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B3M-13787-21116

4 vaccinations 8 coded responses 36 check-ins 7 free-text entries 5 call cases
Sex
Female
Age at first dose
41-45
ZIP prefix
065 / CT
Registered
2021-03-07
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-05
    Dose 1 — Moderna
  2. 2021-03-07
    Registered in v-safe
  3. 2021-03-07
    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
  4. 2021-03-08
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  5. 2021-03-09
    Health check-in — days 1–6 daily, dose 1
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  6. 2021-03-11
    Health check-in — days 1–6 daily, dose 1
    Feeling: Poor · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  7. 2021-03-12
    Health check-in — day 7, dose 1
    Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  8. 2021-03-19
    Survey response — day 14, dose 1
    MedDRA: Cough, Exposure to SARS-CoV-2, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative, Wheezing — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation
    Free text: I had fever, runny nose, congestion, cough wheeze on 3/16, 3/17, 3/18 but was also exposed to covid at my school day before and day of my vaccine on 3/5 at a minimum. My 3 covid tests have come back negative.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-03-19
    Report sent to call center — day 14, dose 1
    Be unable to work · Get care from a doctor or other healthcare professional
    1 call case(s)
  10. 2021-03-27
    Health check-in — day 21, dose 1
    Feeling: Fair
    Adult check-in
  11. 2021-04-02
    Dose 2 — Moderna
  12. 2021-04-03
    Health check-in — days 1–6 daily, dose 2
    Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  13. 2021-04-04
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fatigue or tiredness
    Adult check-in
  14. 2021-04-06
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-04-08
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  16. 2021-04-09
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  17. 2021-04-16
    Survey response — day 14, dose 2
    MedDRA: Fatigue, Ocular discomfort — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Fatigue. Probably unrelated but weird eye problem doctor thinks is chalazion (never had before)- likely from wearing mask & face shield at work.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  18. 2021-04-25
    Health check-in — day 21, dose 2
    Feeling: Good
    Adult check-in
  19. 2021-04-30
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-05-07
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  21. 2021-05-14
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-07-02
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-10-03
    Survey response — 6 months, dose 2
    MedDRA: Asthma, Fall, Hypersensitivity, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Not vaccine related Im sure. Worse than usual Fall asthma/allergies.
    MedDRA releases: 2024-11 · check-in free text available
  24. 2021-11-01
    Dose 3 — Moderna
  25. 2021-11-01
    Survey response — day 0, dose 3
    MedDRA: Immediate post-injection reaction, Pain in extremity, Paraesthesia, Tinnitus — Feeling: Fair · Site: Pain · Fatigue or tiredness
    Free text: Shortly after vaccine (maybe 5 min) I felt like ears ringing & tingly face but it resolved after 10 minutes of sitting & then felt fine other than arm sore.
    MedDRA releases: 2024-11 · check-in free text available
  26. 2021-11-02
    Health check-in — days 1–6 daily, dose 3
    Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school
    Adult check-in
  27. 2021-11-03
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Site: Pain · Abdominal pain
    Adult check-in
  28. 2021-11-05
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Diarrhea
    Adult check-in
  29. 2021-11-06
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · Vomiting
    Adult check-in
  30. 2021-11-07
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  31. 2021-11-08
    Health check-in — day 7, dose 3
    Feeling: Good · Diarrhea
    Adult check-in
  32. 2021-11-15
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  33. 2021-11-24
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  34. 2021-11-29
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  35. 2021-12-06
    Survey response — day 35, dose 3
    MedDRA: Arthralgia, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional
    Free text: Symptoms: Joint pain-hips, shoulders, SI joint · Healthcare visit (other): Chiropractor
    MedDRA releases: 2024-11 · check-in free text available
  36. 2021-12-06
    Report sent to call center — day 35, dose 3
    Get care from a doctor or other healthcare professional
    1 call case(s)
  37. 2021-12-07
  38. 2021-12-19
    Health check-in — day 42, dose 3
    Feeling: Fair
    Adult check-in
  39. 2022-01-31
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  40. 2022-05-02
    Survey response — 6 months, dose 3
    MedDRA: COVID-19 — Feeling: Fair · 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: Got Covid in April
    MedDRA releases: 2024-11 · check-in free text available
  41. 2022-05-02
    Report sent to call center — 6 months, dose 3
    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)
  42. 2022-05-03
  43. 2022-09-12
    Dose 4 — Moderna
  44. 2022-11-02
    Survey response — 12 months, dose 3
    MedDRA: COVID-19 — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    Free text: Not sure when you last contacted me. Since bivalent booster same health. Since Covid worse.
    MedDRA releases: 2024-11 · check-in free text available
  45. 2022-11-02
    Report sent to call center — 12 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  46. 2022-11-03
  47. 2022-11-03
  48. 2022-11-03
  49. 2022-11-03
  50. 2022-12-12
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  51. 2023-03-13
    Survey response — 6 months, dose 4
    MedDRA: Asthma, COVID-19, Ear infection, Gastrooesophageal reflux disease, Heart rate increased, Palpitations — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  52. 2023-03-13
    Report sent to call center — 6 months, dose 4
    Get care from a doctor or other healthcare professional
    Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
  53. 2023-03-14
  54. 2023-03-14
  55. 2023-03-14
  56. 2023-03-14
  57. 2023-03-14
  58. 2023-03-15
  59. 2023-03-15
  60. 2023-03-15
  61. 2023-03-15
  62. 2023-03-15
  63. 2023-03-16
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  64. 2023-03-16
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  65. 2023-03-16
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  66. 2023-03-16
    Call successful
    Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
  67. 2023-03-16
    Call successful
    Completed over the phone

