6Q6-29646-87101

4 vaccinations 9 coded responses 37 check-ins 9 free-text entries 7 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 700 / LA
Registered: 2021-01-07

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-01-10
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains, Fatigue or tiredness

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains

Adult check-in
2021-01-14
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-12
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Survey response — day 35, dose 2
MedDRA: Cough, Eye discharge, Headache, Ocular hyperaemia, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headaches, dry cough, mucus in eyes, redness in eyes, swollen legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — day 42, dose 2
MedDRA: Arthralgia, Eye discharge, Ocular hyperaemia, Office visit, Peripheral swelling — 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: Moderate joint pain, eyes leaking liquid & redness in eyes, swelling of legs · Healthcare visit (other): Eye Dr Visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
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)
2021-05-07
Survey response — 3 months, dose 2
MedDRA: Constipation, Muscular weakness, Nausea, Pain — Feeling: Good · 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: Pain & weakness in legs, nausea, constipation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-10
Call successful
Participant prefers to complete VAERS report online
2021-08-06
Survey response — 6 months, dose 2
MedDRA: Alopecia, Dizziness, Fatigue, Increased tendency to bruise, Insomnia, Myalgia, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Muscle aches all over, tired all the time, hair falling out, bruising easily, cannot sleep, ringing in ears, dizzy

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-06
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-16
Call 1 — Left Voicemail
2021-10-26
Dose 3 — Moderna
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-09
Survey response — day 14, dose 3
MedDRA: Constipation, Proctalgia, 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, Hospitalization

Free text: Symptoms: Constipation & rectal pain · Healthcare visit (other): Testing

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Report sent to call center — day 14, 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

Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2021-11-11
Call successful
Participant prefers to complete VAERS report online
2021-11-17
Survey response — day 21, dose 3
MedDRA: Alopecia, Cardiovascular disorder, Hospitalisation — 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 · Hospitalization

Free text: Symptoms: Severe hair loss & circulation problems · Healthcare visit (other): Test preformed inpt

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
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

Hospitalization · 1 call case(s)
2021-11-18
Call successful
Participant prefers to complete VAERS report online
2021-11-25
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-30
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-08
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
2022-04-01
Dose 4 — Moderna
2022-04-18
Survey response — day 14, dose 4
MedDRA: Pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Body aches, fever

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Survey response — day 21, dose 4
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore joints everywhere

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-06
Survey response — day 35, dose 4
MedDRA: Alopecia, Arthralgia, Furuncle — 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: Pain in all joints, bad hair loss, boils in different locations

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Report sent to call center — day 35, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-09
Call 1 — Left Voicemail
2022-05-15
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-01
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-05	Moderna
3	2021-10-26	Moderna	No
4	2022-04-01	Moderna	No

Call center

7 call center cases

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

See the call center timeline

Free text

Release 5 — day 35, dose 2

2021-03-12

Symptoms: Headaches, dry cough, mucus in eyes, redness in eyes, swollen legs

Release 5 — day 42, dose 2

2021-03-19

Symptoms: Moderate joint pain, eyes leaking liquid & redness in eyes, swelling of legs

Healthcare visit (other): Eye Dr Visit

Release 8 — 3 months, dose 2

2021-05-07

Symptoms: Pain & weakness in legs, nausea, constipation

Release 9 — 6 months, dose 2

2021-08-06

Symptoms: Muscle aches all over, tired all the time, hair falling out, bruising easily, cannot sleep, ringing in ears, dizzy

Release 10 — day 14, dose 3

2021-11-09

Symptoms: Constipation & rectal pain

Healthcare visit (other): Testing

Release 10 — day 21, dose 3

2021-11-17

Symptoms: Severe hair loss & circulation problems

Healthcare visit (other): Test preformed inpt

Release 11 — day 14, dose 4

2022-04-18

Symptoms: Body aches, fever

Release 11 — day 21, dose 4

2022-04-22

Symptoms: Sore joints everywhere

Release 11 — day 35, dose 4

2022-05-06

Symptoms: Pain in all joints, bad hair loss, boils in different locations

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	Hospitalisation	·	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Alopecia	✓	·	✓
SD	Arthralgia	✓	✓	✓
SD	Cardiovascular disorder	·	·	✓
SD	Constipation	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dizziness	✓	·	✓
SD	Eye discharge	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Furuncle	·	·	✓
SD	Headache	✓	✓	✓
SD	Increased tendency to bruise	✓	·	✓
SD	Insomnia	✓	·	✓
SD	Muscular weakness	✓	✓	✓
SD	Myalgia	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Ocular hyperaemia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Proctalgia	·	·	✓
SD	Pyrexia	·	·	✓
SD	Tinnitus	✓	·	✓

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