ZU4-32102-27478

5 vaccinations 9 coded responses 42 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 021 / MA
Registered: 2021-03-26

Relationship: Self
Race: Multiracial
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-26
Registered in v-safe
2021-03-26
Dose 1 — Moderna
2021-03-26
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Abdominal pain

Adult check-in
2021-04-02
Health check-in — day 7, dose 1
Feeling: Fair · Diarrhea, Abdominal pain · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-04-02
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-09
Survey response — day 14, dose 1
MedDRA: Abdominal pain upper, Diarrhoea — Feeling: Good · Be unable to work

Free text: On and off stomach pains and loose bowels or diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 21, dose 1
MedDRA: Throat irritation — Feeling: Good

Free text: A scratchy itchy throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Dose 2 — Moderna
2021-04-23
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-04-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-30
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-05-07
Survey response — day 14, dose 2
MedDRA: Arthralgia, Back pain, Pain in extremity — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I've had paid in lower back and right thigh and knee

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-14
Survey response — day 21, dose 2
MedDRA: Arthralgia, Back pain, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lower back pain that spread to my right thigh and knee and calf

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-14
Call 1 — Left Voicemail
2021-06-14
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-07-23
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Back pain, Physiotherapy — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Lower back pain that goes down to right knee · Healthcare visit (other): Physical therapy

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-23
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-02
Call successful
Participant prefers to complete VAERS report online
2021-10-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Dose 3 — Moderna
2021-11-05
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Abdominal pain

Adult check-in
2021-11-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2021-11-12
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-11-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-10
Survey response — day 35, dose 3
MedDRA: Ear pain, Pain, Pain in jaw — Feeling: Good

Free text: Sudden onset of right jaw pain that travels to right ear pain comes and goes

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-04
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-05-06
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-06-18
Dose 4 — Moderna
2022-09-20
Survey response — 3 months, dose 4
MedDRA: Back disorder, Chest pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I've had back problems and random chest pains

MedDRA releases: 2024-11 · check-in free text available
2022-11-10
Dose 5 — Moderna
2022-12-17
Survey response — 6 months, dose 4
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: After my bivalent covid vaccine I had severe pain in my shoulders that has just now started to ease up.

MedDRA releases: 2024-11 · check-in free text available
2023-05-13
Survey response — 6 months, dose 5
MedDRA: Arthralgia, Myalgia — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-26	Moderna
2	2021-04-23	Moderna
3	2021-11-05	Moderna	No
4	2022-06-18	Moderna	No
5	2022-11-10	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 7 — day 14, dose 1

2021-04-09

Symptoms: On and off stomach pains and loose bowels or diarrhea

Release 7 — day 21, dose 1

2021-04-16

Symptoms: A scratchy itchy throat

Release 8 — day 14, dose 2

2021-05-07

Symptoms: I've had paid in lower back and right thigh and knee

Release 8 — day 21, dose 2

2021-05-14

Symptoms: Lower back pain that spread to my right thigh and knee and calf

Release 9 — 3 months, dose 2

2021-07-23

Symptoms: Lower back pain that goes down to right knee

Healthcare visit (other): Physical therapy

Release 10 — day 35, dose 3

2021-12-10

Symptoms: Sudden onset of right jaw pain that travels to right ear pain comes and goes

Release 12 — 3 months, dose 4

2022-09-20

Symptoms: I've had back problems and random chest pains

Release 12 — 6 months, dose 4

2022-12-17

Symptoms: After my bivalent covid vaccine I had severe pain in my shoulders that has just now started to ease up.

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	Physiotherapy	✓	·	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Back disorder	·	·	✓
SD	Back pain	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Ear pain	·	·	✓
SD	Myalgia	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Pain in jaw	·	·	✓
SD	Throat irritation	✓	✓	✓

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