ZJK-66456-72394

1 vaccination 11 coded responses 16 check-ins 11 free-text entries 10 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 028 / RI
Registered: 2021-03-31

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

2021-03-31
Registered in v-safe
2021-03-31
Dose 1 — Moderna
2021-03-31
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-04-01
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Muscle or body aches

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Did bit start until after 4 pm today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea, Oropharyngeal pain — Feeling: Fair · Site: Redness, Itching · Headache, Muscle or body aches, Diarrhea, Abdominal pain · 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: Sore throat. Symptoms start late afternoon - i felt good this morning. After 3:30 4:00 symptoms start to get worse. Now I have Diarrhea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-06
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Redness, Itching · Headache · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Should I get the second vaccine since I have had reactions all week

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-07
Health check-in — day 7, dose 1
Feeling: Fair · Site: Itching · Headache, Joint pains

Adult check-in
2021-04-14
Survey response — day 14, dose 1
MedDRA: Arthralgia, Headache, Heart rate increased, Insomnia, Myalgia, Pruritus, Urticaria — Feeling: Fair · Be unable to do your normal daily activities

Free text: Rapid heart beat - received several warnings from phone, Hives itchy all over. Headaches, muscle and joint pain. DR put me on Prednisone said I cannot have second covid vaccine. Symptoms are worse in late afternoon and through the night. Cannot sleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 21, dose 1
MedDRA: Diarrhoea, Headache, Heart rate increased, Hyperhidrosis, Myalgia, Office visit — Feeling: Poor · 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: Headaches are terrible, Diarrhea- Rapid heart beat- has been setting off my watch. Heart rate has been as hig as 157 - 127 . Muscle pain- Sweating. Dr out me on Prednisone and i have completed the 6 day course and the symptoms are worse pleAse call · Healthcare visit (other): Went to his office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-28
Survey response — day 28, dose 1
MedDRA: Gastric disorder, Headache, Heart rate increased, Myalgia, Office visit, Pruritus, Urticaria — Feeling: Fair · 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: Rapid heart - headache every evening - hives itch stomach issues. Muscle aches dr said I can Not get second vaccine . Have not heard from CDC or dept of health

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-05
Survey response — day 35, dose 1
MedDRA: Headache, Heart rate abnormal, Hypersensitivity, Medical counselling, Pruritus — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Itchy - headache - Dr (b)(6) said I am allergic to the Moderna Shot and I cannnot get the second shot. My heart rate went crazy and i had many symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Report sent to call center — day 35, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-14
Survey response — day 42, dose 1
MedDRA: Headache, Myalgia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Headaches muscle aches have someone call me! I am allergic to the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Report sent to call center — day 42, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-08
Call successful
Participant prefers to complete VAERS report online
2021-06-08
Call successful
Participant prefers to complete VAERS report online
2021-06-08
Call successful
Participant prefers to complete VAERS report online
2021-06-08
Call successful
Participant prefers to complete VAERS report online
2021-06-08
Call successful
Participant prefers to complete VAERS report online
2021-06-08
Call successful
Participant prefers to complete VAERS report online
2021-06-08
Call successful
Participant prefers to complete VAERS report online
2021-06-30
Survey response — 3 months, dose 1
MedDRA: Hypersensitivity, Mass, Myalgia, Peripheral swelling — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I have muscle pains and still have lump where my covid arm was swollen -I cannot have the second shot because of my allergic reaction-i feel like I am falling through the cracks and not able to get answers. I was called by your dept but no answer

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-30
Report sent to call center — 3 months, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-06
Call successful
Does not wish to fill out VAERS report
2021-09-29
Survey response — 6 months, dose 1
MedDRA: Arthralgia, Feeling abnormal, Headache — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Joint pain arthritis headaches I have not been the same since the covid vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
Report sent to call center — 6 months, dose 1
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-02
Call successful
Does not wish to fill out VAERS report
2022-03-31
Survey response — 12 months, dose 1
MedDRA: COVID-19, Headache, Heart rate increased, Palpitations, SARS-CoV-2 antibody test positive — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I have had rapid heart beat since having COVID - I have had bad headaches - heart palpitations. I have had 3 COVID antibodies tests and as of 3/30/22 I still have long term antibodies. I was tested at CVS . Everyone should get tested for long term

