6HJ-13087-01277

2 vaccinations 13 coded responses 21 check-ins 13 free-text entries 5 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 786 / TX
Registered: 2021-03-03

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

2021-03-02
Dose 1 — Moderna
2021-03-03
Registered in v-safe
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Headache, Pain — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I had my shot yesterday and last night I ran 99.7 temp and had body aches. Not as severe like the flu but still had aches. I had a headache and was very tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Fever · Fatigue or tiredness · Be unable to work

Free text: Most of my symptoms occured last night which was the day after the 1st vaccine I received on Tues.

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

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-23
Survey response — day 21, dose 1
MedDRA: Arthralgia, Body temperature increased, Headache, Myalgia, Nasal congestion, Self-medication — Feeling: Good

Free text: Ran a 100.3 fever Sunday night with muscle and joint pains, stuffy nose, and a headache. Took Advil, Benadryl & MucinexFelt better on Monday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Dose 2 — Moderna
2021-03-31
Survey response — day 0, dose 2
MedDRA: Cough — Feeling: Fair · Site: Pain

Free text: I've had a dry cough for the past couple of days. I'm pretty sure it's allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Influenza, Reaction to previous exposure to any vaccine — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Feels last me moderate flu symptoms. Words than after my 1st shot I got on 3/2/2021

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: I started feeling better around noon. But until then I felt pretty poorly

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

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-04-07
Survey response — day 7, dose 2
MedDRA: Cough — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: I have developed a terrible cough that wont go away.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — day 14, dose 2
MedDRA: Cough, Office visit, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I was just diagnosed with a sinus infection and the cough that I've had since after my first COVID vaccine is getting worse. · Healthcare visit (other): It was an in person visit with an ENT Dr

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

no matching call case
2021-04-21
Survey response — day 21, dose 2
MedDRA: Cough, Malaise, Office visit, Sinusitis — 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: Symptoms: Chronic cough. Again I'm not sure it has anything to do with my vaccine, however, I have been diagnosed with a sinus infection. But honestly I haven't felt like myself since I had my first vaccine. But it's worth it. · Healthcare visit (other): Saw a Dr at (b)(6)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-28
Survey response — day 28, dose 2
MedDRA: Bronchitis, Office visit, Pneumonia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Diagnosed with Acute Bronchitis and pneumonia · Healthcare visit (other): (b)(6) Doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — day 28, 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)
2021-05-05
Survey response — day 35, dose 2
MedDRA: Cough, Office visit, Pneumonia, Pulmonary mass — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: They are treating me for pneumonia. I also have 2 spots on my lungs which were not there on 1/15/21 as verified by chest X-rays. My first COVID shot was 3/2/21 and my second shot was 3/31/21 I had a cough in between the 2 shots. · Healthcare visit (other): Doctors at (b)(6) in (b)(6)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Report sent to call center — day 35, 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
Survey response — day 42, dose 2
MedDRA: Chest pain, Lung neoplasm malignant, Pneumonia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: I was diagnosed with pneumonia and a biopsy was done and they found cancer cells in both lungs. There were no masses or anything in the chest x-ray done on 1/14 & 1/15/21.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
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)
2021-06-30
Survey response — 3 months, dose 2
MedDRA: Pneumonia, Pneumothorax — 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 · Emergency room or emergency department visit, Hospitalization

Free text: I have been diagnosed with Stage 4 cancer where I have a large cancer mass in my right lung that has collapsed the lung, reduced my airway, an infection caused by pneumonia.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-30
Report sent to call center — 3 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

1 call case(s)
2021-07-02
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-03-31	Moderna

Call center

5 call center cases

5 successful

1 check-in flagged for a call with no call center case on record

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): I had my shot yesterday and last night I ran 99.7 temp and had body aches. Not as severe like the flu but still had aches. I had a headache and was very tired.

2021-03-04

Systemic reaction (other): Most of my symptoms occured last night which was the day after the 1st vaccine I received on Tues.

Release 6 — day 21, dose 1

2021-03-23

Symptoms: Ran a 100.3 fever Sunday night with muscle and joint pains, stuffy nose, and a headache. Took Advil, Benadryl & MucinexFelt better on Monday.

Release 6 — day 0, dose 2

2021-03-31

Systemic reaction (other): I've had a dry cough for the past couple of days. I'm pretty sure it's allergies

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): Feels last me moderate flu symptoms. Words than after my 1st shot I got on 3/2/2021

2021-04-02

Systemic reaction (other): I started feeling better around noon. But until then I felt pretty poorly

Release 7 — day 7, dose 2

2021-04-07

Systemic reaction (other): I have developed a terrible cough that wont go away.

Release 7 — day 14, dose 2

2021-04-14

Symptoms: I was just diagnosed with a sinus infection and the cough that I've had since after my first COVID vaccine is getting worse.

Healthcare visit (other): It was an in person visit with an ENT Dr

Release 7 — day 21, dose 2

2021-04-21

Symptoms: Chronic cough. Again I'm not sure it has anything to do with my vaccine, however, I have been diagnosed with a sinus infection. But honestly I haven't felt like myself since I had my first vaccine. But it's worth it.

Healthcare visit (other): Saw a Dr at (b)(6)

redacted (b)(6)

Release 8 — day 28, dose 2

2021-04-28

Symptoms: Diagnosed with Acute Bronchitis and pneumonia

Healthcare visit (other): (b)(6) Doctor

redacted (b)(6)

Release 8 — day 35, dose 2

2021-05-05

Symptoms: They are treating me for pneumonia. I also have 2 spots on my lungs which were not there on 1/15/21 as verified by chest X-rays. My first COVID shot was 3/2/21 and my second shot was 3/31/21 I had a cough in between the 2 shots.

Healthcare visit (other): Doctors at (b)(6) in (b)(6)

redacted (b)(6)

Release 8 — day 42, dose 2

2021-05-14

Symptoms: I was diagnosed with pneumonia and a biopsy was done and they found cancer cells in both lungs. There were no masses or anything in the chest x-ray done on 1/14 & 1/15/21.

Release 9 — 3 months, dose 2

2021-06-30

Symptoms: I have been diagnosed with Stage 4 cancer where I have a large cancer mass in my right lung that has collapsed the lung, reduced my airway, an infection caused by pneumonia.

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	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Body temperature increased	✓	✓	✓
SD	Bronchitis	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Lung neoplasm malignant	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Pneumonia	✓	✓	✓
SD	Pneumothorax	✓	✓	✓
SD	Pulmonary mass	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Influenza	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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