YS7-31915-51841

2 vaccinations 8 coded responses 27 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 750 / TX
Registered: 2021-01-25

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

2021-01-25
Registered in v-safe
2021-01-25
Dose 1 — Moderna
2021-01-25
Survey response — day 0, dose 1
MedDRA: Fatigue, Feeling cold — Feeling: Good · Chills, Headache, Fatigue or tiredness

Free text: Just cold and tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Chills, Fatigue or tiredness

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Fatigue, Insomnia — Feeling: Good · Chills, Fatigue or tiredness

Free text: Chills and fatigue are mild. Just not sleeping good.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-01
Dose 2 — Moderna
2021-03-01
Survey response — day 0, dose 2
MedDRA: Arthralgia, Immunisation reaction, Pain in extremity — Feeling: Fair · Chills, Muscle or body aches

Free text: My arm from shoulder to wrist has been sore since the first shot on 1/25/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Fatigue or tiredness

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site mass, Injection site swelling, Injection site warmth — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Nausea

Free text: The injection site is bigger than a silver dollar. Red. Hot. Swollen. Is this normal.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Pain in extremity — Feeling: Good · Site: Pain

Free text: Left arm is very sore and aching to my elbow.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-22
Survey response — day 21, dose 2
MedDRA: Arthralgia, Pain in extremity — Feeling: Good

Free text: Can you tell me why my arm hurts from my shoulder to my wrist. At times I can barely use it. It has been 3 weeks since my 2nd shot. Thank you.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-30
Survey response — 6 months, dose 2
MedDRA: Dizziness, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Ive been very dizzy since May. Could this be from the moderna shot. Been to the doctor 3 times. No ear infection or sinus infection. Have yo go see an ENT. · Healthcare visit (other): Saw my doctor and cardiologist

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-30
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

1 call case(s)
2021-09-08
Call 1 — Left Voicemail
2022-03-01
Survey response — 12 months, dose 2
MedDRA: Office visit, Rehabilitation therapy, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Serious issues with my leg. · Healthcare visit (other): Seen several doctors. And rehab.

MedDRA releases: 2024-11 · check-in free text available
2022-03-01
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-02
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-25	Moderna
2	2021-03-01	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-08-30	Unsuccessful
2022-03-01	Unsuccessful

Free text

Release 2 — day 0, dose 1

2021-01-25

Systemic reaction (other): Just cold and tired.

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): Chills and fatigue are mild. Just not sleeping good.

Release 4 — day 0, dose 2

2021-03-01

Systemic reaction (other): My arm from shoulder to wrist has been sore since the first shot on 1/25/21

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): The injection site is bigger than a silver dollar. Red. Hot. Swollen. Is this normal.

2021-03-06

Systemic reaction (other): Left arm is very sore and aching to my elbow.

Release 6 — day 21, dose 2

2021-03-22

Symptoms: Can you tell me why my arm hurts from my shoulder to my wrist. At times I can barely use it. It has been 3 weeks since my 2nd shot. Thank you.

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: Ive been very dizzy since May. Could this be from the moderna shot. Been to the doctor 3 times. No ear infection or sinus infection. Have yo go see an ENT.

Healthcare visit (other): Saw my doctor and cardiologist

Release 11 — 12 months, dose 2

2022-03-01

Symptoms: Serious issues with my leg.

Healthcare visit (other): Seen several doctors. And rehab.

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	✓	·	✓
HCVO	Rehabilitation therapy	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Dizziness	✓	·	✓
SD	Office visit	✓	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Unevaluable event	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Immunisation reaction	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site mass	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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