6VT-16827-36753

3 vaccinations 16 coded responses 28 check-ins 16 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 070 / NJ
Registered: 2021-01-20

Relationship: Self
Race: Other
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-20
Registered in v-safe
2021-01-20
Dose 1 — Moderna
2021-01-20
Survey response — day 0, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches

Free text: I took a benedryl ..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Chills

Adult check-in
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Erythema, Fatigue, Headache, Hypersensitivity, Pulmonary pain, Skin burning sensation — Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: My lungs hurt mildly but noticeable ..Ive been tired for several days and I have had the chills periodically.. I did not record these all because I did not realize the text was coming daily for a while .. then I tried to go back and was locked out, basically fatigue has been consistent mild headaches periodically and I think I am having a slight allergic reaction with mild Burn redness of skin snd scalp .. some

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-17
Survey response — day 0, dose 2
MedDRA: Dysgeusia, Dyspnoea — Feeling: Good · Site: Pain

Free text: I could taste metallic in back of throat and feel the vaccine travel..slight shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Inflammation, Palpitations — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Inflammation, heart pinches ..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Hypersomnia — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I slept 14 hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Chills, Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Survey response — day 7, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Yesterday I noticed chest congestion which had continued today..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — day 14, dose 2
MedDRA: Dyspnoea, Hypersensitivity, Pre-existing disease — Feeling: Good

Free text: Sometimes difficulty breathing..but this has been sporadically ongoing since the second vaccine..it comes and goes so I wasnt sure if it was allergies or not

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Survey response — day 28, dose 2
MedDRA: Discomfort, Dyspnoea, Feeling abnormal — Feeling: Good

Free text: Times of difficulty breathing..over the past few days. I thought it was just a one time incident..but the same thing happened over the last 3 days..weird and uncomfortable ..like I cant take a deep breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 35, dose 2
MedDRA: Dyspnoea — Feeling: Good

Free text: Continuing difficulty with deep breaths ...several times daily

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 42, dose 2
MedDRA: Dyspnoea — Feeling: Good

Free text: Still breathing difficulties.. but it does not curtail my daily activities..but I also am not an exerciser.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — 3 months, dose 2
MedDRA: Unevaluable event — Feeling: Fair

Free text: This program does not allow for responses people may actually have to the Covid vaccine so you are actually getting little to NO useful information...your choices are limited ..and therefore do nothing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-18
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Cough — Feeling: Fair · Chills, Fatigue or tiredness

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-29
Survey response — day 7, dose 3
MedDRA: Cough — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Survey response — day 14, dose 3
MedDRA: Chest discomfort, Cough — Feeling: Good

Free text: Ongoing slight cough with lung tightness .since the shot ..I do not consider it serious

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-21
Survey response — 3 months, dose 3
MedDRA: Ear discomfort, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: My ear has been bothering me for a few months. I'm running a slight ear infection I am guessing ( a long term one) · Healthcare visit (other): Dr appt.

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-26
Call successful
Participant prefers to complete VAERS report online
2022-10-22
Survey response — 12 months, dose 3
MedDRA: Bladder cancer, Office visit, Oropharyngeal pain — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Continual sore throat. Low grade 0 bladder cancer · Healthcare visit (other): Doctors office

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-25
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna
3	2021-10-22	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-20

Systemic reaction (other): I took a benedryl ..

Release 2 — days 1–6 daily, dose 1

2021-01-26

Systemic reaction (other): My lungs hurt mildly but noticeable ..Ive been tired for several days and I have had the chills periodically.. I did not record these all because I did not realize the text was coming daily for a while .. then I tried to go back and was locked out, basically fatigue has been consistent mild headaches periodically and I think I am having a slight allergic reaction with mild Burn redness of skin snd scalp .. some

Release 4 — day 0, dose 2

2021-02-17

Systemic reaction (other): I could taste metallic in back of throat and feel the vaccine travel..slight shortness of breath

Release 4 — days 1–6 daily, dose 2

2021-02-18

Systemic reaction (other): Inflammation, heart pinches ..

2021-02-19

Systemic reaction (other): I slept 14 hours

Release 4 — day 7, dose 2

2021-02-24

Systemic reaction (other): Yesterday I noticed chest congestion which had continued today..

Release 5 — day 14, dose 2

2021-03-05

Symptoms: Sometimes difficulty breathing..but this has been sporadically ongoing since the second vaccine..it comes and goes so I wasnt sure if it was allergies or not

Release 5 — day 28, dose 2

2021-03-17

Symptoms: Times of difficulty breathing..over the past few days. I thought it was just a one time incident..but the same thing happened over the last 3 days..weird and uncomfortable ..like I cant take a deep breath.

Release 6 — day 35, dose 2

2021-03-25

Symptoms: Continuing difficulty with deep breaths ...several times daily

Release 6 — day 42, dose 2

2021-04-02

Symptoms: Still breathing difficulties.. but it does not curtail my daily activities..but I also am not an exerciser.

Release 8 — 3 months, dose 2

2021-05-21

Symptoms: This program does not allow for responses people may actually have to the Covid vaccine so you are actually getting little to NO useful information...your choices are limited ..and therefore do nothing

Release 10 — days 1–6 daily, dose 3

2021-10-27

Systemic reaction (other): Cough

Release 10 — day 7, dose 3

2021-10-29

Systemic reaction (other): Cough

Release 10 — day 14, dose 3

2021-11-07

Symptoms: Ongoing slight cough with lung tightness .since the shot ..I do not consider it serious

Release 11 — 3 months, dose 3

2022-01-21

Symptoms: My ear has been bothering me for a few months. I'm running a slight ear infection I am guessing ( a long term one)

Healthcare visit (other): Dr appt.

Release 12 — 12 months, dose 3

2022-10-22

Symptoms: Continual sore throat. Low grade 0 bladder cancer

Healthcare visit (other): Doctors office

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	·	·	✓
SD	Bladder cancer	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Cough	·	·	✓
SD	Discomfort	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Ear discomfort	·	·	✓
SD	Feeling abnormal	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Inflammation	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Pulmonary pain	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Skin burning sensation	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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