23P-10838-22030

3 vaccinations 4 coded responses 41 check-ins 4 free-text entries 4 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 134 / NY
Registered: 2021-05-15

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

2021-05-15
Registered in v-safe
2021-05-15
Dose 1 — Moderna
2021-05-15
Health check-in — 0 day, dose 1
Feeling: Good · None

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-05-17
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion — Feeling: Fair · Site: Pain · Headache, Muscle or body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-22
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-05-31
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-06-05
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-06-12
Dose 2 — Moderna
2021-06-12
Health check-in — 0 day, dose 2
Feeling: Good · None

Adult check-in
2021-06-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-06-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Joint pains, Muscle or body aches · Be unable to work or attend school

Adult check-in
2021-06-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-06-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-06-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-06-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-06-19
Health check-in — 7 day, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-06-26
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-07-03
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-07-10
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-07-17
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-07-24
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-09-11
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-12-11
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2021-12-15
Dose 3 — Moderna
Co-administered: Flu
2021-12-15
Health check-in — 0 day, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-12-15
Report sent to call center — 0 day, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-12-16
Call 2 — Left Voicemail
2021-12-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches

Adult check-in
2021-12-17
Call 3 — Left Voicemail
2021-12-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-22
Health check-in — 7 day, dose 3
Feeling: Good · None

Adult check-in
2021-12-29
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2022-01-05
Survey response — 21 day, dose 3
MedDRA: Fatigue, Headache, Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2022-01-05
Report sent to call center — 21 day, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-06
Call successful
Does not wish to fill out VAERS report
2022-01-12
Survey response — 28 day, dose 3
MedDRA: COVID-19, Fatigue, Pain, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2022-01-12
Report sent to call center — 28 day, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-13
Call 1 — Left Voicemail
2022-01-19
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2022-01-28
Health check-in — 42 day, dose 3
Feeling: Good

Adult check-in
2022-03-16
Health check-in — 3 month, dose 3
Feeling: Good

Adult check-in
2022-06-15
Survey response — 6 month, dose 3
MedDRA: Hypertension, Oedema — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2022-06-15
Report sent to call center — 6 month, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-16
Call 1 — Left Voicemail
2022-06-16
Call 1 — Left Voicemail
2022-06-16
Call 2 — Left Voicemail
2022-06-16
Call 1 — Left Voicemail
2022-12-15
Health check-in — 12 month, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-15	Moderna
2	2021-06-12	Moderna
3	2021-12-15	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-12-15	Successful	Does not wish to fill out VAERS report
2022-01-05	Successful 2022-01-06	Does not wish to fill out VAERS report
2022-01-12	Unsuccessful
2022-06-15	Unsuccessful

Free text

Release 8

Systemic reaction (other): Stuffy nose - similar to sinus/allergy

Release 10

Symptoms: Congestion, headache, sore throat, fatigue

Symptoms: Covid 19 - congestion, body aches, fatigue

Release 12

Symptoms: High blood pressure, edema

Free-text releases are not linked to a specific 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	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Hypertension	·	·	✓
SD	Oedema	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Nasal congestion	✓	✓	✓

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