YG8-97959-13218

2 vaccinations 6 coded responses 23 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 967 / HI
Registered: 2021-04-27

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-04-27
Registered in v-safe
2021-04-27
Dose 1 — Moderna
2021-04-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-05-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-25
Dose 2 — Moderna
2021-05-25
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-26
Survey response — days 1–6 daily, dose 2
MedDRA: Gastroenteritis viral — Feeling: Fair · Site: Itching · Fever · Headache, Joint pains, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: I feel like I have a stomach flu

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-05-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-05-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-05-31
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good · Diarrhea, Abdominal pain

Free text: No rash but itchiness in other parts of my body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-15
Survey response — day 21, dose 2
MedDRA: Arthralgia, Fatigue — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Gets tired easily and unbearable knee joint pains knee pain started before the vaccination started but it seemed to have gotten worst after the 2nd vaccine. I do hand another doctor appointment tomorrow morning for the knee pain and had X-ray done .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-24
Call 1 — Left Voicemail
2021-06-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-06
Survey response — day 42, dose 2
MedDRA: Arthralgia — Feeling: Good · Be unable to do your normal daily activities

Free text: Unbearable pain in my knee cap jut I dont think it has something to do with my vaccine. C Ray showed there was a gap in between the knee caps.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-24
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Mobility decreased, Pain — Feeling: Poor · Be unable to work or attend school, 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: So much pain in my knee cap thats keeping me from functioning normally. Im almost bedridden now because this burning pain is too much to handle. Even when laying down the pain persists.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-24
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-26
Call 1 — Could Not Reach Participant
2021-08-31
Call 2 — Could Not Reach Participant
2021-11-23
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Diarrhoea, Headache, Rectal haemorrhage — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Joint pains, diarreah, discharging blood from my behind, constant headache .

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-11-30
Call 1 — Could Not Reach Participant
2021-12-03
Call 2 — Left Voicemail
2021-12-07
Call 3 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-27	Moderna
2	2021-05-25	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-06-15	Unsuccessful
2021-08-24	Unsuccessful
2021-11-23	Unsuccessful

Free text

Release 8 — days 1–6 daily, dose 2

2021-05-26

Systemic reaction (other): I feel like I have a stomach flu

2021-05-31

Systemic reaction (other): No rash but itchiness in other parts of my body

Release 9 — day 21, dose 2

2021-06-15

Symptoms: Gets tired easily and unbearable knee joint pains knee pain started before the vaccination started but it seemed to have gotten worst after the 2nd vaccine. I do hand another doctor appointment tomorrow morning for the knee pain and had X-ray done . cut off by CDC

Release 9 — day 42, dose 2

2021-07-06

Symptoms: Unbearable pain in my knee cap jut I dont think it has something to do with my vaccine. C Ray showed there was a gap in between the knee caps.

Release 9 — 3 months, dose 2

2021-08-24

Symptoms: So much pain in my knee cap thats keeping me from functioning normally. Im almost bedridden now because this burning pain is too much to handle. Even when laying down the pain persists.

Release 10 — 6 months, dose 2

2021-11-23

Symptoms: Joint pains, diarreah, discharging blood from my behind, constant headache .

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	Arthralgia	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Mobility decreased	✓	·	✓
SD	Pain	✓	·	✓
SD	Rectal haemorrhage	·	·	✓
SRO	Gastroenteritis viral	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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