Y33-23251-55139

5 vaccinations 13 coded responses 41 check-ins 11 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 300 / GA
Registered: 2021-01-14

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

2021-01-12
Dose 1 — Moderna
2021-01-14
Registered in v-safe
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good · Fatigue or tiredness

Free text: Severe Itching on both forearms yesterday afternoon

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-01-19
Health check-in — day 7, dose 1
Feeling: Fair · Site: Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-01-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-02
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-09
Survey response — day 0, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Itching not at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Itching at some of my joints

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Itching at elbow joint and wrist joint.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Itching · Fatigue or tiredness

Free text: Lymph node on right side near armpit swollen night two days after shot. Down today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Joint pains

Adult check-in
2021-02-16
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-09
Survey response — day 28, dose 2
MedDRA: Joint swelling, Peripheral swelling — Feeling: Fair

Free text: Joints. Particularly my fingers are swollen. Never had this issue before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — day 35, dose 2
MedDRA: Dysphagia, Fatigue — Feeling: Fair

Free text: Just more fatigue and a swallowing issue when I drink and sometimes eat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-11
Survey response — 3 months, dose 2
MedDRA: Dysphagia, Oesophageal disorder, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Esophageal swallowing issue. · Healthcare visit (other): Primary care visit and specialists

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-10
Survey response — 6 months, dose 2
MedDRA: Acupuncture, Arthralgia, Dysphagia, Gastrooesophageal reflux disease, Office visit, Weight decreased — Feeling: Fair · 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: Symptoms: Arthritic and joint pain as well as reflux · Healthcare visit (other): Upper endoscopy for symptoms such as weight loss and difficulty swallowing and acupuncture for joint pain

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-10
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-14
Call 2 — Left Voicemail
2021-10-22
Dose 3 — Moderna
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · None

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Abdominal pain

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-14
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-03
Survey response — day 42, dose 3
MedDRA: Dry throat, Rhinorrhoea, Sinus congestion — Feeling: Fair

Free text: Constant runny nose dry throat and sinus congestion.

MedDRA releases: 2024-11 · check-in free text available
2021-12-13
Call 3 — Left Voicemail
2022-01-21
Survey response — 3 months, dose 3
MedDRA: Gastrointestinal pain, Musculoskeletal chest pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Left side rib pain / intestinal pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-24
Call 1 — Left Voicemail
2022-04-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-07-22
Dose 4 — Moderna
2022-10-21
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-12-15
Dose 5 — Moderna
2022-12-27
Health check-in — day 7, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-12-29
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2023-01-05
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2023-01-12
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2023-01-20
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2023-01-26
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-03-16
Survey response — 3 months, dose 5
MedDRA: Nephrolithiasis, Ureteral stent insertion — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-03-16
Report sent to call center — 3 months, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2023-03-17
Call 1 — Left Voicemail
2023-03-17
Call 1 — Left Voicemail
2023-03-17
Call 2 — Left Voicemail
2023-03-17
Call 1 — Left Voicemail
2023-06-17
Survey response — 6 months, dose 5
MedDRA: Nephrolithiasis, Surgery — 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, Emergency room or emergency department visit

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-09	Moderna
3	2021-10-22	Moderna	No
4	2022-07-22	Moderna	No
5	2022-12-15	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-11	Unsuccessful
2021-08-10	Unsuccessful
2022-01-21	Unsuccessful
2023-03-16	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-16

Systemic reaction (other): Severe Itching on both forearms yesterday afternoon

Release 3 — day 0, dose 2

2021-02-09

Systemic reaction (other): Itching not at injection site

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Itching at some of my joints

2021-02-11

Systemic reaction (other): Itching at elbow joint and wrist joint.

2021-02-14

Systemic reaction (other): Lymph node on right side near armpit swollen night two days after shot. Down today.

Release 5 — day 28, dose 2

2021-03-09

Symptoms: Joints. Particularly my fingers are swollen. Never had this issue before.

Release 5 — day 35, dose 2

2021-03-16

Symptoms: Just more fatigue and a swallowing issue when I drink and sometimes eat.

Release 8 — 3 months, dose 2

2021-05-11

Symptoms: Esophageal swallowing issue.

Healthcare visit (other): Primary care visit and specialists

Release 9 — 6 months, dose 2

2021-08-10

Symptoms: Arthritic and joint pain as well as reflux

Healthcare visit (other): Upper endoscopy for symptoms such as weight loss and difficulty swallowing and acupuncture for joint pain

Release 10 — day 42, dose 3

2021-12-03

Symptoms: Constant runny nose dry throat and sinus congestion.

Release 11 — 3 months, dose 3

2022-01-21

Symptoms: Left side rib pain / intestinal pain

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	Acupuncture	✓	·	✓
HCVO	Arthralgia	✓	·	✓
HCVO	Dysphagia	✓	·	✓
HCVO	Office visit	✓	✓	✓
HCVO	Surgery	·	·	✓
HCVO	Ureteral stent insertion	·	·	✓
HCVO	Weight decreased	✓	·	✓
SD	Arthralgia	✓	·	✓
SD	Dry throat	·	·	✓
SD	Dysphagia	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal pain	·	·	✓
SD	Gastrooesophageal reflux disease	✓	·	✓
SD	Joint swelling	✓	✓	✓
SD	Musculoskeletal chest pain	·	·	✓
SD	Nephrolithiasis	·	·	✓
SD	Oesophageal disorder	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinus congestion	·	·	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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