6LN-31787-50580

4 vaccinations 13 coded responses 27 check-ins 13 free-text entries 5 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 208 / MD
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-13
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Eye muscle pain, with h/o TED

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-01-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-03
Survey response — day 21, dose 1
MedDRA: Dyspepsia — Feeling: Fair

Free text: Heartburn, a long-time condition that is recently worse. This has happened before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Dose 2 — Moderna
2021-02-10
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Myalgia, Pre-existing disease — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Light-headedness; more eye muscle pain in context ofThyroid Eye Disease

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain — Feeling: Good · Site: Pain

Free text: Pain in armpit on same side as injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pain in armpit on same side as the injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mild pain in armpit on side of injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mild pain in armpit on injection side of body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 7, dose 2
MedDRA: Axillary pain — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pain under the armpit on the injections side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-03-11
Survey response — day 28, dose 2
MedDRA: Peripheral swelling — Feeling: Good · Be unable to do your normal daily activities

Free text: inflamed toe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 35, dose 2
MedDRA: Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Swishing sound in my ear.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Survey response — day 42, dose 2
MedDRA: Neck pain, Office visit, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Neck pain; pulsing tinnitus · Healthcare visit (other): In-office appts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-12
Survey response — 3 months, dose 2
MedDRA: Blood thyroid stimulating hormone increased, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: HIghly elevated TSH after being stable for a long time. (h/o Hashimoto's)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-11
Callback requested for
05:00PM ET
2021-06-11
Callback requested for
05:00PM ET
2021-06-11
Callback requested for
05:00PM ET
2021-06-11
Call successful
Participant prefers to complete VAERS report online
2021-08-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-10
Dose 3 — Moderna
2022-02-12
Survey response — 12 months, dose 2
MedDRA: Medical counselling, 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 · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: GI · Healthcare visit (other): Phone

MedDRA releases: 2024-11 · check-in free text available
2022-02-12
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-15
Call 1 — Left Voicemail
2022-04-19
Dose 4 — Moderna
2022-04-28
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna
3	2021-11-10	Moderna	No
4	2022-04-19	Moderna	No

Call center

5 call center cases

3 successful · 1 unsuccessful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Eye muscle pain, with h/o TED

Release 3 — day 21, dose 1

2021-02-03

Symptoms: Heartburn, a long-time condition that is recently worse. This has happened before.

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Light-headedness; more eye muscle pain in context ofThyroid Eye Disease

2021-02-13

Systemic reaction (other): Pain in armpit on same side as injection site

2021-02-14

Systemic reaction (other): Pain in armpit on same side as the injection

2021-02-15

Systemic reaction (other): Mild pain in armpit on side of injection site

2021-02-16

Systemic reaction (other): Mild pain in armpit on injection side of body

Release 4 — day 7, dose 2

2021-02-17

Systemic reaction (other): Pain under the armpit on the injections side

Release 5 — day 28, dose 2

2021-03-11

Symptoms: inflamed toe

Release 5 — day 35, dose 2

2021-03-18

Symptoms: Swishing sound in my ear.

Release 6 — day 42, dose 2

2021-03-24

Symptoms: Neck pain; pulsing tinnitus

Healthcare visit (other): In-office appts

Release 8 — 3 months, dose 2

2021-05-12

Symptoms: HIghly elevated TSH after being stable for a long time. (h/o Hashimoto's)

Release 11 — 12 months, dose 2

2022-02-12

Symptoms: GI

Healthcare visit (other): Phone

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	Blood thyroid stimulating hormone increased	✓	✓	✓
SD	Dyspepsia	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Tinnitus	✓	✓	✓
SD	Unevaluable event	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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