CXE-13819-34561

2 vaccinations 9 coded responses 20 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 276 / NC
Registered: 2021-04-12

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

2021-04-12
Registered in v-safe
2021-04-12
Dose 1 — Moderna
2021-04-12
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Pain in arm of injection from shoulder to wrist.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-03
Survey response — day 21, dose 1
MedDRA: Abdominal discomfort, Chills, Fatigue, Nausea — Feeling: Fair · Be unable to work

Free text: Tired, nausea, stomach upset, chills

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Dose 2 — Moderna
2021-05-10
Survey response — day 0, dose 2
MedDRA: Menstruation irregular, Pregnancy — Feeling: Good

Free text: Missed period and negative pregnancy test

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Survey response — days 1–6 daily, dose 2
MedDRA: Burning sensation — Feeling: Fair · Site: Pain, Swelling · Chills, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Burning sensation in arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness, Diarrhea

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-05-18
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Fever · Fatigue or tiredness

Adult check-in
2021-05-26
Survey response — day 14, dose 2
MedDRA: Cough, Fatigue, Head discomfort, Headache, Paranasal sinus discomfort, Sinus congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Cough, headache , some sinus congestion.. pressure in head, fatigue, no fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-31
Survey response — day 21, dose 2
MedDRA: Cough — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-07
Survey response — day 28, dose 2
MedDRA: Kidney infection — Feeling: Poor · Be unable to work, 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, Emergency room or emergency department visit

Free text: Kidney infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-07
Report sent to call center — day 28, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-23
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-08-09
Survey response — 3 months, dose 2
MedDRA: Abdominal pain upper — Feeling: Fair · Be unable to work or attend school

Free text: Some stomach pain. Not sure if gastritis or just a random issue not related to vaccine.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-06
Call 1 — Left Voicemail
2021-11-08
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-05-10
Survey response — 12 months, dose 2
MedDRA: Dysphagia, Immediate post-injection reaction, Injection site pain, Oesophageal pain, Pyrexia, Respiratory tract congestion — 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: After Booster shot administered in November 2021 I experienced difficulty swallowing, esophagus pain and low grade fever with congestion lasting about 4 weeks. I also had significant injection site pain immediately after injection.

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
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)
2022-05-11
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-12	Moderna
2	2021-05-10	Moderna

Call center

4 call center cases

4 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-13

Systemic reaction (other): Pain in arm of injection from shoulder to wrist.

Release 8 — day 21, dose 1

2021-05-03

Symptoms: Tired, nausea, stomach upset, chills

Release 8 — day 0, dose 2

2021-05-10

Systemic reaction (other): Missed period and negative pregnancy test

Release 8 — days 1–6 daily, dose 2

2021-05-11

Systemic reaction (other): Burning sensation in arm

Release 8 — day 14, dose 2

2021-05-26

Symptoms: Cough, headache , some sinus congestion.. pressure in head, fatigue, no fever.

Release 8 — day 21, dose 2

2021-05-31

Symptoms: Cough

Release 8 — day 28, dose 2

2021-06-07

Symptoms: Kidney infection

Release 9 — 3 months, dose 2

2021-08-09

Symptoms: Some stomach pain. Not sure if gastritis or just a random issue not related to vaccine.

Release 11 — 12 months, dose 2

2022-05-10

Symptoms: After Booster shot administered in November 2021 I experienced difficulty swallowing, esophagus pain and low grade fever with congestion lasting about 4 weeks. I also had significant injection site pain immediately after injection.

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	Abdominal discomfort	✓	✓	✓
SD	Abdominal pain upper	✓	·	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dysphagia	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Head discomfort	·	·	✓
SD	Headache	✓	✓	✓
SD	Immediate post-injection reaction	·	·	✓
SD	Injection site pain	·	·	✓
SD	Kidney infection	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oesophageal pain	·	·	✓
SD	Paranasal sinus discomfort	✓	✓	○
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinus congestion	·	·	✓
SRO	Burning sensation	✓	✓	✓
SRO	Menstruation irregular	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pregnancy	✓	✓	○

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