Z5P-11014-62274

2 vaccinations 9 coded responses 22 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 853 / AZ
Registered: 2021-04-05

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

2021-04-05
Registered in v-safe
2021-04-05
Dose 1 — Moderna
2021-04-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 1
MedDRA: Mobility decreased, Pain in extremity — Feeling: Good · Site: Pain

Free text: Just the arm is sore and cant raise it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle fatigue — Feeling: Good · Site: Pain

Free text: I have less pain at th site than yesterday. Also, muscle fatigue in my legs last night not reported since I had not yet experienced it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Had a headache every day but not sure if it's the vaccine or me. I get them sometimes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site discomfort, Neuralgia, Pain — Feeling: Fair · Site: Pain

Free text: I lifted my arm up and touched where the injection site was. Ever since then my arm is uncomfortable like when you hit your funny bone. Like nerve pain. All down my arm to my hand. Yesterday it was better but today since raising my arm is worse.

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

Adult check-in
2021-04-13
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-03
Survey response — day 28, dose 1
MedDRA: Irritable bowel syndrome, Pre-existing disease — Feeling: Fair

Free text: I have IBS. Since the vaccine, my stomach issues have been acting up. I am not sure if its the vaccine or not. I didnt report it but I never thought it could be. Then someone told me it can affect those with IBD so though maybe IBS too.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Dose 2 — Moderna
2021-05-17
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Glands are swollen in my neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Survey response — days 1–6 daily, dose 2
MedDRA: Gastric disorder, Pre-existing disease — Feeling: Good · Headache, Fatigue or tiredness, Abdominal pain

Free text: I have IBS. Stomach is acting up. Suspect its the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal discomfort — Feeling: Fair · Diarrhea · Be unable to do your normal daily activities

Free text: Upset stomach

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-13
Survey response — 3 months, dose 2
MedDRA: Gastritis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Gastritis. This was just diagnosed July 12.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-13
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-09
Call 1 — Left Voicemail
2021-12-09
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-14
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-05	Moderna
2	2021-05-14	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-08-13	Successful 2021-12-09	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-06

Systemic reaction (other): Just the arm is sore and cant raise it.

2021-04-07

Systemic reaction (other): I have less pain at th site than yesterday. Also, muscle fatigue in my legs last night not reported since I had not yet experienced it.

2021-04-08

Systemic reaction (other): Had a headache every day but not sure if it's the vaccine or me. I get them sometimes.

2021-04-09

Systemic reaction (other): I lifted my arm up and touched where the injection site was. Ever since then my arm is uncomfortable like when you hit your funny bone. Like nerve pain. All down my arm to my hand. Yesterday it was better but today since raising my arm is worse.

Release 8 — day 28, dose 1

2021-05-03

Symptoms: I have IBS. Since the vaccine, my stomach issues have been acting up. I am not sure if its the vaccine or not. I didnt report it but I never thought it could be. Then someone told me it can affect those with IBD so though maybe IBS too.

Release 8 — days 1–6 daily, dose 2

2021-05-17

Systemic reaction (other): Glands are swollen in my neck

2021-05-18

Systemic reaction (other): I have IBS. Stomach is acting up. Suspect its the vaccine.

2021-05-19

Systemic reaction (other): Upset stomach

Release 9 — 3 months, dose 2

2021-08-13

Symptoms: Gastritis. This was just diagnosed July 12.

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	Gastritis	✓	·	✓
SD	Irritable bowel syndrome	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Gastric disorder	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site discomfort	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Muscle fatigue	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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