GSS-27636-21831

2 vaccinations 5 coded responses 17 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 136 / NY
Registered: 2021-04-24

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
Dose 1 — Moderna
2021-04-24
Registered in v-safe
2021-04-24
Survey response — day 7, dose 1
MedDRA: Arthralgia, Asthenia, Axillary pain, Blood pressure fluctuation, Breast pain, Dizziness, Musculoskeletal chest pain, Pain in extremity — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Rise in blood pressure and lowering in blood pressure in a minutes of time, dizzy, weakness, pain in armpit and the pain travles down my arm as well into my sholder. And the pain travles from my arm pit into my side of my rib cage. all of this is happening on my right side. And as well as pain in my right breast area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — day 14, dose 1
Feeling: Poor

Adult check-in
2021-05-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-10
Dose 2 — Moderna
2021-05-10
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-12
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Pain in extremity — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: The redness has spread through my arm and pain has traveled

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

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

Adult check-in
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-07
Survey response — day 28, dose 2
MedDRA: Pain, Pain in extremity — Feeling: Fair · Be unable to work

Free text: Body aches and soreness in arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Survey response — day 35, dose 2
MedDRA: Abortion spontaneous — Feeling: Poor · Be unable to work or attend school, 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: Found out I was pregnant and had a miscarriage during my Covid vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Report sent to call center — day 35, 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

1 call case(s)
2021-06-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-23
Call 1 — Left Voicemail
2022-05-10
Survey response — 12 months, dose 2
MedDRA: Amnesia, Blood glucose increased, Dizziness, Epistaxis, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have had issues with nose bleeding and headaches and dizzy spells. I have had problems keeping my sugar under 400. It was steady for a few weeks. I have felt more tired than usual. And noticed I am struggling to concentrate. As well as memory loss.

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

Vaccinations

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

Call center

Reported	Outcome	VAERS-related outcome
2021-06-14	Unsuccessful

Free text

Release 7 — day 7, dose 1

2021-04-24

Systemic reaction (other): Rise in blood pressure and lowering in blood pressure in a minutes of time, dizzy, weakness, pain in armpit and the pain travles down my arm as well into my sholder. And the pain travles from my arm pit into my side of my rib cage. all of this is happening on my right side. And as well as pain in my right breast area.

Release 8 — days 1–6 daily, dose 2

2021-05-12

Systemic reaction (other): The redness has spread through my arm and pain has traveled

Release 8 — day 28, dose 2

2021-06-07

Symptoms: Body aches and soreness in arm.

Release 9 — day 35, dose 2

2021-06-14

Symptoms: Found out I was pregnant and had a miscarriage during my Covid vaccine

Release 11 — 12 months, dose 2

2022-05-10

Symptoms: I have had issues with nose bleeding and headaches and dizzy spells. I have had problems keeping my sugar under 400. It was steady for a few weeks. I have felt more tired than usual. And noticed I am struggling to concentrate. As well as memory loss. cut off by CDC

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	Abortion spontaneous	✓	✓	✓
SD	Amnesia	·	·	✓
SD	Blood glucose increased	·	·	✓
SD	Dizziness	·	·	✓
SD	Epistaxis	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Blood pressure fluctuation	✓	✓	✓
SRO	Breast pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Musculoskeletal chest pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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