Y32-25102-07458

3 vaccinations 11 coded responses 38 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 483 / MI
Registered: 2021-07-31

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-07-31
Registered in v-safe
2021-07-31
Dose 1 — Moderna
2021-07-31
Survey response — day 0, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: Pain down arm of injection

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-01
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site reaction, Joint stiffness, Musculoskeletal stiffness — Feeling: Good · Site: Pain

Free text: Stiffness in shoulder and neck on arm of injection

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-08-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-08-07
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-08-14
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-08-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-08-28
Dose 2 — Moderna
2021-08-28
Survey response — day 0, dose 2
MedDRA: Musculoskeletal stiffness, Pain in extremity — Feeling: Good · Site: Pain

Free text: Sore arm and starting to feel stiff shoulder/neck

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-08-30
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Upper-airway cough syndrome — Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Mild cough post nasal drip which started last night

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-31
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal stiffness — Feeling: Good · Site: Pain, Redness, Swelling

Free text: Stiff arm neck and shoulder on side of body of injection.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-01
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal stiffness — Feeling: Good · Site: Pain

Free text: Stiffness in shoulder/neck

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-09-04
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-09-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-09-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-09-25
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-10-02
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-10-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-11-27
Survey response — 3 months, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: Sore Arm again around where I received vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-02-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-22
Dose 3 — Moderna
2022-04-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-25
Survey response — days 1–6 daily, dose 3
MedDRA: Back pain, Neck pain — Feeling: Fair · Headache, Muscle or body aches

Free text: Neck and back pain

MedDRA releases: 2024-11 · check-in free text available
2022-04-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains

Adult check-in
2022-04-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2022-04-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-04-29
Survey response — day 7, dose 3
MedDRA: Injection site pain — Feeling: Good

Free text: Soreness in arm where received injection

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Survey response — day 14, dose 3
MedDRA: Nasopharyngitis — Feeling: Fair

Free text: Cold like symptoms.

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-05-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-05-31
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-06-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-07-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-10-23
Survey response — 6 months, dose 3
MedDRA: Influenza like illness, Nasopharyngitis — Feeling: Fair · 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: Cold and flu like symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-10-23
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-25
Call 1 — Left Voicemail
2023-04-24
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-31	Moderna	No
2	2021-08-28	Moderna	No
3	2022-04-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-10-23	Unsuccessful

Free text

Release 9 — day 0, dose 1

2021-07-31

Systemic reaction (other): Pain down arm of injection

Release 9 — days 1–6 daily, dose 1

2021-08-01

Systemic reaction (other): Stiffness in shoulder and neck on arm of injection

Release 9 — day 0, dose 2

2021-08-28

Systemic reaction (other): Sore arm and starting to feel stiff shoulder/neck

Release 9 — days 1–6 daily, dose 2

2021-08-30

Systemic reaction (other): Mild cough post nasal drip which started last night

2021-08-31

Systemic reaction (other): Stiff arm neck and shoulder on side of body of injection.

2021-09-01

Systemic reaction (other): Stiffness in shoulder/neck

Release 10 — 3 months, dose 2

2021-11-27

Symptoms: Sore Arm again around where I received vaccine

Release 11 — days 1–6 daily, dose 3

2022-04-25

Systemic reaction (other): Neck and back pain

Release 11 — day 7, dose 3

2022-04-29

Systemic reaction (other): Soreness in arm where received injection

Release 11 — day 14, dose 3

2022-05-06

Symptoms: Cold like symptoms.

Release 12 — 6 months, dose 3

2022-10-23

Symptoms: Cold and flu like symptoms

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	Influenza like illness	·	·	✓
SD	Injection site pain	·	·	✓
SD	Nasopharyngitis	·	·	✓
SRO	Back pain	·	·	✓
SRO	Cough	✓	·	✓
SRO	Injection site pain	·	·	✓
SRO	Injection site reaction	✓	·	✓
SRO	Joint stiffness	✓	·	✓
SRO	Musculoskeletal stiffness	✓	·	✓
SRO	Neck pain	·	·	✓
SRO	Pain in extremity	✓	·	✓
SRO	Upper-airway cough syndrome	✓	·	✓

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