YZ9-19335-57865

2 vaccinations 7 coded responses 18 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 466 / IN
Registered: 2021-01-22

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Moderna
2021-01-22
Health check-in — day 0, dose 1
Feeling: Fair · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain — Feeling: Fair

Free text: Pain UNDER the arm I got the injection in

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — day 7, dose 1
MedDRA: Pain in extremity — Feeling: Good

Free text: Soreness under the arm of injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-19
Dose 2 — Moderna
2021-02-26
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-05
Survey response — day 14, dose 2
MedDRA: Arthralgia, Fatigue, Insomnia — Feeling: Fair · Be unable to work

Free text: Fatigue, joint pain, insomnia.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 21, dose 2
MedDRA: Gallbladder disorder, Toothache — Feeling: Fair · Be unable to work, 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: Gallbladder problems. Problems with pain in my teeth.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 21, 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)
2021-03-19
Survey response — day 28, dose 2
MedDRA: Toothache — Feeling: Fair · Be unable to do your normal daily activities

Free text: My teeth hurt really bad.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — day 35, dose 2
MedDRA: Toothache, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: My teeth have become horribly painful. · Healthcare visit (other): Made an appointment to be checked out

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-21
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-21
Survey response — 6 months, dose 2
MedDRA: Rash, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I now have a strange rash on various parts of my body. Never had anything like this before. Not sure if this is related to the horrible side effects from the vaccine · Healthcare visit (other): Visit next week

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-21
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-24
Call 1 — Left Voicemail
2021-08-24
Call 1 — Left Voicemail
2021-08-24
Call 1 — Left Voicemail
2022-02-19
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-19	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-12	Unsuccessful
2021-03-28	Unsuccessful
2021-08-21	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-28

Systemic reaction (other): Pain UNDER the arm I got the injection in

Release 3 — day 7, dose 1

2021-01-29

Systemic reaction (other): Soreness under the arm of injection

Release 5 — day 14, dose 2

2021-03-05

Symptoms: Fatigue, joint pain, insomnia.

Release 5 — day 21, dose 2

2021-03-12

Symptoms: Gallbladder problems. Problems with pain in my teeth.

Release 6 — day 28, dose 2

2021-03-19

Symptoms: My teeth hurt really bad.

Release 6 — day 35, dose 2

2021-03-28

Symptoms: My teeth have become horribly painful.

Healthcare visit (other): Made an appointment to be checked out

Release 9 — 6 months, dose 2

2021-08-21

Symptoms: I now have a strange rash on various parts of my body. Never had anything like this before. Not sure if this is related to the horrible side effects from the vaccine

Healthcare visit (other): Visit next week

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	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gallbladder disorder	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Rash	✓	·	✓
SD	Toothache	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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