Y3B-79900-08362

3 vaccinations 10 coded responses 28 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 483 / MI
Registered: 2021-03-22

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

2021-03-22
Registered in v-safe
2021-03-22
Dose 1 — Moderna
2021-03-22
Health check-in — day 0, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Joint pains · Be unable to do your normal daily activities

Free text: I have severe RA & was advised to go off my meds for a week because of the covid vaccine. Just as a precaution. I had already been off Enbrel because of a snow storm delay in deliver & having to order a replacement shipment. Now off of Methotrexate in addition, plus very rainy damp conditions. I personally do not feel that my poor physical condition has to do directly with the vaccine .If that helps you.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — day 7, dose 1
Feeling: Good · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-04-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-13
Survey response — day 21, dose 1
MedDRA: Contusion, Dark circles under eyes, Periorbital swelling, Skin swelling — Feeling: Good · Be unable to do your normal daily activities

Free text: These probably are not related, but they are changes in how Ive been feeling.My face has been very puffy, circles, bags actually under my eyes. Even my eye lids feel puffy.I feel like I have some bruises (my left side rib area & my right armpit ar

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Dose 2 — Moderna
2021-04-19
Survey response — day 0, dose 2
MedDRA: Musculoskeletal stiffness, Pain, Pre-existing disease — Feeling: Good · Joint pains · Be unable to do your normal daily activities

Free text: I have RA & woke up stiff & a bit sore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site warmth — Feeling: Good · Site: Itching · Headache

Free text: My arm where I received the vaccine is hot to the touch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease, Rheumatoid arthritis — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I have severe RA, & I am off my meds because of the vaccine The symptoms I mentioned are most likely from lack of RA meds.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-26
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-05-03
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-10
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-17
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-24
Survey response — day 35, dose 2
MedDRA: Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: My left hip & right ankle continue to worsen. My hands & feet are swollen. I see my Rhumatologist on Thursday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-19
Survey response — 3 months, dose 2
MedDRA: Bursitis — Feeling: Good · Be unable to do your normal daily activities

Free text: Probably not related but I have been diagnosed with Bursitis in my hip.

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Joint swelling, Neuropathy peripheral, Office visit, Pain in extremity, Paraesthesia, Peripheral swelling, Pre-existing disease, Rheumatoid arthritis, Vision blurred — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: First, it probably has nothing to do with the vaccine. I have severe RA & if it is not under control, being an auto immune disease other areas can be affected.Swelling, tingling & pain in hands, feet & ankles. Neuropathy on both heels. Blurred visio · Healthcare visit (other): My regular eye, general & Rhumatologist doctors .

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
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)
2021-10-25
Call 2 — Left Voicemail
2022-01-18
Dose 3 — Moderna
2022-04-22
Survey response — 12 months, dose 2
MedDRA: Arthralgia, Back pain, 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, Emergency room or emergency department visit, Hospitalization

Free text: Extreme lower back & left hip pain. Could possibly be osteoporosis? I already struggle with RA.

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
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

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-25
Call 2 — Left Voicemail
2022-07-19
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2023-01-18
Survey response — 12 months, dose 3
MedDRA: Blood pressure abnormal, Musculoskeletal stiffness, Office visit, Pre-existing disease, Red blood cell count decreased, Rheumatoid arthritis — 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

MedDRA releases: 2024-11
2023-01-18
Report sent to call center — 12 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)
2023-01-19
Call 1 — Left Voicemail
2023-01-19
Call 1 — Left Voicemail
2023-01-19
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-19	Moderna
3	2022-01-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-19	Unsuccessful
2022-04-22	Unsuccessful
2023-01-18	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-28

Systemic reaction (other): I have severe RA & was advised to go off my meds for a week because of the covid vaccine. Just as a precaution. I had already been off Enbrel because of a snow storm delay in deliver & having to order a replacement shipment. Now off of Methotrexate in addition, plus very rainy damp conditions. I personally do not feel that my poor physical condition has to do directly with the vaccine .If that helps you.

Release 7 — day 21, dose 1

2021-04-13

Symptoms: These probably are not related, but they are changes in how Ive been feeling.My face has been very puffy, circles, bags actually under my eyes. Even my eye lids feel puffy.I feel like I have some bruises (my left side rib area & my right armpit ar

Release 7 — day 0, dose 2

2021-04-19

Systemic reaction (other): I have RA & woke up stiff & a bit sore.

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): My arm where I received the vaccine is hot to the touch

2021-04-24

Systemic reaction (other): I have severe RA, & I am off my meds because of the vaccine The symptoms I mentioned are most likely from lack of RA meds.

Release 8 — day 35, dose 2

2021-05-24

Symptoms: My left hip & right ankle continue to worsen. My hands & feet are swollen. I see my Rhumatologist on Thursday.

Release 9 — 3 months, dose 2

2021-07-19

Symptoms: Probably not related but I have been diagnosed with Bursitis in my hip.

Release 10 — 6 months, dose 2

2021-10-19

Symptoms: First, it probably has nothing to do with the vaccine. I have severe RA & if it is not under control, being an auto immune disease other areas can be affected.Swelling, tingling & pain in hands, feet & ankles. Neuropathy on both heels. Blurred visio cut off by CDC

Healthcare visit (other): My regular eye, general & Rhumatologist doctors .

Release 11 — 12 months, dose 2

2022-04-22

Symptoms: Extreme lower back & left hip pain. Could possibly be osteoporosis? I already struggle with RA.

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	Office visit	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	·	·	✓
SD	Blood pressure abnormal	·	·	✓
SD	Bursitis	·	·	✓
SD	Contusion	✓	✓	✓
SD	Dark circles under eyes	✓	✓	✓
SD	Joint swelling	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Neuropathy peripheral	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Paraesthesia	·	·	✓
SD	Periorbital swelling	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Red blood cell count decreased	·	·	✓
SD	Rheumatoid arthritis	·	·	✓
SD	Skin swelling	✓	✓	✓
SD	Vision blurred	·	·	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rheumatoid arthritis	✓	✓	✓

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