3DC-26512-54012

5 vaccinations 12 coded responses 43 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 338 / FL
Registered: 2021-04-07

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

2021-03-10
Dose 1 — Moderna
2021-04-07
Registered in v-safe
2021-04-07
Dose 2 — Moderna
2021-04-07
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-14
Health check-in — day 7, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-05
Survey response — day 28, dose 2
MedDRA: Abdominal distension, Diarrhoea, Discomfort — Feeling: Fair

Free text: Diarrhea, stomach bloating, pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Extreme fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-07
Survey response — 3 months, dose 2
MedDRA: Respiratory tract congestion — Feeling: Fair

Free text: chest congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-06
Survey response — 6 months, dose 2
MedDRA: Fatigue, Sinus congestion, Wheezing — Feeling: Fair

Free text: Sinus congestion wheezing. Fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-11-12
Dose 3 — Moderna
2022-04-07
Survey response — 12 months, dose 2
MedDRA: Office visit, Respiratory tract congestion, Sinus congestion — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Chest congestion. Sinus congestion · Healthcare visit (other): Office visit

MedDRA releases: 2024-11 · check-in free text available
2022-04-07
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-11
Call 1 — Left Voicemail
2022-05-15
Dose 4 — Moderna
2022-05-17
Survey response — days 1–6 daily, dose 4
MedDRA: Respiratory tract congestion, Wheezing — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Wheezing, chest congestion

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-22
Health check-in — day 7, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-06-03
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-05
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-19
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-26
Survey response — day 42, dose 4
MedDRA: Abdominal discomfort, Malaise — Feeling: Fair

Free text: Not feeling well, abdominal discomfort

MedDRA releases: 2024-11 · check-in free text available
2022-08-14
Survey response — 3 months, dose 4
MedDRA: Cough, Sinus congestion, Sinus headache — Feeling: Fair

Free text: Sinus congestion, cough, sinus headache

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Dose 5 — Moderna
2022-10-05
Health check-in — day 0, dose 5
Feeling: Good · None

Adult check-in
2022-10-06
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Adult check-in
2022-10-07
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-10-08
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-10-09
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-10-10
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-10-11
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-10-12
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-19
Survey response — day 14, dose 5
MedDRA: Fatigue, Pyrexia, Sinus congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extremely tired, feverish, sinus congestion

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Survey response — day 21, dose 5
MedDRA: Chills, Malaise, Nausea, Office visit, Pyrexia — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional

Free text: Symptoms: Sick, chills. Severe nausea, feverish · Healthcare visit (other): Doctor office visit

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Report sent to call center — day 21, dose 5
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-31
Call successful
Participant prefers to complete VAERS report online
2022-10-31
Call successful
Participant prefers to complete VAERS report online
2022-11-03
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-11-09
Survey response — day 35, dose 5
MedDRA: Epistaxis, Fatigue, Impaired work ability — Feeling: Fair · Be unable to work or attend school

Free text: Nose bleed today, fatigue, went home from work after controlling the nose bleed in case it happens again.

MedDRA releases: 2024-11 · check-in free text available
2022-11-16
Survey response — day 42, dose 5
MedDRA: Pain, Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: UTI, sore all over. Don't know if my Rheumatoid Arthritis is part of the problem.

MedDRA releases: 2024-11 · check-in free text available
2022-11-16
Report sent to call center — day 42, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-04
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-05
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-07	Moderna
3	2021-11-12	Moderna	No
4	2022-05-15	Moderna	No
5	2022-10-05	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 8 — day 28, dose 2

2021-05-05

Symptoms: Diarrhea, stomach bloating, pressure

Release 8 — day 35, dose 2

2021-05-12

Symptoms: Extreme fatigue

Release 9 — 3 months, dose 2

2021-07-07

Symptoms: chest congestion

Release 10 — 6 months, dose 2

2021-10-06

Symptoms: Sinus congestion wheezing. Fatigue

Release 11 — 12 months, dose 2

2022-04-07

Symptoms: Chest congestion. Sinus congestion

Healthcare visit (other): Office visit

Release 11 — days 1–6 daily, dose 4

2022-05-17

Systemic reaction (other): Wheezing, chest congestion

Release 12 — day 42, dose 4

2022-06-26

Symptoms: Not feeling well, abdominal discomfort

Release 12 — 3 months, dose 4

2022-08-14

Symptoms: Sinus congestion, cough, sinus headache

Release 12 — day 14, dose 5

2022-10-19

Symptoms: Extremely tired, feverish, sinus congestion

Release 12 — day 21, dose 5

2022-10-28

Symptoms: Sick, chills. Severe nausea, feverish

Healthcare visit (other): Doctor office visit

Release 12 — day 35, dose 5

2022-11-09

Symptoms: Nose bleed today, fatigue, went home from work after controlling the nose bleed in case it happens again.

Release 12 — day 42, dose 5

2022-11-16

Symptoms: UTI, sore all over. Don't know if my Rheumatoid Arthritis is part of the problem.

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	Abdominal discomfort	·	·	✓
SD	Abdominal distension	✓	✓	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Discomfort	✓	✓	✓
SD	Epistaxis	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Impaired work ability	·	·	✓
SD	Malaise	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sinus congestion	·	·	✓
SD	Sinus headache	·	·	✓
SD	Urinary tract infection	·	·	✓
SD	Wheezing	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Wheezing	·	·	✓

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