6UG-30920-21449

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

Sex: Female
Age at first dose: 51-55
ZIP prefix: 201 / VA
Registered: 2021-01-05

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Survey response — day 0, dose 1
MedDRA: Injection site pain, Pain in extremity — Feeling: Good · Site: Pain

Free text: pain at injection site and achiness throughout the arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Survey response — day 14, dose 1
MedDRA: Haematuria, Injection site erythema, Injection site swelling, Medical counselling, Office visit, Urinary tract infection, Urine leukocyte esterase positive — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Continued Swelling, redness & priorities at site. Leukocytes & gross hematuria in urine. Treated for UTI. · Healthcare visit (other): Office visit & follow up call

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Report sent to call center — day 14, dose 1
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)
2021-02-04
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lymph node swelling under arm where shot received

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Fever · Headache, Joint pains

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Rash papular, Rash pruritic — Feeling: Fair · Site: Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Raised bumps that itch (similar to a mosquito bite) where I had previously received Botox (lateral to Eye)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling, Itching · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-20
Survey response — day 14, dose 2
MedDRA: Exercise tolerance decreased, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Ongoing fatigue has hindered my normal workout routine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Survey response — day 28, dose 2
MedDRA: Arthralgia, Exercise tolerance decreased, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue, joint pain that comes & goes. Cant consistently do my normal workouts (HIIT, run, weight lifting).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-02
Call 1 — Left Voicemail
2022-02-05
Survey response — 12 months, dose 2
MedDRA: Actinic cheilitis, Cryotherapy, Dry skin, Hair texture abnormal, Lip exfoliation, Office visit, Skin cryotherapy, Skin infection, Skin wound, Trichorrhexis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Extremely dry hair with breakage; cuts that have turned to infections requiring antibiotic. Have Actinic Cheilitis but noticed Increased frequency of peeling lips and eruption of dry patches on forehead that were never there. · Healthcare visit (other): Pcp, specialists and multiple prescriptions & cryotherapy w liquid nitrogen

MedDRA releases: 2024-11 · check-in free text available
2022-02-05
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-09
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-05	Moderna

Call center

2 call center cases

2 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — day 0, dose 1

2021-01-05

Systemic reaction (other): pain at injection site and achiness throughout the arm.

Release 2 — day 14, dose 1

2021-01-19

Symptoms: Continued Swelling, redness & priorities at site. Leukocytes & gross hematuria in urine. Treated for UTI.

Healthcare visit (other): Office visit & follow up call

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): Lymph node swelling under arm where shot received

2021-02-09

Systemic reaction (other): Raised bumps that itch (similar to a mosquito bite) where I had previously received Botox (lateral to Eye)

Release 4 — day 14, dose 2

2021-02-20

Symptoms: Ongoing fatigue has hindered my normal workout routine

Release 5 — day 28, dose 2

2021-03-05

Symptoms: Fatigue, joint pain that comes & goes. Cant consistently do my normal workouts (HIIT, run, weight lifting).

Release 11 — 12 months, dose 2

2022-02-05

Symptoms: Extremely dry hair with breakage; cuts that have turned to infections requiring antibiotic. Have Actinic Cheilitis but noticed Increased frequency of peeling lips and eruption of dry patches on forehead that were never there.

Healthcare visit (other): Pcp, specialists and multiple prescriptions & cryotherapy w liquid nitrogen

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	Cryotherapy	·	·	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Skin cryotherapy	·	·	✓
SD	Actinic cheilitis	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Dry skin	·	·	✓
SD	Exercise tolerance decreased	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Haematuria	✓	✓	✓
SD	Hair texture abnormal	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Lip exfoliation	·	·	✓
SD	Skin infection	·	·	✓
SD	Skin wound	·	·	✓
SD	Trichorrhexis	·	·	✓
SD	Urinary tract infection	✓	✓	✓
SD	Urine leukocyte esterase positive	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Rash papular	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓

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