6X9-18320-39995

4 vaccinations 14 coded responses 53 check-ins 13 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 880 / NM
Registered: 2021-03-02

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

2021-03-01
Dose 1 — Moderna
2021-03-02
Registered in v-safe
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain

Free text: Sore throat

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

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: I feel relieved and less worried now that I have #1 vaccine!!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Survey response — day 14, dose 1
MedDRA: Cough, Malaise, Oropharyngeal pain, Palpitations, Vaccination site pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pain in arm (vaccination site). Heart palpitations. Malaise. Dry cough. Sore throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — day 21, dose 1
MedDRA: Diarrhoea, Palpitations — Feeling: Poor · 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: Terrible diarrhea. Heart palpitations.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-28
Dose 2 — Moderna
2021-03-28
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

Adult check-in
2021-04-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-02
Survey response — day 35, dose 2
MedDRA: Pruritus — Feeling: Fair

Free text: My skin, all over my body itches. It was oneof the symptoms I had when I had Covid in July.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — day 42, dose 2
MedDRA: Palpitations, Pruritus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Itching skin!! This was one of my most frustrating symptoms when I had covid last July. Also heart palpitations are back with a vengeance

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-27
Survey response — 3 months, dose 2
MedDRA: Bradycardia, Tachycardia — Feeling: Poor · Be unable to do your normal daily activities

Free text: I have tachycardia AND Bradycardia so I will get a pacemaker July 1st

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-26
Survey response — 6 months, dose 2
MedDRA: Cardiac pacemaker insertion, Emergency care — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Had a pacemaker inserted in my chest and ended up in the ER twice. No additional Covid symptoms thankfully.

MedDRA releases: 2024-11 · check-in free text available
2021-09-26
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-09-28
Call 1 — Left Voicemail
2021-09-28
Call successful
Does not wish to fill out VAERS report
2021-10-25
Dose 3 — Moderna
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Survey response — day 35, dose 3
MedDRA: Pleural effusion, Pleurisy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pleurisy and Pleural Effusion

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Survey response — day 42, dose 3
MedDRA: Pleurisy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pleurisy

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Survey response — 3 months, dose 3
MedDRA: Pleurisy, Pre-existing disease, Systemic lupus erythematosus — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Diagnosed with Lupus and continued problems with pleurisy. Not sure if these are related to my Covid infection July 2020 or not.

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-01-25
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-25
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-23
Dose 4 — Moderna
2022-05-23
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2022-05-24
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-05-25
Survey response — days 1–6 daily, dose 4
MedDRA: Chest discomfort, Dyspnoea — Feeling: Good · Site: Pain

Free text: I feel a weight on my chest. It's hard to take a deep breath, but it's tolerable.

MedDRA releases: 2024-11 · check-in free text available
2022-05-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-30
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-20
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-27
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-04
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-22
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-21
Survey response — 6 months, dose 4
MedDRA: Confusional state, Depression, Office visit, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Deep depression and confusion from long Covid. · Healthcare visit (other): Grief counselor

MedDRA releases: 2024-11 · check-in free text available
2022-11-21
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-22
Call successful
Not applicable - Accidental Reporting
2023-05-23
Survey response — 12 months, dose 4
MedDRA: Crying, Depression, Fatigue, Office visit, Pain, Post-acute COVID-19 syndrome, Pruritus, Vertigo — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-05-23
Call case (no matching report) — Successful
Participant prefers to complete VAERS report online
2023-05-24
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-03-28	Moderna
3	2021-10-25	Moderna	No
4	2022-05-23	Moderna	No

Call center

6 call center cases

6 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-03-02

Systemic reaction (other): Sore throat

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): I feel relieved and less worried now that I have #1 vaccine!!

Release 5 — day 14, dose 1

2021-03-15

Symptoms: Pain in arm (vaccination site). Heart palpitations. Malaise. Dry cough. Sore throat.

Release 6 — day 21, dose 1

2021-03-22

Symptoms: Terrible diarrhea. Heart palpitations.

Release 8 — day 35, dose 2

2021-05-02

Symptoms: My skin, all over my body itches. It was oneof the symptoms I had when I had Covid in July.

Release 8 — day 42, dose 2

2021-05-09

Symptoms: Itching skin!! This was one of my most frustrating symptoms when I had covid last July. Also heart palpitations are back with a vengeance

Release 9 — 3 months, dose 2

2021-06-27

Symptoms: I have tachycardia AND Bradycardia so I will get a pacemaker July 1st

Release 9 — 6 months, dose 2

2021-09-26

Symptoms: Had a pacemaker inserted in my chest and ended up in the ER twice. No additional Covid symptoms thankfully.

Release 10 — day 35, dose 3

2021-11-29

Symptoms: Pleurisy and Pleural Effusion

Release 10 — day 42, dose 3

2021-12-06

Symptoms: Pleurisy

Release 11 — 3 months, dose 3

2022-01-24

Symptoms: Diagnosed with Lupus and continued problems with pleurisy. Not sure if these are related to my Covid infection July 2020 or not.

Release 11 — days 1–6 daily, dose 4

2022-05-25

Systemic reaction (other): I feel a weight on my chest. It's hard to take a deep breath, but it's tolerable.

Release 12 — 6 months, dose 4

2022-11-21

Symptoms: Deep depression and confusion from long Covid.

Healthcare visit (other): Grief counselor

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	Bradycardia	✓	✓	✓
SD	Cardiac pacemaker insertion	·	·	✓
SD	Confusional state	·	·	✓
SD	Cough	✓	✓	✓
SD	Crying	·	·	✓
SD	Depression	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Emergency care	·	·	✓
SD	Fatigue	·	·	✓
SD	Malaise	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	·	·	✓
SD	Palpitations	✓	✓	✓
SD	Pleural effusion	·	·	✓
SD	Pleurisy	·	·	✓
SD	Post-acute COVID-19 syndrome	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Systemic lupus erythematosus	·	·	✓
SD	Tachycardia	✓	✓	✓
SD	Vaccination site pain	✓	✓	✓
SD	Vertigo	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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