Vaccinations

DoseDateManufacturerCo-administered
12021-03-05Moderna
22021-04-02Moderna
32021-11-01Moderna No
42022-09-12Moderna No

Call center

5 call center cases

5 successful

VAERS report filed, before or during a call: 1

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-19

Symptoms: I had fever, runny nose, congestion, cough wheeze on 3/16, 3/17, 3/18 but was also exposed to covid at my school day before and day of my vaccine on 3/5 at a minimum. My 3 covid tests have come back negative.

Release 7 — day 14, dose 2

2021-04-16

Symptoms: Fatigue. Probably unrelated but weird eye problem doctor thinks is chalazion (never had before)- likely from wearing mask & face shield at work.

Release 9 — 6 months, dose 2

2021-10-03

Symptoms: Not vaccine related Im sure. Worse than usual Fall asthma/allergies.

Release 10 — day 0, dose 3

2021-11-01

Systemic reaction (other): Shortly after vaccine (maybe 5 min) I felt like ears ringing & tingly face but it resolved after 10 minutes of sitting & then felt fine other than arm sore.

Release 10 — day 35, dose 3

2021-12-06

Symptoms: Joint pain-hips, shoulders, SI joint
Healthcare visit (other): Chiropractor

Release 11 — 6 months, dose 3

2022-05-02

Symptoms: Got Covid in April

Release 12 — 12 months, dose 3

2022-11-02

Symptoms: Not sure when you last contacted me. Since bivalent booster same health. Since Covid worse.

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit · · ✓
SDArthralgia · · ✓
SDAsthma · · ✓
SDCough ✓ ✓ ✓
SDCOVID-19 · · ✓
SDEar infection · · ✓
SDExposure to SARS-CoV-2 ✓ ✓ ✓
SDFall · · ✓
SDFatigue ✓ ✓ ✓
SDGastrooesophageal reflux disease · · ✓
SDHeart rate increased · · ✓
SDHypersensitivity · · ✓
SDOcular discomfort ✓ ✓ ✓
SDPalpitations · · ✓
SDPre-existing disease · · ✓
SDPyrexia ✓ ✓ ✓
SDRespiratory tract congestion ✓ ✓ ✓
SDRhinorrhoea ✓ ✓ ✓
SDSARS-CoV-2 test negative ✓ ✓ ✓
SDWheezing ✓ ✓ ✓
SROImmediate post-injection reaction · · ✓
SROPain in extremity · · ✓
SROParaesthesia · · ✓
SROTinnitus · · ✓

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

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