Z9D-20733-31537

3 vaccinations 13 coded responses 38 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 804 / CO
Registered: 2021-03-14

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

2021-03-14
Registered in v-safe
2021-03-14
Dose 1 — Moderna
2021-03-14
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Nausea

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction, Pre-existing disease — Feeling: Good

Free text: Ive forgotten to mention that I have RA, an autoimmune condition, and take Actemra, a biologic immune suppression medication. I am so happy to get the vaccine. I am trying not to report RA symptoms that are similar to the symptom list but I believe are due to RA not the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good

Free text: RA/immune suppression. Felt all over good today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Ear infection, Malaise, Rheumatoid arthritis — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Free text: Not feeling well from my ear infection or RA

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — day 7, dose 1
MedDRA: Ear infection, Feeling abnormal — Feeling: Fair · Headache, Nausea

Free text: Besides RA, I still have a long- lasting ear infection. The doctor just switched me to a different antibiotic this morning because it was still not clearing and it is possibly why Im feeling so poorly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — day 14, dose 1
Feeling: Fair

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

Adult check-in
2021-04-11
Dose 2 — Moderna
2021-04-11
Survey response — day 0, dose 2
MedDRA: Arthralgia, Fatigue — Feeling: Fair

Free text: I have RA and am overall not feeling great with that: fatigue and joint pain. So I think if I get a fever Ill be able to know its side effect and not continuing RA symptom. Or I might not notice any side effects because RA bad feelings can feel like the side effects people have complained about, similar to body flu

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

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

Adult check-in
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease, Rheumatoid arthritis — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: This all might just be Ra symptoms now, not vaccine related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: These are probably due to my Ra, not the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Again, this is probably due to my RA, not the vaccine. My RA is not under control right now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Rheumatoid arthritis — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Again, I think Im still having uncontrolled RA symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — day 7, dose 2
MedDRA: Pre-existing disease, Rheumatoid arthritis — Feeling: Good · Fatigue or tiredness

Free text: From RA probably

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-04
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-09
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-16
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-25
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-13
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-06
Dose 3 — Moderna
2021-10-06
Health check-in — day 0, dose 3
Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-10-07
Survey response — days 1–6 daily, dose 3
MedDRA: Dry throat — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Very dry throat (not a problem, but a symptom)

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-10
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: I have RA so some of this is normal

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-10-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-13
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-10-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-27
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-10
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-05
Survey response — 3 months, dose 3
MedDRA: Adverse reaction, COVID-19, Unevaluable event — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I had Covid around Thanksgiving time and some symptoms lasted for several weeks. I'm not experiencing any symptoms any more though. · Healthcare visit (other): Chest xrays

MedDRA releases: 2024-11 · check-in free text available
2022-01-05
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-06
Call 1 — Could Not Reach Participant
2022-01-11
Call 2 — Could Not Reach Participant
2022-04-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-14	Moderna
2	2021-04-11	Moderna
3	2021-10-06	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-05	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Ive forgotten to mention that I have RA, an autoimmune condition, and take Actemra, a biologic immune suppression medication. I am so happy to get the vaccine. I am trying not to report RA symptoms that are similar to the symptom list but I believe are due to RA not the vaccine

2021-03-18

Systemic reaction (other): RA/immune suppression. Felt all over good today

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Not feeling well from my ear infection or RA

Release 6 — day 7, dose 1

2021-03-23

Systemic reaction (other): Besides RA, I still have a long- lasting ear infection. The doctor just switched me to a different antibiotic this morning because it was still not clearing and it is possibly why Im feeling so poorly

Release 7 — day 0, dose 2

2021-04-11

Systemic reaction (other): I have RA and am overall not feeling great with that: fatigue and joint pain. So I think if I get a fever Ill be able to know its side effect and not continuing RA symptom. Or I might not notice any side effects because RA bad feelings can feel like the side effects people have complained about, similar to body flu

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): This all might just be Ra symptoms now, not vaccine related

2021-04-15

Systemic reaction (other): These are probably due to my Ra, not the vaccine

2021-04-16

Systemic reaction (other): Again, this is probably due to my RA, not the vaccine. My RA is not under control right now

2021-04-17

Systemic reaction (other): Again, I think Im still having uncontrolled RA symptoms

Release 7 — day 7, dose 2

2021-04-20

Systemic reaction (other): From RA probably

Release 10 — days 1–6 daily, dose 3

2021-10-07

Systemic reaction (other): Very dry throat (not a problem, but a symptom)

2021-10-10

Systemic reaction (other): I have RA so some of this is normal

Release 10 — 3 months, dose 3

2022-01-05

Symptoms: I had Covid around Thanksgiving time and some symptoms lasted for several weeks. I'm not experiencing any symptoms any more though.

Healthcare visit (other): Chest xrays

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	Adverse reaction	·	·	✓
SD	COVID-19	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Dry throat	·	·	✓
SRO	Ear infection	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rheumatoid arthritis	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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