ZM5-62981-44847

5 vaccinations 7 coded responses 48 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 122 / NY
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

2021-03-06
Dose 1 — Moderna
2021-04-03
Dose 2 — Moderna
2021-04-05
Registered in v-safe
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-04-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-10
Survey response — day 35, dose 2
MedDRA: Muscle spasms, Sleep disorder, Telemedicine — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Saturday night, 5/8/21: Severe muscle cramps on left side of body near rib cage; woke me from a sound sleep around 1:30 a.m. and lasted more than 30 minutes. I had never before experienced anything like it. Did a telehealth call around 2 a.m.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-03
Dose 3 — Moderna
2021-11-03
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Body temperature increased — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: My body temp was 95.5 before the shot, so 99,5 is feverish!

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Good · Site: Pain · Chills, Nausea

Free text: Lack of appetite

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Chills, Nausea

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-19
Survey response — day 14, dose 3
MedDRA: Injection site pain — Feeling: Good

Free text: Left arm at site of booster shot ached for several days earlier this week.

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-02
Survey response — 3 months, dose 3
MedDRA: Injection site pain — Feeling: Good

Free text: Upper left arm (site of vaccines, booster, & flu shot) periodically aches; have been unable to discern any pattern/cause (weather, food, activity, etc).

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Call successful
Not applicable - Accidental Reporting
2022-05-06
Dose 4 — Moderna
2022-05-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-06
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-05-07
Survey response — days 1–6 daily, dose 4
MedDRA: Injection site pain, Pain — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Nausea · Be unable to do your normal daily activities

Free text: My arm near the injection site is painful when I try to do anything with that arm

MedDRA releases: 2024-11 · check-in free text available
2022-05-08
Survey response — days 1–6 daily, dose 4
MedDRA: Diarrhoea — Feeling: Fair · Site: Pain · Headache, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Diarrhea started last night around 2100

MedDRA releases: 2024-11 · check-in free text available
2022-05-09
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-05-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Diarrhea

Adult check-in
2022-05-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Diarrhea

Adult check-in
2022-05-13
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-20
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-10
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-17
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-05
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-12
Dose 5 — Moderna
Co-administered: Flu
2022-10-03
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-10
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-18
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-24
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-12
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-03-13
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-06	Moderna
2	2021-04-03	Moderna
3	2021-11-03	Moderna	No
4	2022-05-06	Moderna	No
5	2022-09-12	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-05-10	Successful 2022-04-18	Not applicable - Accidental Reporting

Free text

Release 8 — day 35, dose 2

2021-05-10

Symptoms: Saturday night, 5/8/21: Severe muscle cramps on left side of body near rib cage; woke me from a sound sleep around 1:30 a.m. and lasted more than 30 minutes. I had never before experienced anything like it. Did a telehealth call around 2 a.m.

Release 10 — days 1–6 daily, dose 3

2021-11-04

Systemic reaction (other): My body temp was 95.5 before the shot, so 99,5 is feverish!

2021-11-06

Systemic reaction (other): Lack of appetite

Release 10 — day 14, dose 3

2021-11-19

Symptoms: Left arm at site of booster shot ached for several days earlier this week.

Release 11 — 3 months, dose 3

2022-02-02

Symptoms: Upper left arm (site of vaccines, booster, & flu shot) periodically aches; have been unable to discern any pattern/cause (weather, food, activity, etc).

Release 11 — days 1–6 daily, dose 4

2022-05-07

Systemic reaction (other): My arm near the injection site is painful when I try to do anything with that arm

2022-05-08

Systemic reaction (other): Diarrhea started last night around 2100

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	Injection site pain	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Sleep disorder	✓	✓	✓
SD	Telemedicine	✓	✓	✓
SRO	Body temperature increased	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Diarrhoea	·	·	✓
SRO	Injection site pain	·	·	✓
SRO	Pain	·	·	✓

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