ZJN-10237-03892

2 vaccinations 12 coded responses 26 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 027 / MA
Registered: 2021-03-02

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

2021-03-02
Registered in v-safe
2021-03-02
Dose 1 — Moderna
2021-03-02
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Nausea

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Burning sensation, Condition aggravated, Intervertebral disc protrusion, Pre-existing disease — Feeling: Fair · Site: Pain, Redness · Joint pains, Nausea

Free text: Burning sensation left side neck, shoulder,shoulder blade. I have herniated discs in my neck and those areas bother me when things flare up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Burning sensation — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Same burning sensation on left neck, shoulder, shoulder blade & arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Hypoaesthesia, Paraesthesia — Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Numbness & tingling in my left hand

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Burning sensation, Pre-existing disease — Feeling: Good · Fatigue or tiredness

Free text: Left side old injury still burning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-03-31
Survey response — day 0, dose 2
MedDRA: Burning sensation — Feeling: Good · Site: Pain

Free text: Burning like last shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Ageusia — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: No sense of taste since the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Ageusia — Feeling: Good

Free text: No sense of taste

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — day 7, dose 2
MedDRA: Ageusia — Feeling: Good

Free text: No taste

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-04-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-05
Survey response — day 35, dose 2
MedDRA: Diarrhoea — Feeling: Fair

Free text: Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — day 42, dose 2
MedDRA: Asthenia, Fatigue, Gastrointestinal disorder — Feeling: Fair

Free text: Tired a lot, low energy bowel issues, ect

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-29
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Fatigue, Mood swings, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities

Free text: Tired from the start to finish of my dayWorsened pre existing condition which have been control for yearsMood swings ect

MedDRA releases: 2024-11 · check-in free text available
2022-03-31
Survey response — 12 months, dose 2
MedDRA: Feeling abnormal, Gastrointestinal disorder, Office visit — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Digestive & bowel issues I just haven't felt them same since I started the Series · Healthcare visit (other): Endoscopy Trips to the ask Gastro intestinal doctor

MedDRA releases: 2024-11 · check-in free text available
2022-03-31
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-04
Call 1 — Left Voicemail
2022-04-05
Call 2 — Left Voicemail
2022-04-05
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-03-31	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-03-31	Successful 2022-04-05	Participant prefers to complete VAERS report online

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): Burning sensation left side neck, shoulder,shoulder blade. I have herniated discs in my neck and those areas bother me when things flare up

2021-03-04

Systemic reaction (other): Same burning sensation on left neck, shoulder, shoulder blade & arm

2021-03-07

Systemic reaction (other): Numbness & tingling in my left hand

2021-03-08

Systemic reaction (other): Left side old injury still burning

Release 6 — day 0, dose 2

2021-03-31

Systemic reaction (other): Burning like last shot

Release 6 — days 1–6 daily, dose 2

2021-04-05

Systemic reaction (other): No sense of taste since the shot

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): No sense of taste

Release 7 — day 7, dose 2

2021-04-07

Systemic reaction (other): No taste

Release 8 — day 35, dose 2

2021-05-05

Symptoms: Diarrhea

Release 8 — day 42, dose 2

2021-05-12

Symptoms: Tired a lot, low energy bowel issues, ect

Release 9 — 6 months, dose 2

2021-09-29

Symptoms: Tired from the start to finish of my dayWorsened pre existing condition which have been control for yearsMood swings ect

Release 11 — 12 months, dose 2

2022-03-31

Symptoms: Digestive & bowel issues I just haven't felt them same since I started the Series

Healthcare visit (other): Endoscopy Trips to the ask Gastro intestinal doctor

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	Asthenia	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	·	·	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Mood swings	·	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Ageusia	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Intervertebral disc protrusion	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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