2QY-18387-42010

2 vaccinations 8 coded responses 25 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 479 / IN
Registered: 2021-01-22

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Moderna
2021-01-22
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-23
Dose 2 — Moderna
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Fatigue, Malaise, Pain — Feeling: Good · Site: Pain

Free text: I was very sick on the day after the shot . shot. Chills pain and very tired . I felt horrible now two days after the shot I feel fine .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good

Free text: Felt great today . Only horrible day was the day after the shot .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-16
Survey response — day 21, dose 2
MedDRA: Hypertension — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: My nocturnal blood pressure has been extremely high for the past two weeks . I have never had BP remain that high for so many nights in a row . My highest this week was 186/104 and heart rate of 100. Other evenings high but not that high .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-23
Survey response — day 28, dose 2
MedDRA: Hypertension, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Extremely high nocturnal blood pressure . I have not had this . Ive been taking no meds for two years and it has been regulated . Docs have run many test and cant figure why this is happening . This since second shot. · Healthcare visit (other): Medicare

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-30
Survey response — day 35, dose 2
MedDRA: Blood pressure increased — Feeling: Good

Free text: Just the nocturnal rise in blood pressure .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-25
Survey response — 3 months, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Very very tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-24
Survey response — 6 months, dose 2
MedDRA: Fatigue, Joint swelling — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Fatigue and swollen left knee

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-24
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-25
Call 1 — Left Voicemail
2022-02-23
Survey response — 12 months, dose 2
MedDRA: Dyspepsia, Office visit, Palpitations, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Horrible indigestion and heart palpitations . Feel this is the result from having Covid in October and now I'm a long hauler . Damn Covid! Problems may even be from the vaccine who REALLY KNOWS??? I'M NOT SURE WHEN U LAST CHECKED IN . Got the moniclo · Healthcare visit (other): Saw my doctor in his office .

MedDRA releases: 2024-11 · check-in free text available
2022-02-23
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-24
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-23	Moderna

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): I was very sick on the day after the shot . shot. Chills pain and very tired . I felt horrible now two days after the shot I feel fine .

2021-02-26

Systemic reaction (other): Felt great today . Only horrible day was the day after the shot .

Release 5 — day 21, dose 2

2021-03-16

Symptoms: My nocturnal blood pressure has been extremely high for the past two weeks . I have never had BP remain that high for so many nights in a row . My highest this week was 186/104 and heart rate of 100. Other evenings high but not that high .

Release 6 — day 28, dose 2

2021-03-23

Symptoms: Extremely high nocturnal blood pressure . I have not had this . Ive been taking no meds for two years and it has been regulated . Docs have run many test and cant figure why this is happening . This since second shot.

Healthcare visit (other): Medicare

Release 6 — day 35, dose 2

2021-03-30

Symptoms: Just the nocturnal rise in blood pressure .

Release 8 — 3 months, dose 2

2021-05-25

Symptoms: Very very tired

Release 9 — 6 months, dose 2

2021-08-24

Symptoms: Fatigue and swollen left knee

Release 11 — 12 months, dose 2

2022-02-23

Symptoms: Horrible indigestion and heart palpitations . Feel this is the result from having Covid in October and now I'm a long hauler . Damn Covid! Problems may even be from the vaccine who REALLY KNOWS??? I'M NOT SURE WHEN U LAST CHECKED IN . Got the moniclo cut off by CDC

Healthcare visit (other): Saw my doctor in his office .

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	Blood pressure increased	✓	✓	✓
SD	Dyspepsia	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Joint swelling	✓	·	✓
SD	Palpitations	·	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Pain	✓	✓	✓

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