ZH6-98490-18791

3 vaccinations 13 coded responses 27 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 926 / CA
Registered: 2021-03-25

Relationship: Self
Race: Multiracial
Ethnicity: N/A

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-24
Dose 1 — Moderna
2021-03-24
Dose 2 — Moderna
2021-03-25
Registered in v-safe
2021-03-25
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Shooting pains throughout mmh y body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms — Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Free text: Leg cramp in the middle of the nite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Good · Site: Redness, Itching · Fatigue or tiredness

Free text: Unusual leg pain that wakes me up. Not like a leg cramp

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-31
Survey response — day 7, dose 2
MedDRA: Pain in extremity — Feeling: Good · Headache, Fatigue or tiredness

Free text: Unusual pain in my leg that wakes me up during the nite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-21
Survey response — day 28, dose 2
MedDRA: Pain — Feeling: Fair

Free text: achy body. Maybe arthritis?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — day 35, dose 2
MedDRA: Abdominal pain upper, Diarrhoea — Feeling: Good · Be unable to do your normal daily activities

Free text: Diarrhea & extreme upper stomach pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-23
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-22
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Pain — Feeling: Fair

Free text: Extreme pain in the shoulder when moving arm .

MedDRA releases: 2024-11 · check-in free text available
2022-01-05
Dose 3 — Moderna
2022-01-06
Survey response — days 1–6 daily, dose 3
MedDRA: Pain, Sleep disorder — Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Shooting pains kept me awake all nite

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2022-01-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Abdominal pain

Adult check-in
2022-01-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-12
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-01-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-26
Survey response — day 21, dose 3
MedDRA: Insomnia — Feeling: Good

Free text: Forgot to mention previously that I have insomnia since first vaccinated

MedDRA releases: 2024-11 · check-in free text available
2022-02-02
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-02-09
Survey response — day 35, dose 3
MedDRA: Alopecia — Feeling: Good

Free text: After booster, I noticed hair loss!

MedDRA releases: 2024-11 · check-in free text available
2022-02-16
Survey response — day 42, dose 3
MedDRA: Abdominal pain upper, Asthenia, Tremor — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe stomachs pain last nite; better now; just weak & shaky

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Survey response — 3 months, dose 3
MedDRA: Abdominal pain upper — Feeling: Good

Free text: Stomach ache

MedDRA releases: 2024-11 · check-in free text available
2022-07-06
Survey response — 6 months, dose 3
MedDRA: Fall, Office visit, Wrist fracture — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Broken wrist from falling · Healthcare visit (other): S urgeon

MedDRA releases: 2024-11 · check-in free text available
2022-07-06
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-07-07
Call 1 — Left Voicemail
2023-01-05
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-24	Moderna
2	2021-03-24	Moderna
3	2022-01-05	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-07-06	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-25

Systemic reaction (other): Shooting pains throughout mmh y body

2021-03-27

Systemic reaction (other): Leg cramp in the middle of the nite

2021-03-28

Systemic reaction (other): Unusual leg pain that wakes me up. Not like a leg cramp

Release 6 — day 7, dose 2

2021-03-31

Systemic reaction (other): Unusual pain in my leg that wakes me up during the nite

Release 7 — day 28, dose 2

2021-04-21

Symptoms: achy body. Maybe arthritis?

Release 8 — day 35, dose 2

2021-04-28

Symptoms: Diarrhea & extreme upper stomach pain

Release 9 — 6 months, dose 2

2021-09-22

Symptoms: Extreme pain in the shoulder when moving arm .

Release 10 — days 1–6 daily, dose 3

2022-01-06

Systemic reaction (other): Shooting pains kept me awake all nite

Release 11 — day 21, dose 3

2022-01-26

Symptoms: Forgot to mention previously that I have insomnia since first vaccinated

Release 11 — day 35, dose 3

2022-02-09

Symptoms: After booster, I noticed hair loss!

Release 11 — day 42, dose 3

2022-02-16

Symptoms: Severe stomachs pain last nite; better now; just weak & shaky

Release 11 — 3 months, dose 3

2022-04-06

Symptoms: Stomach ache

Release 12 — 6 months, dose 3

2022-07-06

Symptoms: Broken wrist from falling

Healthcare visit (other): S urgeon

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	·	·	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Alopecia	·	·	✓
SD	Arthralgia	·	·	✓
SD	Asthenia	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Fall	·	·	✓
SD	Insomnia	·	·	✓
SD	Pain	✓	✓	✓
SD	Tremor	·	·	✓
SD	Wrist fracture	·	·	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Sleep disorder	·	·	✓

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