N6K-31935-70847

5 vaccinations 21 coded responses 60 check-ins 21 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 926 / CA
Registered: 2021-01-09

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

5Y3-24079-40867 Child or adolescent in my care · Male · 2022-09-06

Timeline

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

2021-01-09
Registered in v-safe
2021-01-09
Dose 1 — Moderna
2021-01-09
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Muscle or body aches

Free text: Just a tiny bit sore at injection site not bad at all

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Nausea — Feeling: Good · Nausea

Free text: Mild nausea it passed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Nausea

Adult check-in
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: Good today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches

Adult check-in
2021-01-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-06
Dose 2 — Moderna
2021-02-06
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Pyrexia, Self-medication — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Ive had a rather time with second shot but I think it will pass I just have to wait it out. I get some relief with aspirin. So Ive taken that. Definitely different than first shot. Resting & watching fever went down to 99.1 after aspirin.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Nausea

Free text: Feeling better today although some symptoms persist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling, Telemedicine — Feeling: Fair · Site: Redness · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Contacted Primary Physician received an anti-itch ointment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness

Free text: Better today!! Feeling tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Nausea, Rash — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Rash going away no fevers slight nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-16
Call 1 — Left Voicemail
2021-08-07
Survey response — 6 months, dose 2
MedDRA: Cough — Feeling: Good

Free text: Developed bad cough no fever, had for 10 days and it went away.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-22
Dose 3 — Moderna
2021-09-03
Survey response — day 7, dose 3
MedDRA: Pain in extremity, Pyrexia — Feeling: Good

Free text: 14 days after third dose; initial symptoms included very sore arm; fever 101. All went away in 4 days

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-09-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-09-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-09-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-02-20
Survey response — 6 months, dose 3
MedDRA: COVID-19 — Feeling: Good · 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: Suspected COVID-19

MedDRA releases: 2024-11 · check-in free text available
2022-02-20
Report sent to call center — 6 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 · 1 call case(s)
2022-02-21
Call 1 — Left Voicemail
2022-02-22
Dose 4 — Moderna
2022-02-22
Health check-in — day 0, dose 4
Feeling: Good · Fever · None

Adult check-in
2022-02-23
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-02-24
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-02-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-02-26
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-02-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2022-03-01
Health check-in — day 7, dose 4
Feeling: Fair · Nausea

Adult check-in
2022-03-08
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-03-19
Survey response — day 21, dose 4
MedDRA: Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Legs are hurting last couple weeks comes & goes but painful like bad arthritis still have this

MedDRA releases: 2024-11 · check-in free text available
2022-03-23
Survey response — day 28, dose 4
MedDRA: Pain in extremity — Feeling: Fair

Free text: Leg pain

MedDRA releases: 2024-11 · check-in free text available
2022-03-29
Survey response — day 35, dose 4
MedDRA: Pain in extremity — Feeling: Fair

Free text: Leg pain hurts going to see my Dr for this.

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-08-23
Survey response — 6 months, dose 4
MedDRA: Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Leg pain

MedDRA releases: 2024-11 · check-in free text available
2022-08-23
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 · 1 call case(s)
2022-08-24
Call successful
Participant prefers to complete VAERS report online
2022-08-24
Call successful
Participant prefers to complete VAERS report online
2022-08-24
Call successful
Participant prefers to complete VAERS report online
2022-09-06
Dose 5 — Moderna
Co-administered: Flu
2022-09-06
Survey response — day 0, dose 5
MedDRA: Fatigue, Headache, Pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Day 1 headache body aches pain fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-09-09
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness · Headache, Muscle or body aches

Adult check-in
2022-09-10
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-11
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Swelling, Itching · Muscle or body aches

Adult check-in
2022-09-12
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Muscle or body aches

Adult check-in
2022-09-13
Health check-in — day 7, dose 5
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-09-21
Survey response — day 14, dose 5
MedDRA: Cough, Pain, Pain in extremity, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Continuing cough, legs hurt body aches fever had shingles shot #2 and an infusion ReClast. But cough is persistent and body aches as well since receiving the 2nd 3rd doses of COVID vaccines

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Survey response — day 21, dose 5
MedDRA: Cough, Nausea, Pain, SARS-CoV-2 test negative — Feeling: Fair

Free text: Nausea/cough persistent although negative COVID tests-risidule from last vaccination. Body aches

MedDRA releases: 2024-11 · check-in free text available
2022-10-04
Survey response — day 28, dose 5
MedDRA: Headache, Nausea, Pain — Feeling: Fair

Free text: Continued nausea every day body aches headaches . The nausea really bothers me.