MedDRA releases: 2024-11 · check-in free text available
2022-03-31
Report sent to call center — 12 months, dose 1
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-04
Call 1 — Left Voicemail
2022-04-04
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-31	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-01	Successful 2021-06-08	Participant prefers to complete VAERS report online
2021-04-05	Successful 2021-06-08	Participant prefers to complete VAERS report online
2021-04-06	Successful 2021-06-08	Participant prefers to complete VAERS report online
2021-04-21	Successful 2021-06-08	Participant prefers to complete VAERS report online
2021-04-28	Successful 2021-06-08	Participant prefers to complete VAERS report online
2021-05-05	Successful 2021-06-08	Participant prefers to complete VAERS report online
2021-05-14	Successful 2021-06-08	Participant prefers to complete VAERS report online
2021-06-30	Successful 2021-07-06	Does not wish to fill out VAERS report
2021-09-29	Successful 2021-10-02	Does not wish to fill out VAERS report
2022-03-31	Successful 2022-04-04	Participant prefers to complete VAERS report online

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-04

Systemic reaction (other): Did bit start until after 4 pm today

2021-04-05

Systemic reaction (other): Sore throat. Symptoms start late afternoon - i felt good this morning. After 3:30 4:00 symptoms start to get worse. Now I have Diarrhea.

Release 7 — days 1–6 daily, dose 1

2021-04-06

Systemic reaction (other): Should I get the second vaccine since I have had reactions all week

Release 7 — day 14, dose 1

2021-04-14

Symptoms: Rapid heart beat - received several warnings from phone, Hives itchy all over. Headaches, muscle and joint pain. DR put me on Prednisone said I cannot have second covid vaccine. Symptoms are worse in late afternoon and through the night. Cannot sleep cut off by CDC

Release 7 — day 21, dose 1

2021-04-21

Symptoms: Headaches are terrible, Diarrhea- Rapid heart beat- has been setting off my watch. Heart rate has been as hig as 157 - 127 . Muscle pain- Sweating. Dr out me on Prednisone and i have completed the 6 day course and the symptoms are worse pleAse call cut off by CDC

Healthcare visit (other): Went to his office

Release 8 — day 28, dose 1

2021-04-28

Symptoms: Rapid heart - headache every evening - hives itch stomach issues. Muscle aches dr said I can Not get second vaccine . Have not heard from CDC or dept of health

Release 8 — day 35, dose 1

2021-05-05

Symptoms: Itchy - headache - Dr (b)(6) said I am allergic to the Moderna Shot and I cannnot get the second shot. My heart rate went crazy and i had many symptoms

redacted (b)(6)

Release 8 — day 42, dose 1

2021-05-14

Symptoms: Headaches muscle aches have someone call me! I am allergic to the vaccine

Release 9 — 3 months, dose 1

2021-06-30

Symptoms: I have muscle pains and still have lump where my covid arm was swollen -I cannot have the second shot because of my allergic reaction-i feel like I am falling through the cracks and not able to get answers. I was called by your dept but no answer

Release 9 — 6 months, dose 1

2021-09-29

Symptoms: Joint pain arthritis headaches I have not been the same since the covid vaccine

Release 11 — 12 months, dose 1

2022-03-31

Symptoms: I have had rapid heart beat since having COVID - I have had bad headaches - heart palpitations. I have had 3 COVID antibodies tests and as of 3/30/22 I still have long term antibodies. I was tested at CVS . Everyone should get tested for long term cut off by CDC

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	Arthralgia	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Feeling abnormal	·	·	✓
SD	Gastric disorder	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Heart rate abnormal	✓	✓	✓
SD	Heart rate increased	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Mass	✓	✓	✓
SD	Medical counselling	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Palpitations	·	·	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	SARS-CoV-2 antibody test positive	·	·	✓
SD	Urticaria	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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