VNR-24694-17579

4 vaccinations 5 coded responses 54 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 217 / MD
Registered: 2021-03-18

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-18
Registered in v-safe
2021-03-18
Dose 1 — Moderna
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2021-03-25
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Survey response — day 14, dose 1
MedDRA: Arthralgia, Back pain — Feeling: Good

Free text: Left shoulder back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-15
Dose 2 — Moderna
2021-04-15
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-30
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-10-29
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Itching

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Survey response — day 7, dose 3
MedDRA: Dizziness — Feeling: Fair · Site: Itching

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-28
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-19
Dose 4 — Moderna
2022-05-19
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-05-26
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-02
Survey response — day 14, dose 4
MedDRA: Hypoaesthesia, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: My index finger on the injection side is numb and painful

MedDRA releases: 2024-11 · check-in free text available
2022-06-09
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-16
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-23
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-02
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-17
Survey response — 6 months, dose 4
MedDRA: COVID-19 — Feeling: Poor · 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: Covid

MedDRA releases: 2024-11 · check-in free text available
2022-11-17
Report sent to call center — 6 months, dose 4
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)
2022-11-18
Call 1 — Left Voicemail
2023-05-19
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-15	Moderna
3	2021-10-29	Moderna	No
4	2022-05-19	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-11-17	Unsuccessful

Free text

Release 6 — day 14, dose 1

2021-04-01

Symptoms: Left shoulder back pain

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): Dizziness

Release 10 — day 7, dose 3

2021-11-05

Systemic reaction (other): Dizziness

Release 11 — day 14, dose 4

2022-06-02

Symptoms: My index finger on the injection side is numb and painful

Release 12 — 6 months, dose 4

2022-11-17

Symptoms: Covid

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	Back pain	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Pain in extremity	·	·	✓
SRO	Dizziness	·	·	✓

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