ZZ2-31662-97242

4 vaccinations 12 coded responses 36 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 730 / OK
Registered: 2021-01-14

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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Moderna
2021-01-14
Health check-in — day 0, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site swelling, Myalgia, Pain, Self-medication — Feeling: Good

Free text: Yesterday evening, I had muscle pain and a mild swelling around my injection spot like someone had hit the area. Pain radiated through the muscles down my arm for about two hrs. I took ibuprofen and it went away. No pain after that.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Survey response — day 7, dose 1
MedDRA: No adverse event, Unevaluable event — Feeling: Fair · Fever · Abdominal pain

Free text: My normal temp is 96.0

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event, Office visit — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): none · Healthcare visit (other): doctor's office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Night sweats, Pyrexia — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness

Free text: I soaked my sheets during the night when I had a fever. I have never done that.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-03-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-19
Survey response — day 21, dose 2
MedDRA: Pruritus, Rash — Feeling: Good

Free text: I seem to be having a lot of my itching from sudden pop up rashes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Rash — Feeling: Good

Free text: I am having frequent autoimmune rashes. Prior to the vaccine, I didn't typically have a rash but once a year. Now, it's several times a week

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-11-17
Call successful
Participant prefers to complete VAERS report online
2022-02-25
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-07-22
Dose 4 — Moderna
2022-07-26
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-07-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2022-07-28
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Fair · Site: Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text:

MedDRA releases: 2024-11 · check-in free text available
2022-07-29
Health check-in — day 7, dose 4
Feeling: Poor · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-08-05
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-08-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-08-19
Survey response — day 28, dose 4
MedDRA: Loss of personal independence in daily activities, Osteoarthritis, Pre-existing disease, Urticaria — Feeling: Fair · Be unable to do your normal daily activities

Free text: Since my vaccine, I have multiple autoimmune utucaria flare ups and osteoarthritis flare ups.befie this last immunization booster, I had only had one autoimmune episodein 4 years. I wasn't able to do my. Volunteer work or church

MedDRA releases: 2024-11 · check-in free text available
2022-08-26
Survey response — day 35, dose 4
MedDRA: Pre-existing disease, Urticaria — Feeling: Good

Free text: I have developed multiple autoimmune utucaria outbreaks since receiving my last immunization of moderna. Prior to this, I had only had two outbreaks over a four-year period the outbreaks occur on my face in the form of giant hives.

MedDRA releases: 2024-11 · check-in free text available
2022-09-02
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-10-21
Survey response — 3 months, dose 4
MedDRA: Dyspnoea, Heart rate increased — Feeling: Good · Be unable to do your normal daily activities

Free text: Rapid heart beat of 129+ at times., shortness of breath.

MedDRA releases: 2024-11 · check-in free text available
2023-01-20
Survey response — 6 months, dose 4
MedDRA: Atrial fibrillation, Cardiac disorder, Dyspnoea, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-01-20
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2023-01-23
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-25	Moderna
3	2021-10-29	Moderna	No
4	2022-07-22	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-19

Systemic reaction (other): Yesterday evening, I had muscle pain and a mild swelling around my injection spot like someone had hit the area. Pain radiated through the muscles down my arm for about two hrs. I took ibuprofen and it went away. No pain after that.

Release 2 — day 7, dose 1

2021-01-21

Systemic reaction (other): My normal temp is 96.0

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): none

Healthcare visit (other): doctor's office

2021-02-27

Systemic reaction (other): I soaked my sheets during the night when I had a fever. I have never done that.

Release 5 — day 21, dose 2

2021-03-19

Symptoms: I seem to be having a lot of my itching from sudden pop up rashes.

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: I am having frequent autoimmune rashes. Prior to the vaccine, I didn't typically have a rash but once a year. Now, it's several times a week

Release 12 — days 1–6 daily, dose 4

2022-07-26

Systemic reaction (other): No

2022-07-28

Release 12 — day 28, dose 4

2022-08-19

Symptoms: Since my vaccine, I have multiple autoimmune utucaria flare ups and osteoarthritis flare ups.befie this last immunization booster, I had only had one autoimmune episodein 4 years. I wasn't able to do my. Volunteer work or church

Release 12 — day 35, dose 4

2022-08-26

Symptoms: I have developed multiple autoimmune utucaria outbreaks since receiving my last immunization of moderna. Prior to this, I had only had two outbreaks over a four-year period the outbreaks occur on my face in the form of giant hives.

Release 12 — 3 months, dose 4

2022-10-21

Symptoms: Rapid heart beat of 129+ at times., shortness of breath.

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	Atrial fibrillation	·	·	✓
SD	Cardiac disorder	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Loss of personal independence in daily activities	·	·	✓
SD	Osteoarthritis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Urticaria	·	·	✓
SRO	Injection site swelling	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Unevaluable event	✓	·	✓

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