95J-22674-62986

3 vaccinations 9 coded responses 34 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 141 / NY
Registered: 2021-04-01

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

2021-04-01
Registered in v-safe
2021-04-01
Dose 1 — Moderna
2021-04-01
Survey response — day 0, dose 1
MedDRA: Ear discomfort, Feeling hot, Immediate post-injection reaction — Feeling: Good · Chills, Muscle or body aches, Fatigue or tiredness

Free text: A few minutes after getting the vaccine, my right ear (same side I was injected) started "burning" and felt really warm....the burning sensation went away after another 5 minutes or so

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

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain, Pain in extremity — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: The pain isnt just at the immediate injection site. My whole arm, hand, and u der my arm hurt.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain, Injected limb mobility decreased, Self-medication — Feeling: Fair · Site: Pain · Be unable to do your normal daily activities

Free text: The arm tbat was injected still has limited movement. The underarm area really hurts, even though I've taken Tylenol.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain — Feeling: Good · Site: Pain

Free text: Still some soresness in my underarm area, but it's nit as painful as it has been

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-29
Dose 2 — Moderna
2021-04-29
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Fatigue, Pain in extremity, Pyrexia — Feeling: Good

Free text: Soreness still in the armpit area (so for 4 days so far). I also experienced a fever of 99.4F and extreme tiredness on the day after my shot, but had already reported my symptoms before the fever appeared. The next day, I was fine and only had soreness in the armpit area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-13
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-05-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Survey response — 6 months, dose 2
MedDRA: Abortion spontaneous, Uterine dilation and curettage — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Had a miscarriage · Healthcare visit (other): Surgery-DNC

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
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

1 call case(s)
2021-11-01
Call 1 — Could Not Reach Participant
2021-11-04
Call 2 — Could Not Reach Participant
2021-11-28
Dose 3 — Moderna
2021-11-28
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-03
Survey response — days 1–6 daily, dose 3
MedDRA: Sneezing — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sneezing

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-13
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-26
Survey response — day 28, dose 3
MedDRA: Ear pain, Respiratory tract congestion, Throat irritation — Feeling: Fair · Be unable to do your normal daily activities

Free text: Congestion, ear pain, scratchy throat (for about a week)

MedDRA releases: 2024-11 · check-in free text available
2022-01-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-09
Survey response — day 42, dose 3
MedDRA: Fatigue, Nasal congestion — Feeling: Poor · Be unable to do your normal daily activities

Free text: Nadal congestion, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-02-28
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-28
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Moderna
2	2021-04-29	Moderna
3	2021-11-28	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-28	Unsuccessful

Free text

Release 6 — day 0, dose 1

2021-04-01

Systemic reaction (other): A few minutes after getting the vaccine, my right ear (same side I was injected) started "burning" and felt really warm....the burning sensation went away after another 5 minutes or so

Release 6 — days 1–6 daily, dose 1

2021-04-03

Systemic reaction (other): The pain isnt just at the immediate injection site. My whole arm, hand, and u der my arm hurt.

2021-04-04

Systemic reaction (other): The arm tbat was injected still has limited movement. The underarm area really hurts, even though I've taken Tylenol.

2021-04-05

Systemic reaction (other): Still some soresness in my underarm area, but it's nit as painful as it has been

Release 8 — days 1–6 daily, dose 2

2021-05-03

Systemic reaction (other): Soreness still in the armpit area (so for 4 days so far). I also experienced a fever of 99.4F and extreme tiredness on the day after my shot, but had already reported my symptoms before the fever appeared. The next day, I was fine and only had soreness in the armpit area.

Release 10 — 6 months, dose 2

2021-10-28

Symptoms: Had a miscarriage

Healthcare visit (other): Surgery-DNC

Release 10 — days 1–6 daily, dose 3

2021-12-03

Systemic reaction (other): Sneezing

Release 10 — day 28, dose 3

2021-12-26

Symptoms: Congestion, ear pain, scratchy throat (for about a week)

Release 10 — day 42, dose 3

2022-01-09

Symptoms: Nadal congestion, fatigue

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	Uterine dilation and curettage	·	·	✓
SD	Abortion spontaneous	·	·	✓
SD	Ear pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Throat irritation	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injected limb mobility decreased	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Sneezing	·	·	✓

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