Y9J-48555-66779

5 vaccinations 8 coded responses 38 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 276 / NC
Registered: 2021-01-28

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Health check-in — day 0, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-11
Survey response — day 14, dose 1
MedDRA: Immunisation reaction, Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth, Urticaria — 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

Free text: Moderna shot was 1/28. On 2/5 I developed a raised red itching 2 welt hot to touch at inject site. 6 days later its a 5 circle still itching, hot, painful. I read in a magazine its being called Covid Vaccination Arm. Still have initial he

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Fever · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · 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
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 21, dose 2
MedDRA: Headache — Feeling: Good · Be unable to do your normal daily activities

Free text: Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Condition aggravated, Pre-existing disease, Seasonal allergy, Skin odour abnormal — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Body odor has changed.Seasonal allergy symptoms were off the chart worse and longer lasting.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-09
Call 1 — Left Voicemail
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Blindness transient, Headache, Office visit — 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: Symptoms: Temporary loss of vision in left eye, now resolved. Continue to have headaches. · Healthcare visit (other): Primary and ophthalmology

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
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)
2021-08-31
Call successful
Does not wish to fill out VAERS report
2021-11-15
Dose 3 — Moderna
2022-02-25
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-07-22
Dose 4 — Moderna
2022-10-18
Dose 5 — Moderna
2022-10-21
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-22
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-23
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-24
Survey response — days 1–6 daily, dose 5
MedDRA: Poor quality sleep — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Restless sleep

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Health check-in — day 7, dose 5
Feeling: Good · Joint pains

Adult check-in
2022-11-01
Survey response — day 14, dose 5
MedDRA: Arthralgia, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme joint pain in all joints in my body. I had a flu shot Friday. I've never had side effects from any flu shot previously. I had no side effects after my shot on Friday. But Monday I suddenly developed full body and joint pain.

MedDRA releases: 2024-11 · check-in free text available
2022-11-08
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-15
Survey response — day 28, dose 5
MedDRA: Fatigue, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Worsening fatigue but due to post radiation therapy

MedDRA releases: 2024-11 · check-in free text available
2022-11-22
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-29
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-17
Survey response — 3 months, dose 5
MedDRA: Cough, Influenza like illness, Oropharyngeal pain, Respiratory tract congestion — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-04-18
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-11-15	Moderna	No
4	2022-07-22	Moderna	No
5	2022-10-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-11	Unsuccessful
2021-05-27	Unsuccessful
2021-08-26	Successful 2021-08-31	Does not wish to fill out VAERS report

Free text

Release 4 — day 14, dose 1

2021-02-11

Symptoms: Moderna shot was 1/28. On 2/5 I developed a raised red itching 2 welt hot to touch at inject site. 6 days later its a 5 circle still itching, hot, painful. I read in a magazine its being called Covid Vaccination Arm. Still have initial he

Release 5 — day 21, dose 2

2021-03-18

Symptoms: Headaches

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: Body odor has changed.Seasonal allergy symptoms were off the chart worse and longer lasting.

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: Temporary loss of vision in left eye, now resolved. Continue to have headaches.

Healthcare visit (other): Primary and ophthalmology

Release 12 — days 1–6 daily, dose 5

2022-10-24

Systemic reaction (other): Restless sleep

Release 12 — day 14, dose 5

2022-11-01

Symptoms: Extreme joint pain in all joints in my body. I had a flu shot Friday. I've never had side effects from any flu shot previously. I had no side effects after my shot on Friday. But Monday I suddenly developed full body and joint pain.

Release 12 — day 28, dose 5

2022-11-15

Symptoms: Worsening fatigue but due to post radiation therapy

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	Blindness transient	✓	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Cough	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Immunisation reaction	✓	✓	✓
SD	Influenza like illness	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Seasonal allergy	✓	✓	✓
SD	Skin odour abnormal	✓	✓	✓
SD	Urticaria	✓	✓	✓
SRO	Poor quality sleep	·	·	✓

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