6HL-28600-71733

3 vaccinations 11 coded responses 30 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 495 / MI
Registered: 2021-03-17

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

2021-03-16
Dose 1 — Moderna
2021-03-17
Registered in v-safe
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Diarrhea

Adult check-in
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Swelling

Free text: Just a slight bit of soreness at the injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Office visit — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: An appointment with my case management team

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: I've been feeling extremely tired.I don't know if it's my new medicine or the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-12
Dose 2 — Moderna
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Euphoric mood, Limb discomfort, Unevaluable event — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, 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: Systemic reaction (other): Felt high after the shot and feel light headed and legs and body feel extremely heavy · Healthcare visit (other): Doctors office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Report sent to call center — days 1–6 daily, 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)
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Feeling cold, Pruritus — Feeling: Good · Site: Pain, Swelling, Itching · Chills, Headache, Abdominal pain · Be unable to work

Free text: Iching. I think I'm on the mend. I get chilly easy. I NEVER do NEVER

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Just extreme exhaustion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-12
Survey response — 3 months, dose 2
MedDRA: Injection site erythema, Pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: My medical injections seem to be more and more painful and there seems to be more and more redness at the injection sites as well as I seem to be experiencing more cistic growths along with an increase in pain at the cost sites

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-11
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-14
Call successful
Does not wish to fill out VAERS report
2022-04-14
Survey response — 12 months, dose 2
MedDRA: COVID-19, Malaise — 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

Free text: Symptoms: Contacted the covid verient · Healthcare visit (other): Just stayed home until I got well again

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Report sent to call center — 12 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)
2022-04-19
Call successful
Not applicable - Accidental Reporting
2022-05-10
Dose 3 — Moderna
2022-05-11
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Light headedness

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-05-13
Survey response — days 1–6 daily, dose 3
MedDRA: Discomfort, Fatigue — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Feeling slightly (the word I would use is exhausted and heavy

MedDRA releases: 2024-11 · check-in free text available
2022-05-14
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-15
Survey response — days 1–6 daily, dose 3
MedDRA: No adverse event — Feeling: Good · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness · Fatigue or tiredness, Diarrhea

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-16	Moderna
2	2021-04-12	Moderna
3	2022-05-10	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-19

Systemic reaction (other): Just a slight bit of soreness at the injection site

Release 6 — days 1–6 daily, dose 1

2021-03-22

Healthcare visit (other): An appointment with my case management team

Release 6 — day 14, dose 1

2021-03-30

Symptoms: I've been feeling extremely tired.I don't know if it's my new medicine or the vaccine.

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): Felt high after the shot and feel light headed and legs and body feel extremely heavy

Healthcare visit (other): Doctors office

2021-04-14

Systemic reaction (other): Iching. I think I'm on the mend. I get chilly easy. I NEVER do NEVER

2021-04-17

Systemic reaction (other): Just extreme exhaustion

Release 9 — 3 months, dose 2

2021-07-12

Symptoms: My medical injections seem to be more and more painful and there seems to be more and more redness at the injection sites as well as I seem to be experiencing more cistic growths along with an increase in pain at the cost sites

Release 11 — 12 months, dose 2

2022-04-14

Symptoms: Contacted the covid verient

Healthcare visit (other): Just stayed home until I got well again

Release 11 — days 1–6 daily, dose 3

2022-05-11

Systemic reaction (other): Light headedness

2022-05-13

Systemic reaction (other): Feeling slightly (the word I would use is exhausted and heavy

2022-05-15

Systemic reaction (other): No

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	Malaise	·	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Pain	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Discomfort	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Euphoric mood	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Limb discomfort	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Pruritus	✓	✓	✓

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