U7S-28520-62598

3 vaccinations 9 coded responses 25 check-ins 8 free-text entries 5 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 796 / TX
Registered: 2020-12-29

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

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Survey response — day 0, dose 1
MedDRA: Palpitations — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Heart pounding, as if I exercised

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Sensitive skin — Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Abdominal pain

Free text: Very sensitive skin on my back/shoulder on the same side as the injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Back pain, Sensitive skin — Feeling: Fair · Muscle or body aches · Be unable to do your normal daily activities

Free text: Very sensitive skin and pain on upper back and shoulder, coming around to the front, on the injection site side of the body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Rash, Rash papular, Rash pruritic — Feeling: Fair · Chills, Muscle or body aches, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Rash on upper back on the same side of body as the injection. Raised rash that is both itchy and painful to touch. Clothing hurts to wear

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Herpes zoster — Feeling: Poor · Chills, Muscle or body aches, Rash, not including the immediate area around the injection site · 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: Diagnosed with shingles today brought on by the Moderna vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Herpes zoster, Pain — Feeling: Poor · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Extreme pain due to shingles brought in by the COVID vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-14
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Palpitations — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Pounding heart

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Fatigue or tiredness

Adult check-in
2021-01-28
Call 1 — Left Voicemail
2021-01-28
Call successful
Participant prefers to complete VAERS report online
2021-01-28
Call successful
Participant prefers to complete VAERS report online
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-02-02
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness · Nausea

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-14
Dose 3 — Moderna
2022-01-28
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-07-17
Survey response — 6 months, dose 3
MedDRA: Body temperature increased, Exposure to SARS-CoV-2, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Been directly exposed to COVID and have COVID symptoms, 99.6 temperature, but a negative at-home COVID test.

MedDRA releases: 2024-11 · check-in free text available
2023-01-16
Survey response — 12 months, dose 3
MedDRA: Abortion spontaneous, Immediate post-injection reaction, Reaction to previous exposure to any vaccine, Uterine dilation and curettage — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-01-16
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2023-01-17
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna
3	2022-01-14	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-01	Successful	Participant prefers to complete VAERS report online
2021-01-02	Successful	Participant prefers to complete VAERS report online
2021-01-03	Successful 2021-01-28	Participant prefers to complete VAERS report online
2021-01-04	Successful 2021-01-28	Participant prefers to complete VAERS report online
2023-01-16	Unsuccessful

Free text

Release 1 — day 0, dose 1

2020-12-29

Systemic reaction (other): Heart pounding, as if I exercised

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): Very sensitive skin on my back/shoulder on the same side as the injection

2021-01-01

Systemic reaction (other): Very sensitive skin and pain on upper back and shoulder, coming around to the front, on the injection site side of the body

2021-01-02

Systemic reaction (other): Rash on upper back on the same side of body as the injection. Raised rash that is both itchy and painful to touch. Clothing hurts to wear

2021-01-03

Systemic reaction (other): Diagnosed with shingles today brought on by the Moderna vaccine

2021-01-04

Systemic reaction (other): Extreme pain due to shingles brought in by the COVID vaccine

Release 2 — days 1–6 daily, dose 2

2021-01-27

Systemic reaction (other): Pounding heart

Release 12 — 6 months, dose 3

2022-07-17

Symptoms: Been directly exposed to COVID and have COVID symptoms, 99.6 temperature, but a negative at-home COVID test.

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
HCVO	Uterine dilation and curettage	·	·	✓
SD	Abortion spontaneous	·	·	✓
SD	Body temperature increased	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Immediate post-injection reaction	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Condition aggravated	○	○	○
SRO	Herpes zoster	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Rash papular	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Sensitive skin	✓	✓	✓

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