Y3D-89874-72458

3 vaccinations 6 coded responses 20 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 314 / GA
Registered: 2021-02-12

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

2021-02-12
Registered in v-safe
2021-02-12
Dose 1 — Moderna
2021-02-12
Survey response — day 0, dose 1
MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Muscle or body aches

Free text: Mild soreness site of injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Musculoskeletal discomfort — Feeling: Good · Muscle or body aches

Free text: Discomfort left shoulder and neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-03-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Survey response — day 14, dose 2
MedDRA: Blood glucose increased — Feeling: Fair

Free text: Elevated blood sugar in mornings since taking the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 28, dose 2
MedDRA: Asthenia, Fatigue, Musculoskeletal pain, Office visit, Swelling, Temporomandibular joint syndrome — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Muscular skeletal pain, swelling of lower extremities, weakness and fatigue. TMJ, · Healthcare visit (other): Office visit.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-25
Survey response — day 42, dose 2
MedDRA: Muscular weakness, Musculoskeletal stiffness, Office visit, Pain in jaw — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Reoccurring stiffness in neck, pain in left jaw, weakness in hands, arms and legs. · Healthcare visit (other): Office visit, bloodwork results pending.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-12
Dose 3 — Pfizer-BioNTech
2022-03-12
Survey response — 12 months, dose 2
MedDRA: Constipation, Diarrhoea, Muscle spasms, Nausea — Feeling: Good · 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: Gastrointestinal: nausea, constipation, diarrhea, cramping. Scheduled colonoscopy March 15th

MedDRA releases: 2024-11 · check-in free text available
2022-03-12
Report sent to call center — 12 months, dose 2
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)
2022-03-14
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2021-10-12	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-09	Successful	Participant prefers to complete VAERS report online
2021-04-25	Successful	Participant prefers to complete VAERS report online
2022-03-12	Successful 2022-03-14	Participant prefers to complete VAERS report online

Free text

Release 4 — day 0, dose 1

2021-02-12

Systemic reaction (other): Mild soreness site of injection

Release 4 — days 1–6 daily, dose 1

2021-02-13

Systemic reaction (other): Discomfort left shoulder and neck

Release 6 — day 14, dose 2

2021-03-26

Symptoms: Elevated blood sugar in mornings since taking the vaccine.

Release 7 — day 28, dose 2

2021-04-09

Symptoms: Muscular skeletal pain, swelling of lower extremities, weakness and fatigue. TMJ,

Healthcare visit (other): Office visit.

Release 7 — day 42, dose 2

2021-04-25

Symptoms: Reoccurring stiffness in neck, pain in left jaw, weakness in hands, arms and legs.

Healthcare visit (other): Office visit, bloodwork results pending.

Release 11 — 12 months, dose 2

2022-03-12

Symptoms: Gastrointestinal: nausea, constipation, diarrhea, cramping. Scheduled colonoscopy March 15th

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	Asthenia	✓	✓	✓
SD	Blood glucose increased	✓	✓	✓
SD	Constipation	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Muscle spasms	·	·	✓
SD	Muscular weakness	✓	✓	✓
SD	Musculoskeletal pain	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Nausea	·	·	✓
SD	Pain in jaw	✓	✓	✓
SD	Swelling	✓	✓	✓
SD	Temporomandibular joint syndrome	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Musculoskeletal discomfort	✓	✓	✓

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