K4N-67456-92866

2 vaccinations 9 coded responses 22 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 242 / VA
Registered: 2021-10-07

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-10-06
Dose 1 — Moderna
2021-10-07
Registered in v-safe
2021-10-07
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-10
Survey response — days 1–6 daily, dose 1
MedDRA: Anosmia, Feeding disorder, Parosmia — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: My smell is coming back after 10 months. However, food smells like trash to me and I can't really eat

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Survey response — days 1–6 daily, dose 1
MedDRA: Anosmia, Decreased appetite, Nausea, Parosmia — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: My smell has finally come back after 10 months. All smells are intensified, Still not really able to eat. As food smells like garbage to me and makes me very nauseous

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-13
Health check-in — day 7, dose 1
Feeling: Good · Headache · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-20
Survey response — day 14, dose 1
MedDRA: Kidney infection, Nephrolithiasis, Office visit, Pain, Pyrexia, Renal disorder — 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 · Outpatient clinic or urgent care clinic visit

Free text: They is something wrong with my kidney. I have been running a fever and in extreme pain. I went to urgent care and they told me to go to ER. That I had a kidney infection or kidney stones (I have never had ever).

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
Report sent to call center — day 14, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-22
Call successful
Participant prefers to complete VAERS report online
2021-10-27
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-11-03
Survey response — day 28, dose 1
MedDRA: Condition aggravated, Constipation, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I noticed my hair is starting to fall out a little more. It fell out really bad with Covid and I had to be put on medicine. I'm still dying and very constipated

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Dose 2 — Moderna
2021-11-11
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-11-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-11-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: I am very dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2021-11-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-20
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-25
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-12-04
Survey response — day 21, dose 2
MedDRA: Cardiac disorder, Streptococcal infection — Feeling: Fair · Be unable to work or attend school

Free text: Strep and heart problems. Was put on medicine

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Survey response — day 35, dose 2
MedDRA: Pneumonia — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Pneumonia

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Report sent to call center — day 35, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-17
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-23
Survey response — day 42, dose 2
MedDRA: Pneumonia — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Pneumonia

MedDRA releases: 2024-11 · check-in free text available
2021-12-23
Report sent to call center — day 42, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-27
Call 1 — Left Voicemail
2022-02-10
Survey response — 3 months, dose 2
MedDRA: Pneumonia, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Still battling pneumonia, I don't think it's from the vaccine. I think it's from Covid last year

MedDRA releases: 2024-11 · check-in free text available
2022-02-10
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-15
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-10-06	Moderna	No
2	2021-11-11	Moderna	No

Call center

4 call center cases

2 successful · 2 unsuccessful

See the call center timeline

Free text

Release 10 — days 1–6 daily, dose 1

2021-10-10

Systemic reaction (other): My smell is coming back after 10 months. However, food smells like trash to me and I can't really eat

2021-10-11

Systemic reaction (other): My smell has finally come back after 10 months. All smells are intensified, Still not really able to eat. As food smells like garbage to me and makes me very nauseous

Release 10 — day 14, dose 1

2021-10-20

Symptoms: They is something wrong with my kidney. I have been running a fever and in extreme pain. I went to urgent care and they told me to go to ER. That I had a kidney infection or kidney stones (I have never had ever).

Release 10 — day 28, dose 1

2021-11-03

Symptoms: I noticed my hair is starting to fall out a little more. It fell out really bad with Covid and I had to be put on medicine. I'm still dying and very constipated

Release 10 — days 1–6 daily, dose 2

2021-11-14

Systemic reaction (other): I am very dizzy

Release 10 — day 21, dose 2

2021-12-04

Symptoms: Strep and heart problems. Was put on medicine

Release 10 — day 35, dose 2

2021-12-16

Symptoms: Pneumonia

Release 10 — day 42, dose 2

2021-12-23

Symptoms: Pneumonia

Release 11 — 3 months, dose 2

2022-02-10

Symptoms: Still battling pneumonia, I don't think it's from the vaccine. I think it's from Covid last year

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	Cardiac disorder	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Constipation	·	·	✓
SD	Kidney infection	·	·	✓
SD	Nephrolithiasis	·	·	✓
SD	Office visit	·	·	✓
SD	Pain	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	Renal disorder	·	·	✓
SD	Streptococcal infection	·	·	✓
SRO	Anosmia	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Feeding disorder	·	·	✓
SRO	Nausea	·	·	✓
SRO	Parosmia	·	·	✓

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