YA9-12882-20850

3 vaccinations 6 coded responses 19 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 920 / CA
Registered: 2021-04-28

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

2021-04-28
Registered in v-safe
2021-04-28
Dose 1 — Moderna
2021-04-28
Survey response — day 0, dose 1
MedDRA: Arthralgia, Impaired work ability, Mobility decreased — Feeling: Poor · Site: Pain, Redness · Joint pains, Muscle or body aches · Be unable to work, 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: I cant move my shoulder. Very painful - pain level is 9 out of 10. This is my 2nd moderna dose. I cant get dress without crying. I cant work either.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — day 0, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-04-29
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-30
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to do your normal daily activities

Free text: Pain at the injection sight of my arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — days 1–6 daily, dose 1
MedDRA: Fluid retention, Weight increased — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches · Be unable to do your normal daily activities

Free text: I gained 5 pounds since 5 days ago. Lots of water retention

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-02
Survey response — days 1–6 daily, dose 1
MedDRA: Fluid retention, Localised oedema, Oedema peripheral — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I gained a lot of water weight since I had the vaccine. I developed water retention in my ankles and shoulder back area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Fluid retention — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Nausea · Be unable to do your normal daily activities

Free text: Lots of water retention in my shoulder. Pain in my shoulder. Wearing a lidocaine patch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-05-05
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-05-12
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-05-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-06-01
Dose 2 — Moderna
2021-06-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-07-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-07-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-31
Survey response — 3 months, dose 2
MedDRA: Blood cholesterol increased, Hypothyroidism, Vaginal disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Vaginal issues, hypothyroid - new diagnosis, high chloresterol

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-31
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-01
Call 1 — Could Not Reach Participant
2021-09-15
Call 2 — Could Not Reach Participant
2021-11-22
Dose 3 — Moderna
2021-12-01
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-28	Moderna
2	2021-06-01	Moderna
3	2021-11-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-28	Unsuccessful
2021-04-29	Unsuccessful
2021-08-31	Unsuccessful

Free text

Release 8 — day 0, dose 1

2021-04-28

Systemic reaction (other): I cant move my shoulder. Very painful - pain level is 9 out of 10. This is my 2nd moderna dose. I cant get dress without crying. I cant work either.

Release 8 — days 1–6 daily, dose 1

2021-04-30

Systemic reaction (other): Pain at the injection sight of my arm

2021-05-01

Systemic reaction (other): I gained 5 pounds since 5 days ago. Lots of water retention

2021-05-02

Systemic reaction (other): I gained a lot of water weight since I had the vaccine. I developed water retention in my ankles and shoulder back area.

2021-05-03

Systemic reaction (other): Lots of water retention in my shoulder. Pain in my shoulder. Wearing a lidocaine patch

Release 9 — 3 months, dose 2

2021-08-31

Symptoms: Vaginal issues, hypothyroid - new diagnosis, high chloresterol

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	Blood cholesterol increased	✓	·	✓
SD	Hypothyroidism	✓	·	✓
SD	Vaginal disorder	✓	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Fluid retention	✓	✓	✓
SRO	Impaired work ability	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Localised oedema	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Weight increased	✓	✓	✓

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