YJU-93600-71917

4 vaccinations 27 coded responses 45 check-ins 27 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 077 / NJ
Registered: 2021-04-01

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

2021-04-01
Registered in v-safe
2021-04-01
Dose 1 — Moderna
2021-04-01
Health check-in — day 0, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 1
MedDRA: Irritability — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Severe irritability

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Joint stiffness, Musculoskeletal stiffness — Feeling: Good · Headache, Fatigue or tiredness, Diarrhea

Free text: Stiff fingers with occasional numbness. Stiff knee

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2021-04-15
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site induration, Injection site mass, Injection site pruritus, Pruritus — Feeling: Good

Free text: Itchy spots on low back, leg, chest and injection site. Just 1 spot each location. Hard lump at injection site. Slight red at injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 21, dose 1
MedDRA: Headache, Office visit, Rash, Vertigo — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Rash on arm spread and still feels sore in that area and i have a headache everyday. Today i have vertigo · Healthcare visit (other): family doctor office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-28
Dose 2 — Moderna
2021-04-28
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperhidrosis — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Night sweats — Feeling: Fair · Site: Itching · Headache, Nausea · Be unable to do your normal daily activities

Free text: Night sweats. Woke up soaking wet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling — Feeling: Poor · Site: Pain, Redness, Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Called doctor office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Temperature 96.1-97.1

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Survey response — days 1–6 daily, dose 2
MedDRA: Body temperature decreased, Hyperhidrosis — Feeling: Fair · Site: Itching · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Low temperature 96.0-96.5F and sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-05
Health check-in — day 7, dose 2
Feeling: Poor · Headache · Be unable to do your normal daily activities

Adult check-in
2021-05-13
Survey response — day 14, dose 2
MedDRA: Fatigue, Insomnia, Rash pruritic, Tinnitus — Feeling: Fair

Free text: Itchy rash on lower belly in skin fold. Ringing in my ears. Insomnia. Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 21, dose 2
MedDRA: Brain fog, Mood swings, Muscle spasms, Musculoskeletal stiffness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Mood swings, brain fog, stiff muscles with spasms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 28, dose 2
MedDRA: Arthralgia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Back of both legs ache.Extreme fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue is extreme

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-09
Survey response — day 42, dose 2
MedDRA: Blood glucose increased, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: More severe headachesIncreased blood sugar and now I'm diabetic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-28
Survey response — 3 months, dose 2
MedDRA: Drug hypersensitivity, Fatigue, Office visit, Pre-existing disease, Rash, Sinusitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Sinus infection Became allergic to penicillinrashPrescribed medicine for diabetes Severe exhaustion · Healthcare visit (other): In office pcp and specialist

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-28
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)
2021-08-03
Call 1 — Left Voicemail
2021-10-27
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-20
Dose 3 — Moderna
2021-12-23
Survey response — days 1–6 daily, dose 3
MedDRA: Facial pain, Muscular weakness, Tinnitus — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: face pain, knees giving out, ears ringing

MedDRA releases: 2024-11 · check-in free text available
2021-12-25
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: armpit is swollen for past 72 hours

MedDRA releases: 2024-11 · check-in free text available
2021-12-26
Survey response — days 1–6 daily, dose 3
MedDRA: Oedema peripheral — Feeling: Fair · Site: Itching · Headache, Joint pains, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: armpit swollen

MedDRA releases: 2024-11 · check-in free text available
2021-12-27
Health check-in — day 7, dose 3
Feeling: Good · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-01-03
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-10
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-01-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-25
Survey response — day 35, dose 3
MedDRA: Arthralgia, Headache, Tendonitis — Feeling: Good · Be unable to do your normal daily activities

Free text: Joint pain. Tendinitis. Headaches

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Survey response — day 42, dose 3
MedDRA: Arthralgia, Musculoskeletal stiffness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint pain. Can't bend fingers. Required steroid injection.

MedDRA releases: 2024-11 · check-in free text available
2022-03-21
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-06-22
Survey response — 6 months, dose 3
MedDRA: Rash — Feeling: Good

Free text: Rash under right arm near arm pit

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Dose 4 — Moderna
2022-09-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-09-23
Survey response — days 1–6 daily, dose 4
MedDRA: Insomnia — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Insomnia last night

MedDRA releases: 2024-11 · check-in free text available
2022-09-24
Health check-in — day 7, dose 4
Feeling: Poor · Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-10-01
Survey response — day 14, dose 4
MedDRA: Headache, Muscle tightness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscles in neck tightened up for 2 days. Getting more frequent headaches but not sure if it's weather related

MedDRA releases: 2024-11 · check-in free text available
2022-10-08
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-15
Survey response — day 28, dose 4
MedDRA: Fatigue, Headache, Irritability, Oropharyngeal pain, Paranasal sinus hypersecretion, Sinus congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sinus congestion and drainage. Headaches. Fatigue. Irritability. Sore throat.

