stones removal. · Healthcare visit (other): In-home nursing

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Survey response — day 7, dose 3
MedDRA: Arthralgia, Myalgia, Physiotherapy — Feeling: Good · Joint pains, Muscle or body aches · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): I have muscle and joint pain daily. I am working on it through physical therapy. · Healthcare visit (other): Physical therapy

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-11-18
Report sent to call center — day 7, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-19
Call successful
Does not wish to fill out VAERS report
2021-11-19
Call successful
Does not wish to fill out VAERS report
2021-11-24
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-01
Survey response — day 21, dose 3
MedDRA: Diarrhoea, Nausea — Feeling: Poor · Be unable to work or attend school, 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: Sick to my stomach, but not throwing up. Excessive diarrhea

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Report sent to call center — day 21, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-02
Call 1 — Left Voicemail
2021-12-08
Survey response — day 28, dose 3
MedDRA: Diarrhoea, Unevaluable event — 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 · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Diarrhea · Healthcare visit (other): Diagnostic tests.

MedDRA releases: 2024-11 · check-in free text available
2021-12-08
Report sent to call center — day 28, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-09
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-15
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-22
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-13
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-24
Dose 4 — Moderna
2022-10-24
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-10-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains

Adult check-in
2022-10-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches

Adult check-in
2022-10-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches

Adult check-in
2022-10-28
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia, Myalgia, Pre-existing disease — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Free text: Joint and muscle pain is normal for me.

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia, Myalgia — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Free text: Pain in my joints and muscles is a daily problem even without the vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-10-30
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia, Myalgia — Feeling: Good · Joint pains, Muscle or body aches

Free text: Joint and muscle pains are normal for me.

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Survey response — day 7, dose 4
MedDRA: Arthralgia, Myalgia, Pre-existing disease — Feeling: Good · Joint pains, Muscle or body aches

Free text: Joint and muscle pain is normal for me.

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Survey response — day 14, dose 4
MedDRA: Fracture blisters, Hospitalisation, Pre-existing disease, Road traffic accident, Swelling, Tibia fracture — 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 · Emergency room or emergency department visit, Hospitalization

Free text: I was in an auto accident on 11/03/2022. I broke my tibia and my knee replacement. I am in the hospital. I cannot have surgery to reconstruct my knee replacement until the swelling goes down and what they call fracture blisters go away.

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Report sent to call center — day 14, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-11-08
Call 1 — Left Voicemail
2022-11-14
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-21
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-28
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-05
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-01-23
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-24
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-22	Moderna
2	2021-05-20	Moderna
3	2021-11-10	Moderna	No
4	2022-10-24	Moderna	No

Call center

6 call center cases

5 successful · 1 unsuccessful

See the call center timeline

Free text

Release 9 — day 28, dose 2

2021-06-17

Symptoms: Shortness of breath.

Release 9 — day 35, dose 2

2021-06-24

Symptoms: Headache

Release 9 — day 42, dose 2

2021-07-01

Symptoms: Headache.

Release 10 — day 7, dose 3

2021-11-18

Systemic reaction (other): I have muscle and joint pain daily. I am working on it through physical therapy.

Healthcare visit (other): Physical therapy

Release 10 — 6 months, dose 2

2021-11-18

Symptoms: I had large kidney stones removal.

Healthcare visit (other): In-home nursing

Release 10 — day 21, dose 3

2021-12-01

Symptoms: Sick to my stomach, but not throwing up. Excessive diarrhea

Release 10 — day 28, dose 3

2021-12-08

Symptoms: Diarrhea

Healthcare visit (other): Diagnostic tests.

Release 12 — days 1–6 daily, dose 4

2022-10-28

Systemic reaction (other): Joint and muscle pain is normal for me.

2022-10-29

Systemic reaction (other): Pain in my joints and muscles is a daily problem even without the vaccine.

2022-10-30

Systemic reaction (other): Joint and muscle pains are normal for me.

Release 12 — day 7, dose 4

2022-10-31

Systemic reaction (other): Joint and muscle pain is normal for me.

Release 12 — day 14, dose 4

2022-11-07

Symptoms: I was in an auto accident on 11/03/2022. I broke my tibia and my knee replacement. I am in the hospital. I cannot have surgery to reconstruct my knee replacement until the swelling goes down and what they call fracture blisters go away.

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	Physiotherapy	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fracture blisters	·	·	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	·	·	✓
SD	Nausea	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Renal stone removal	·	·	✓
SD	Road traffic accident	·	·	✓
SD	Swelling	·	·	✓
SD	Tibia fracture	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Myalgia	·	·	✓
SRO	Pre-existing disease	·	·	✓

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