YAY-28932-46042

4 vaccinations 12 coded responses 33 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 921 / CA
Registered: 2021-01-15

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

2021-01-15
Registered in v-safe
2021-01-15
Dose 1 — Moderna
2021-01-15
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-12
Dose 2 — Moderna
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Breathing slightly labored

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-19
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-26
Survey response — day 14, dose 2
MedDRA: Injection site pain — Feeling: Good

Free text: Arm still sore at injection site. Strange soreness, like a deep bruise.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — day 21, dose 2
MedDRA: Vaccination site pain — Feeling: Fair

Free text: Left arm still has derp soreness at vaccination site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 28, dose 2
MedDRA: Injection site pain, Mobility decreased, Musculoskeletal stiffness — Feeling: Good

Free text: Left arm at injection site still sore and aches. It is a strange soreness, vague but very present. Arm a bit stiff. Some arm movements are restricted more than normal.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — day 35, dose 2
MedDRA: Feeling abnormal, Injection site pain, Mobility decreased — Feeling: Good

Free text: Sore arm at injection site. Feels strange, like an echo. Slightly painful to raise arm, hurts more to touch it lightly. Fearful of someone touching my arm or bumping into something. Y

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — day 42, dose 2
MedDRA: Fatigue, Pain in extremity — Feeling: Good

Free text: Left arm still sore. Arm gets tired when driving. A bit sore deep within arm. Strange feeling like an echo. Worry about arm being bumped or touched by someone else.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — 3 months, dose 2
MedDRA: Asthenia, Injection site pain — Feeling: Fair

Free text: Continued soreness at vaccination site in left arm. Do not want my arm touched. It is sire but also feels like a hollow spot. Very strange feeling. I have also been experiencing low energy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-15
Survey response — 6 months, dose 2
MedDRA: Hypoaesthesia, Pain in extremity, Sensory disturbance — Feeling: Good

Free text: Sensation in left arm continues. It is a strange hollow feeling. Not as painful as previously.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-25
Dose 3 — Moderna
2021-11-26
Survey response — 3 months, dose 3
MedDRA: Injection site discomfort, Injection site hypoaesthesia — Feeling: Good

Free text: Still have strange feeling in upper left arm at injection site. Not painful more like a deep numbness.

MedDRA releases: 2024-11 · check-in free text available
2022-02-26
Survey response — 6 months, dose 3
MedDRA: Respiratory disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: More frequent respiratory issues

MedDRA releases: 2024-11 · check-in free text available
2022-02-26
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-17
Call 1 — Left Voicemail
2022-04-05
Dose 4 — Moderna
2022-04-14
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-04-21
Survey response — day 14, dose 4
MedDRA: Dyspnoea — Feeling: Fair

Free text: Difficulty breathing...could be weather change.

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-05
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-10
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-17
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-05
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-06
Survey response — 6 months, dose 4
MedDRA: Myalgia — Feeling: Fair

Free text: Since bivalent booster on 9/29, I have experienced muscle aches in shoulders. Mid upper back. They have diminished simce 1st night, still occur from time to time.

MedDRA releases: 2024-11 · check-in free text available
2023-04-05
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-12	Moderna
3	2021-08-25	Moderna	No
4	2022-04-05	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-26	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-13

Systemic reaction (other): Breathing slightly labored

Release 4 — day 14, dose 2

2021-02-26

Symptoms: Arm still sore at injection site. Strange soreness, like a deep bruise.

Release 5 — day 21, dose 2

2021-03-06

Symptoms: Left arm still has derp soreness at vaccination site.

Release 5 — day 28, dose 2

2021-03-12

Symptoms: Left arm at injection site still sore and aches. It is a strange soreness, vague but very present. Arm a bit stiff. Some arm movements are restricted more than normal.

Release 6 — day 35, dose 2

2021-03-19

Symptoms: Sore arm at injection site. Feels strange, like an echo. Slightly painful to raise arm, hurts more to touch it lightly. Fearful of someone touching my arm or bumping into something. Y

Release 6 — day 42, dose 2

2021-03-26

Symptoms: Left arm still sore. Arm gets tired when driving. A bit sore deep within arm. Strange feeling like an echo. Worry about arm being bumped or touched by someone else.

Release 8 — 3 months, dose 2

2021-05-14

Symptoms: Continued soreness at vaccination site in left arm. Do not want my arm touched. It is sire but also feels like a hollow spot. Very strange feeling. I have also been experiencing low energy.

Release 9 — 6 months, dose 2

2021-08-15

Symptoms: Sensation in left arm continues. It is a strange hollow feeling. Not as painful as previously.

Release 10 — 3 months, dose 3

2021-11-26

Symptoms: Still have strange feeling in upper left arm at injection site. Not painful more like a deep numbness.

Release 11 — 6 months, dose 3

2022-02-26

Symptoms: More frequent respiratory issues

Release 11 — day 14, dose 4

2022-04-21

Symptoms: Difficulty breathing...could be weather change.

Release 12 — 6 months, dose 4

2022-10-06

Symptoms: Since bivalent booster on 9/29, I have experienced muscle aches in shoulders. Mid upper back. They have diminished simce 1st night, still occur from time to time.

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	Asthenia	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Hypoaesthesia	✓	·	✓
SD	Injection site discomfort	·	·	✓
SD	Injection site hypoaesthesia	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Mobility decreased	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Respiratory disorder	·	·	✓
SD	Sensory disturbance	✓	·	✓
SD	Vaccination site pain	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓

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