WGJ-27095-11870

2 vaccinations 5 coded responses 15 check-ins 5 free-text entries 5 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 370 / TN
Registered: 2021-04-01

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

2021-03-06
Dose 1 — Moderna
2021-04-01
Registered in v-safe
2021-04-01
Dose 2 — Moderna
2021-04-01
Health check-in — day 0, dose 2
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Adult check-in
2021-04-03
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — day 7, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-04-15
Survey response — day 14, dose 2
MedDRA: Medical counselling, Neuralgia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Muscle stuffness on my entire right side. This caused me to tear my rhombus muscle and pinch the nerve from my back down my arm. Now I don't have much use of my right arm due to weakness, loss of function and numbness/tingling. · Healthcare visit (other): Our friend is a PA for (b)(6) in town and my husband got him to come over to see me

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-22
Survey response — day 21, dose 2
MedDRA: Joint dislocation, Musculoskeletal stiffness, Rotator cuff syndrome, Specialist consultation — Feeling: Poor · 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: Symptoms: The stiffening that I have experienced in my muscles on my right side have caused me to dislocate my shoulder and tear my rotator cuff just from stretching! · Healthcare visit (other): Had to see an orthopedic doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-06
Survey response — day 35, dose 2
MedDRA: Injection site rash, Injection site reaction, Injection site swelling, Office visit, Rash macular — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have red, raised blotches on my arm where I got the vaccine · Healthcare visit (other): Orthipedic surgeon and a physical therapist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-13
Survey response — day 42, dose 2
MedDRA: Erythema, Pruritus, Skin swelling — Feeling: Fair

Free text: There was a dime-sized red raised mark that popped up last week or so and it has increased in size until it is the size of a quarter. It itches a tiny amount, but not bad.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Call 1 — Left Voicemail
2021-07-01
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-30
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-04
Survey response — 12 months, dose 2
MedDRA: Haemoglobin increased, Platelet count decreased, Syncope, White blood cell count decreased — 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, Outpatient clinic or urgent care clinic visit

Free text: Low WBC and platelet count, hemoglobin up for no reason, syncope episodes

MedDRA releases: 2024-11 · check-in free text available
2022-04-04
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-05
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-06	Moderna
2	2021-04-01	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-03	Unsuccessful
2021-04-15	Unsuccessful
2021-04-22	Unsuccessful
2021-05-06	Unsuccessful
2022-04-04	Unsuccessful

Free text

Release 7 — day 14, dose 2

2021-04-15

Symptoms: Muscle stuffness on my entire right side. This caused me to tear my rhombus muscle and pinch the nerve from my back down my arm. Now I don't have much use of my right arm due to weakness, loss of function and numbness/tingling.

Healthcare visit (other): Our friend is a PA for (b)(6) in town and my husband got him to come over to see me

redacted (b)(6)

Release 7 — day 21, dose 2

2021-04-22

Symptoms: The stiffening that I have experienced in my muscles on my right side have caused me to dislocate my shoulder and tear my rotator cuff just from stretching!

Healthcare visit (other): Had to see an orthopedic doctor

Release 8 — day 35, dose 2

2021-05-06

Symptoms: I have red, raised blotches on my arm where I got the vaccine

Healthcare visit (other): Orthipedic surgeon and a physical therapist

Release 8 — day 42, dose 2

2021-05-13

Symptoms: There was a dime-sized red raised mark that popped up last week or so and it has increased in size until it is the size of a quarter. It itches a tiny amount, but not bad.

Release 11 — 12 months, dose 2

2022-04-04

Symptoms: Low WBC and platelet count, hemoglobin up for no reason, syncope episodes

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Specialist consultation	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Haemoglobin increased	·	·	✓
SD	Injection site rash	✓	✓	✓
SD	Injection site reaction	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Joint dislocation	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Neuralgia	✓	✓	✓
SD	Platelet count decreased	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash macular	✓	✓	✓
SD	Rotator cuff syndrome	✓	✓	✓
SD	Skin swelling	✓	✓	✓
SD	Syncope	·	·	✓
SD	White blood cell count decreased	·	·	✓

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