YAN-29627-60760

4 vaccinations 5 coded responses 32 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 078 / NJ
Registered: 2021-03-25

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

2021-02-27
Dose 1 — Moderna
2021-03-25
Registered in v-safe
2021-03-25
Survey response — day 21, dose 1
MedDRA: Fatigue, Headache, Pain, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities

Free text: After dose 1: very sore arm for 2 days, headaches for first 3 days. On day 4, moderate to severe body aches and extreme exhaustion for 4 days. On day 8, back to normal. No fever or any other symptoms besides what's stated above.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Dose 2 — Moderna
2021-03-27
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Survey response — day 7, dose 3
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Not sure it's booster related though. I have preexisting issues.

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Survey response — day 42, dose 3
MedDRA: Chest pain, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pain in my chest (not severe) and tiredness.

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-31
Dose 4 — Moderna
2022-04-18
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-21
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-29
Survey response — 6 months, dose 4
MedDRA: Muscle spasms, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Leg cramps, like Charlie horses, that happened twice, the 1st time lasted 5 days non-stop and the 2nd time lasted for 9 days. · Healthcare visit (other): Office visit to get a prescription for a Doppler venous ultrasound to check for blood clots. No blood clots found.

MedDRA releases: 2024-11 · check-in free text available
2022-09-29
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-09-30
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-31
Health check-in — 12 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-27	Moderna
2	2021-03-27	Moderna
3	2021-10-25	Moderna	No
4	2022-03-31	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-09-29	Successful 2022-09-30	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 6 — day 21, dose 1

2021-03-25

Symptoms: After dose 1: very sore arm for 2 days, headaches for first 3 days. On day 4, moderate to severe body aches and extreme exhaustion for 4 days. On day 8, back to normal. No fever or any other symptoms besides what's stated above.

Release 6 — day 0, dose 2

2021-03-27

Systemic reaction (other): No

Release 10 — day 7, dose 3

2021-11-01

Systemic reaction (other): Not sure it's booster related though. I have preexisting issues.

Release 10 — day 42, dose 3

2021-12-06

Symptoms: Pain in my chest (not severe) and tiredness.

Release 12 — 6 months, dose 4

2022-09-29

Symptoms: Leg cramps, like Charlie horses, that happened twice, the 1st time lasted 5 days non-stop and the 2nd time lasted for 9 days.

Healthcare visit (other): Office visit to get a prescription for a Doppler venous ultrasound to check for blood clots. No blood clots found.

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	Chest pain	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Muscle spasms	·	·	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pre-existing disease	·	·	✓

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