76J-25960-13563

4 vaccinations 9 coded responses 40 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 405 / KY
Registered: 2021-01-22

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Moderna
2021-01-22
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Survey response — day 14, dose 1
MedDRA: Mass — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: A hard, painful knot appeared on my shin and has since spread over both legs. I dont know that its related to the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-19
Dose 2 — Moderna
2021-02-19
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Ear discomfort — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Ears clogged up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Ear discomfort, Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Dizziness, clogged ears, foggy-headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Ear discomfort, Feeling abnormal — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Ears are clogged, foggy-headed, dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — day 7, dose 2
MedDRA: Aphonia, Ear discomfort, Feeling abnormal — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Clogged ears, foggy-headed, started losing my voice

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-02
Call 2 — Left Voicemail
2021-08-20
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-10
Dose 3 — Moderna
2022-02-21
Survey response — 12 months, dose 2
MedDRA: Cough, Ear pain, Fatigue, Headache, Nausea, Respiratory tract congestion, Tongue ulceration — Feeling: Good · Be unable to work or attend school, 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: Headache, nausea, cough, congestion, earache, fatigue, sores on tongue

MedDRA releases: 2024-11 · check-in free text available
2022-02-21
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-22
Call 2 — Left Voicemail
2023-01-12
Dose 4 — Moderna
2023-01-12
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2023-01-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2023-01-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2023-01-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2023-01-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2023-01-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2023-01-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2023-01-19
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2023-01-26
Survey response — day 14, dose 4
MedDRA: Cough, Fatigue, Nausea, Pain, Respiratory tract congestion, Rhinorrhoea, Sneezing — Feeling: Fair

MedDRA releases: 2024-11
2023-02-02
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2023-02-09
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2023-02-16
Survey response — day 35, dose 4
MedDRA: Cough, Dyspnoea, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-02-16
Report sent to call center — day 35, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-02-17
Call 1 — Left Voicemail
2023-02-17
Call 1 — Left Voicemail
2023-02-17
Call 1 — Left Voicemail
2023-02-23
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-04-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-19	Moderna
3	2021-10-10	Moderna	No
4	2023-01-12	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-05	Unsuccessful
2022-02-21	Unsuccessful
2023-02-16	Unsuccessful

Free text

Release 3 — day 14, dose 1

2021-02-05

Symptoms: A hard, painful knot appeared on my shin and has since spread over both legs. I dont know that its related to the vaccine.

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): Dizziness

2021-02-23

Systemic reaction (other): Ears clogged up

2021-02-24

Systemic reaction (other): Dizziness, clogged ears, foggy-headed

2021-02-25

Systemic reaction (other): Ears are clogged, foggy-headed, dizzy

Release 4 — day 7, dose 2

2021-02-26

Systemic reaction (other): Clogged ears, foggy-headed, started losing my voice

Release 11 — 12 months, dose 2

2022-02-21

Symptoms: Headache, nausea, cough, congestion, earache, fatigue, sores on tongue

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
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Ear pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Mass	✓	✓	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sneezing	·	·	✓
SD	Tongue ulceration	·	·	✓
SRO	Aphonia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓

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