ZWF-20939-50176

4 vaccinations 15 coded responses 47 check-ins 14 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 070 / NJ
Registered: 2021-02-18

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

2021-02-18
Registered in v-safe
2021-02-18
Dose 1 — Moderna
2021-02-18
Health check-in — day 0, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-02-25
Health check-in — day 7, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-18
Dose 2 — Moderna
2021-03-18
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-19
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site mass — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Lump under skin at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site swelling — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Swollen at injection site and extremely red as well as part of my arm below the injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-25
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-15
Survey response — day 28, dose 2
MedDRA: Arthralgia — Feeling: Fair

Free text: Pain in tip of right shoulder, same arm that received the vaccination. Also, very sharp pain in lower left pelvis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-29
Survey response — day 42, dose 2
MedDRA: Myalgia — Feeling: Good

Free text: Achy and sore muscles all over my body

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Survey response — 3 months, dose 2
MedDRA: Eye disorder, Pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Problem with left eye and extreme body pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-16
Survey response — 6 months, dose 2
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair

Free text: Coughing and congestion

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Dose 3 — Moderna
2021-11-12
Survey response — days 1–6 daily, dose 3
MedDRA: Neck pain, Unevaluable event — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Neck pain · Healthcare visit (other): None

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Report sent to call center — days 1–6 daily, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-11-13
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Ear pain, Oropharyngeal pain — Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Cough, sore throat and ear pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Survey response — days 1–6 daily, dose 3
MedDRA: Ear pain, Sinus pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sinus and Left ear pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — days 1–6 daily, dose 3
MedDRA: Ear pain, Oropharyngeal pain — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Sore throat and ear

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Survey response — day 7, dose 3
MedDRA: Ear pain, Oropharyngeal pain — Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Free text: Sore throat and ear ache

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Call successful
Participant prefers to complete VAERS report online
2021-11-23
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-07
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-14
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-21
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-08
Survey response — 3 months, dose 3
MedDRA: Eye pain, Fatigue, Muscle spasms, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Muscle spasms in my back and right jaw. Left eye pain and extreme fatigue · Healthcare visit (other): Discussed at follow up Dr appt

MedDRA releases: 2024-11 · check-in free text available
2022-02-08
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-09
Call 1 — Left Voicemail
2022-02-17
Call 2 — Left Voicemail
2022-03-22
Call successful
Participant prefers to complete VAERS report online
2022-05-10
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-11
Survey response — 12 months, dose 3
MedDRA: Arthralgia, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscle and joint pain

MedDRA releases: 2024-11 · check-in free text available
2022-11-17
Dose 4 — Moderna
2022-11-18
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-11-19
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-11-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-11-24
Health check-in — day 7, dose 4
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2022-12-01
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-12-08
Survey response — day 21, dose 4
MedDRA: Injection site pain, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities

Free text: My right arm hurts all the time at the vaccination site down to my hand

MedDRA releases: 2024-11 · check-in free text available
2022-12-19
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2023-01-01
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-02-16
Survey response — 3 months, dose 4
MedDRA: Antinuclear antibody positive, Migraine, Pain in extremity — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-18	Moderna
2	2021-03-18	Moderna
3	2021-11-09	Moderna	No
4	2022-11-17	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-19

Systemic reaction (other): Lump under skin at injection site

2021-03-20

Systemic reaction (other): Swollen at injection site and extremely red as well as part of my arm below the injection site

Release 7 — day 28, dose 2

2021-04-15

Symptoms: Pain in tip of right shoulder, same arm that received the vaccination. Also, very sharp pain in lower left pelvis.

Release 8 — day 42, dose 2

2021-04-29

Symptoms: Achy and sore muscles all over my body

Release 9 — 3 months, dose 2

2021-06-17

Symptoms: Problem with left eye and extreme body pain

Release 9 — 6 months, dose 2

2021-09-16

Symptoms: Coughing and congestion

Release 10 — days 1–6 daily, dose 3

2021-11-12

Systemic reaction (other): Neck pain

Healthcare visit (other): None

2021-11-13

Systemic reaction (other): Cough, sore throat and ear pain

2021-11-14

Systemic reaction (other): Sinus and Left ear pain

2021-11-15

Systemic reaction (other): Sore throat and ear

Release 10 — day 7, dose 3

2021-11-16

Systemic reaction (other): Sore throat and ear ache

Release 11 — 3 months, dose 3

2022-02-08

Symptoms: Muscle spasms in my back and right jaw. Left eye pain and extreme fatigue

Healthcare visit (other): Discussed at follow up Dr appt

Release 12 — 12 months, dose 3

2022-11-11

Symptoms: Muscle and joint pain

Release 12 — day 21, dose 4

2022-12-08

Symptoms: My right arm hurts all the time at the vaccination site down to my hand

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	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Antinuclear antibody positive	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Cough	·	·	✓
SD	Eye disorder	✓	✓	✓
SD	Eye pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Injection site pain	·	·	✓
SD	Migraine	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Cough	·	·	✓
SRO	Ear pain	·	·	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site mass	✓	✓	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Neck pain	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Sinus pain	·	·	✓

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