YK6-17037-54069

3 vaccinations 6 coded responses 33 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 853 / AZ
Registered: 2021-03-12

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

2021-03-12
Registered in v-safe
2021-03-12
Dose 1 — Moderna
2021-03-12
Survey response — day 0, dose 1
MedDRA: Dizziness, Immediate post-injection reaction, Self-medication — Feeling: Fair · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dizziness started following injection about 30 min later. I took Benadryl as per dr orders prior to the shot. Hrs later still dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease, Rash macular — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: My lupus (macular) rash became visiable today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 7, dose 1
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-26
Survey response — day 14, dose 1
MedDRA: Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sudden sharp pain in my leg.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-08
Dose 2 — Moderna
2021-04-08
Survey response — day 0, dose 2
MedDRA: Emergency care, Muscle spasms — Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Ended up in er w devere muscle spasms abd nuro issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — day 0, dose 2
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)
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None · Be unable to work

Adult check-in
2021-04-15
Survey response — day 7, dose 2
MedDRA: Nasal congestion, Nasopharyngitis, Oxygen saturation decreased, Pre-existing disease — Feeling: Poor · Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Oxygen low but probabaly not related as om chronic. Also severe stuffness and head cxold symptoms .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-13
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-20
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-08
Health check-in — 3 months, dose 2
Feeling: Poor

Adult check-in
2021-10-07
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Nausea

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Fair · Headache

Adult check-in
2021-11-05
Survey response — day 14, dose 3
MedDRA: Nasopharyngitis, Pre-existing disease — Feeling: Fair

Free text: Picked up a cold. I've a weekend immune system so i wasn't surprised. Otherwise i feel fine. The shot didn't trigger a lupus or fibro flare, no soreness in the arm etc so it was just coincidence

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-17
Call 1 — Could Not Reach Participant
2021-12-22
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Moderna
2	2021-04-08	Moderna
3	2021-10-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-08	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-12

Systemic reaction (other): Dizziness started following injection about 30 min later. I took Benadryl as per dr orders prior to the shot. Hrs later still dizzy

Release 5 — days 1–6 daily, dose 1

2021-03-18

Systemic reaction (other): My lupus (macular) rash became visiable today

Release 6 — day 14, dose 1

2021-03-26

Symptoms: Sudden sharp pain in my leg.

Release 7 — day 0, dose 2

2021-04-08

Systemic reaction (other): Ended up in er w devere muscle spasms abd nuro issues

Release 7 — day 7, dose 2

2021-04-15

Systemic reaction (other): Oxygen low but probabaly not related as om chronic. Also severe stuffness and head cxold symptoms .

Release 10 — day 14, dose 3

2021-11-05

Symptoms: Picked up a cold. I've a weekend immune system so i wasn't surprised. Otherwise i feel fine. The shot didn't trigger a lupus or fibro flare, no soreness in the arm etc so it was just coincidence

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	Nasopharyngitis	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Oxygen saturation decreased	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rash macular	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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