VGM-52516-63353

5 vaccinations 13 coded responses 47 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 981 / WA
Registered: 2021-03-02

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

2021-03-02
Registered in v-safe
2021-03-02
Dose 1 — Moderna
2021-03-02
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Dry eye, Eye pruritus, Ocular hyperaemia — Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work

Free text: Dry red itchy eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Erythema, Eye pruritus — Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness · Be unable to work

Free text: Dry itchy eyes, slight redness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — day 7, dose 1
Feeling: Fair · Site: Itching · Joint pains, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-30
Dose 2 — Moderna
2021-03-30
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye, Eye pruritus, Ocular hyperaemia — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Red dry itchy eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye, Erythema, Eye pruritus, Nasal congestion — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Red dry itchy eyes, nasal congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye, Ocular hyperaemia — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Red dry eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion, Ocular hyperaemia, Periorbital swelling — Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Nasal congestion and red puffy eye

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion, Ocular hyperaemia — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Nasal congestion, red eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Ocular hyperaemia, Respiratory tract congestion — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Congestion and red eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-21
Survey response — day 21, dose 2
MedDRA: Ocular hyperaemia — Feeling: Good

Free text: Red eyes, eye infection?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-29
Survey response — 3 months, dose 2
MedDRA: Dry eye — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Dry eyes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-29
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-06
Call 1 — Left Voicemail
2021-09-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-19
Dose 3 — Moderna
Co-administered: Flu
2021-10-26
Health check-in — day 7, dose 3
Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-23
Survey response — day 35, dose 3
MedDRA: Fatigue, Nasal congestion, Oropharyngeal pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sore throat, nasal congestion, fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-24
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-30
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-18
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-21
Dose 4 — Moderna
2022-04-19
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-29
Dose 5 — Moderna
2022-09-29
Health check-in — day 0, dose 5
Feeling: Good · None

Adult check-in
2022-09-30
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Itching · Fever · Joint pains, Fatigue or tiredness

Adult check-in
2022-10-01
Survey response — days 1–6 daily, dose 5
MedDRA: Rhinorrhoea, Sneezing — Feeling: Fair · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sneezing, runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-10-02
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Itching · Headache

Adult check-in
2022-10-04
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-10-05
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-10-06
Health check-in — day 7, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-10-13
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-20
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-03
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-11-10
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-29
Health check-in — 3 months, dose 5
Feeling: Poor

Adult check-in
2023-03-30
Survey response — 6 months, dose 5
MedDRA: Dyspnoea, Palpitations, Pre-existing disease — 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

MedDRA releases: 2024-11
2023-03-30
Report sent to call center — 6 months, dose 5
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)
2023-03-31
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-03-30	Moderna
3	2021-10-19	Moderna	Flu
4	2022-03-21	Moderna	No
5	2022-09-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-29	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-23	Successful 2021-11-24	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2023-03-30	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): Dry red itchy eyes

2021-03-05

Systemic reaction (other): Dry itchy eyes, slight redness

Release 6 — days 1–6 daily, dose 2

2021-03-31

Systemic reaction (other): Red dry itchy eyes

2021-04-01

Systemic reaction (other): Red dry itchy eyes, nasal congestion

2021-04-02

Systemic reaction (other): Red dry eyes

2021-04-03

Systemic reaction (other): Nasal congestion and red puffy eye

2021-04-04

Systemic reaction (other): Nasal congestion, red eyes

2021-04-05

Systemic reaction (other): Congestion and red eyes

Release 7 — day 21, dose 2

2021-04-21

Symptoms: Red eyes, eye infection?

Release 9 — 3 months, dose 2

2021-06-29

Symptoms: Dry eyes.

Release 10 — day 35, dose 3

2021-11-23

Symptoms: Sore throat, nasal congestion, fatigue

Release 12 — days 1–6 daily, dose 5

2022-10-01

Systemic reaction (other): Sneezing, runny nose

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	Dry eye	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Ocular hyperaemia	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Palpitations	·	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Dry eye	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Ocular hyperaemia	✓	✓	✓
SRO	Periorbital swelling	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Sneezing	·	·	✓

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