MedDRA releases: 2024-11 · check-in free text available
2022-10-11
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-19
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-12-06
Survey response — 3 months, dose 5
MedDRA: Abdominal distension, Myalgia, Vomiting — Feeling: Fair · Be unable to do your normal daily activities

Free text: A bulge in tummy vomiting will contact Dr . Muscle aches continue since shots especially legs

MedDRA releases: 2024-11 · check-in free text available
2023-03-08
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-09	Moderna
2	2021-02-06	Moderna
3	2021-08-22	Moderna	No
4	2022-02-22	Moderna	No
5	2022-09-06	Moderna	Flu

Call center

3 call center cases

3 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — day 0, dose 1

2021-01-09

Systemic reaction (other): No

Release 1 — days 1–6 daily, dose 1

2021-01-10

Systemic reaction (other): Just a tiny bit sore at injection site not bad at all

2021-01-11

Systemic reaction (other): Mild nausea it passed.

2021-01-13

Systemic reaction (other): Good today

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): Ive had a rather time with second shot but I think it will pass I just have to wait it out. I get some relief with aspirin. So Ive taken that. Definitely different than first shot. Resting & watching fever went down to 99.1 after aspirin.

2021-02-08

Systemic reaction (other): Feeling better today although some symptoms persist

2021-02-09

Systemic reaction (other): Contacted Primary Physician received an anti-itch ointment

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Better today!! Feeling tired

2021-02-11

Systemic reaction (other): Rash going away no fevers slight nausea

Release 9 — 6 months, dose 2

2021-08-07

Symptoms: Developed bad cough no fever, had for 10 days and it went away.

Release 9 — day 7, dose 3

2021-09-03

Systemic reaction (other): 14 days after third dose; initial symptoms included very sore arm; fever 101. All went away in 4 days

Release 11 — 6 months, dose 3

2022-02-20

Symptoms: Suspected COVID-19

Release 11 — day 21, dose 4

2022-03-19

Symptoms: Legs are hurting last couple weeks comes & goes but painful like bad arthritis still have this

Release 11 — day 28, dose 4

2022-03-23

Symptoms: Leg pain

Release 11 — day 35, dose 4

2022-03-29

Symptoms: Leg pain hurts going to see my Dr for this.

Release 12 — 6 months, dose 4

2022-08-23

Symptoms: Leg pain

Release 12 — day 0, dose 5

2022-09-06

Systemic reaction (other): Day 1 headache body aches pain fatigue

Release 12 — day 14, dose 5

2022-09-21

Symptoms: Continuing cough, legs hurt body aches fever had shingles shot #2 and an infusion ReClast. But cough is persistent and body aches as well since receiving the 2nd 3rd doses of COVID vaccines

Release 12 — day 21, dose 5

2022-09-29

Symptoms: Nausea/cough persistent although negative COVID tests-risidule from last vaccination. Body aches

Release 12 — day 28, dose 5

2022-10-04

Symptoms: Continued nausea every day body aches headaches . The nausea really bothers me.

Release 12 — 3 months, dose 5

2022-12-06

Symptoms: A bulge in tummy vomiting will contact Dr . Muscle aches continue since shots especially legs

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 distension	·	·	✓
SD	Cough	✓	·	✓
SD	COVID-19	·	·	✓
SD	Headache	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vomiting	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Medical counselling	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Pain in extremity	✓	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Telemedicine	✓	✓	○
SRO	Unevaluable event	✓	✓	✓

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