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Survey response — day 35, dose 4
MedDRA: Fatigue, Heart rate irregular — Feeling: Poor · Be unable to do your normal daily activities

Free text: Extreme exhaustion. I walk across the room and heart rate goes to 100. I sit down and it slowly goes back to 77. O2 levels 97-99% so not an issue.

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Survey response — day 42, dose 4
MedDRA: Fatigue, Office visit, Tachycardia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Tachycardia with bouts of extreme fatigue. Diagnosed by PCP · Healthcare visit (other): Office visit with PCP

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Report sent to call center — day 42, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-31
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-31
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-31
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-31
Call successful
Does not wish to fill out VAERS report
2022-12-18
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-03-18
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Moderna
2	2021-04-28	Moderna
3	2021-12-20	Moderna	No
4	2022-09-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-22	Successful 2022-10-31	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-05-01	Successful 2022-10-31	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-07-28	Successful 2022-10-31	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-29	Successful 2022-10-31	Does not wish to fill out VAERS report

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-02

Systemic reaction (other): Severe irritability

2021-04-05

Systemic reaction (other): Stiff fingers with occasional numbness. Stiff knee

Release 7 — day 14, dose 1

2021-04-15

Symptoms: Itchy spots on low back, leg, chest and injection site. Just 1 spot each location. Hard lump at injection site. Slight red at injection site.

Release 7 — day 21, dose 1

2021-04-22

Symptoms: Rash on arm spread and still feels sore in that area and i have a headache everyday. Today i have vertigo

Healthcare visit (other): family doctor office visit

Release 8 — day 0, dose 2

2021-04-28

Systemic reaction (other): Light headed

Release 8 — days 1–6 daily, dose 2

2021-04-29

Systemic reaction (other): sweats

2021-04-30

Systemic reaction (other): Night sweats. Woke up soaking wet

2021-05-01

Healthcare visit (other): Called doctor office

2021-05-02

Systemic reaction (other): Temperature 96.1-97.1

2021-05-03

Systemic reaction (other): Low temperature 96.0-96.5F and sweats

Release 8 — day 14, dose 2

2021-05-13

Symptoms: Itchy rash on lower belly in skin fold. Ringing in my ears. Insomnia. Fatigue

Release 8 — day 21, dose 2

2021-05-19

Symptoms: Mood swings, brain fog, stiff muscles with spasms

Release 8 — day 28, dose 2

2021-05-26

Symptoms: Back of both legs ache.Extreme fatigue

Release 8 — day 35, dose 2

2021-06-02

Symptoms: Fatigue is extreme

Release 9 — day 42, dose 2

2021-06-09

Symptoms: More severe headachesIncreased blood sugar and now I'm diabetic

Release 9 — 3 months, dose 2

2021-07-28

Symptoms: Sinus infection Became allergic to penicillinrashPrescribed medicine for diabetes Severe exhaustion

Healthcare visit (other): In office pcp and specialist

Release 10 — days 1–6 daily, dose 3

2021-12-23

Systemic reaction (other): face pain, knees giving out, ears ringing

2021-12-25

Systemic reaction (other): armpit is swollen for past 72 hours

2021-12-26

Systemic reaction (other): armpit swollen

Release 11 — day 35, dose 3

2022-01-25

Symptoms: Joint pain. Tendinitis. Headaches

Release 11 — day 42, dose 3

2022-02-01

Symptoms: Joint pain. Can't bend fingers. Required steroid injection.

Release 12 — 6 months, dose 3

2022-06-22

Symptoms: Rash under right arm near arm pit

Release 12 — days 1–6 daily, dose 4

2022-09-23

Systemic reaction (other): Insomnia last night

Release 12 — day 14, dose 4

2022-10-01

Symptoms: Muscles in neck tightened up for 2 days. Getting more frequent headaches but not sure if it's weather related

Release 12 — day 28, dose 4

2022-10-15

Symptoms: Sinus congestion and drainage. Headaches. Fatigue. Irritability. Sore throat.

Release 12 — day 35, dose 4

2022-10-22

Symptoms: Extreme exhaustion. I walk across the room and heart rate goes to 100. I sit down and it slowly goes back to 77. O2 levels 97-99% so not an issue.

Release 12 — day 42, dose 4

2022-10-29

Symptoms: Tachycardia with bouts of extreme fatigue. Diagnosed by PCP

Healthcare visit (other): Office visit with PCP

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Blood glucose increased	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Drug hypersensitivity	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Heart rate irregular	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site induration	✓	✓	✓
SD	Injection site mass	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Irritability	·	·	✓
SD	Mood swings	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Muscle tightness	·	·	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Office visit	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Sinus congestion	·	·	✓
SD	Sinusitis	✓	·	✓
SD	Tachycardia	·	·	✓
SD	Tendonitis	·	·	✓
SD	Tinnitus	✓	✓	✓
SD	Vertigo	✓	✓	✓
SRO	Body temperature decreased	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Facial pain	·	·	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Insomnia	·	·	✓
SRO	Irritability	✓	✓	✓
SRO	Joint stiffness	✓	✓	✓
SRO	Muscular weakness	·	·	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Oedema peripheral	·	·	✓
SRO	Tinnitus	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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