KK6-18330-39437

2 vaccinations 5 coded responses 19 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 967 / HI
Registered: 2021-10-11

Relationship: Self
Race: Native Hawaiian or other Pacific Islander
Ethnicity: Not Hispanic or Latino

Registered dependents

XYH-67916-63545 Child or adolescent in my care · Female · 2021-10-11

Timeline

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

2021-10-11
Registered in v-safe
2021-10-11
Dose 1 — Moderna
2021-10-11
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · 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

Adult check-in
2021-10-12
Report sent to call center — days 1–6 daily, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-13
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain — Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches

Free text: Under arm pain, same arm as the administered shot was given

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-10-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-10-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-18
Health check-in — day 7, dose 1
Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-18
Call 1 — Left Voicemail
2021-10-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-11-01
Survey response — day 21, dose 1
MedDRA: Fatigue — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Dose 2 — Moderna
2021-11-10
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

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

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

Adult check-in
2021-11-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-11-23
Health check-in — day 14, dose 2
Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Chest discomfort muscle weakness

Adult check-in · check-in free text available
2021-11-30
Survey response — day 21, dose 2
MedDRA: Chest discomfort, Fatigue, Neck mass, Paraesthesia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Discomfort in chest. Large lump in nape of neck. Tingling in limbs. Fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Survey response — day 28, dose 2
MedDRA: Diarrhoea, Fatigue — 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 · Telehealth, virtual health, or email health consultation

Free text: Severe diarrhea and fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Report sent to call center — day 28, 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)
2021-12-14
Call successful
Participant prefers to complete VAERS report online
2022-02-08
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Muscular weakness — 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: Pain in joints all over body. Weakness in all extremities.

MedDRA releases: 2024-11 · check-in free text available
2022-02-08
Report sent to call center — 3 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-11
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-10-11	Moderna	No
2	2021-11-09	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 10 — days 1–6 daily, dose 1

2021-10-13

Systemic reaction (other): Under arm pain, same arm as the administered shot was given

Release 10 — day 21, dose 1

2021-11-01

Symptoms: Fatigue

Release 10 — day 21, dose 2

2021-11-30

Symptoms: Discomfort in chest. Large lump in nape of neck. Tingling in limbs. Fatigue

Release 10 — day 28, dose 2

2021-12-09

Symptoms: Severe diarrhea and fatigue

Release 11 — 3 months, dose 2

2022-02-08

Symptoms: Pain in joints all over body. Weakness in all extremities.

Release 12 — day 14, dose 2

2021-11-23

Symptoms: Chest discomfort muscle weakness

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	Arthralgia	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Muscular weakness	·	·	✓
SD	Neck mass	·	·	✓
SD	Paraesthesia	·	·	✓
SRO	Axillary pain	·	·	✓

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