6TK-15193-08293

2 vaccinations 7 coded responses 20 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 857 / AZ
Registered: 2021-03-19

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

2021-03-19
Registered in v-safe
2021-03-19
Dose 1 — Moderna
2021-03-19
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Joint swelling, Oedema peripheral, Peripheral swelling — Feeling: Good · Site: Pain, Swelling, Itching

Free text: Swollen arm, forearm, elbow, wrist and hand.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fever · Headache, Muscle or body aches

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Itching · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-02
Survey response — day 14, dose 1
MedDRA: Breast pain, Office visit — Feeling: Good

Free text: Stabbibg, sharp pain undwr left breast. ER visit, but found nothing with heart.

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

Adult check-in
2021-04-16
Survey response — day 28, dose 1
MedDRA: Musculoskeletal discomfort, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: There is something growing in my neck. I'm getting ultrasounds to see what is happening. · Healthcare visit (other): Dr. Appointment with PCP.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-17
Dose 2 — Moderna
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-11
Survey response — day 21, dose 2
MedDRA: Injection site pain, Pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Muscular pain in the upper left arm near the injection sight. I don't know if it is just a coincidence. It is painful to use the arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-17
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Atrial fibrillation, Condition aggravated, Nephrolithiasis, Osteoarthritis, Pre-existing disease, Tachycardia, Urinary tract infection — 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, Emergency room or emergency department visit, Hospitalization

Free text: UTI, great acceleration in osteoarthritis pain, kidney function worse, worse cholesterol-starting a statin, afib with tachycardia, kidney stones.

MedDRA releases: 2024-11 · check-in free text available
2021-07-17
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)
2021-07-23
Call successful
Does not wish to fill out VAERS report
2021-10-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-17
Survey response — 12 months, dose 2
MedDRA: Atrial fibrillation, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: More atrial fibrillation problems. · Healthcare visit (other): Doctor visits, med change.

MedDRA releases: 2024-11 · check-in free text available
2022-04-17
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna
2	2021-04-17	Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-19

Systemic reaction (other): Dizziness

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Swollen arm, forearm, elbow, wrist and hand.

Release 6 — day 14, dose 1

2021-04-02

Symptoms: Stabbibg, sharp pain undwr left breast. ER visit, but found nothing with heart.

Release 7 — day 28, dose 1

2021-04-16

Symptoms: There is something growing in my neck. I'm getting ultrasounds to see what is happening.

Healthcare visit (other): Dr. Appointment with PCP.

Release 8 — day 21, dose 2

2021-05-11

Symptoms: Muscular pain in the upper left arm near the injection sight. I don't know if it is just a coincidence. It is painful to use the arm.

Release 9 — 3 months, dose 2

2021-07-17

Symptoms: UTI, great acceleration in osteoarthritis pain, kidney function worse, worse cholesterol-starting a statin, afib with tachycardia, kidney stones.

Release 11 — 12 months, dose 2

2022-04-17

Symptoms: More atrial fibrillation problems.

Healthcare visit (other): Doctor visits, med change.

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	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Atrial fibrillation	·	·	✓
SD	Breast pain	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Musculoskeletal discomfort	✓	✓	✓
SD	Nephrolithiasis	·	·	✓
SD	Office visit	✓	✓	✓
SD	Osteoarthritis	·	·	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Tachycardia	·	·	✓
SD	Urinary tract infection	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Joint swelling	✓	✓	✓
SRO	Oedema peripheral	✓	✓	○
SRO	Peripheral swelling	✓	✓	✓

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