49E-40635-53578

3 vaccinations 8 coded responses 35 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 467 / IN
Registered: 2021-02-14

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

2021-02-12
Dose 1 — Moderna
2021-02-14
Registered in v-safe
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Joint pains

Free text: I had my weekly chemo today of Taxol and Herceptin.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-12
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Had chemo on Tuesday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Chemotherapy, Emergency care — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: I am receiving chemo . My oncologist sent me to the ER to be evaluated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Survey response — day 14, dose 2
MedDRA: Heart rate increased, Hypotension — Feeling: Fair · Be unable to do your normal daily activities

Free text: B/p is running low and pulse is. High

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-13
Call 1 — Left Voicemail
2022-02-01
Dose 3 — Moderna
2022-02-01
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2022-02-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains

Adult check-in
2022-02-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-02-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-02-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-02-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-02-08
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-02-15
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-22
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-03-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-03-08
Survey response — day 35, dose 3
MedDRA: Blood pressure increased, Dizziness — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Elevated blood pressure, dizziness due to medication changes unrelated to Covid vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-03-08
Report sent to call center — day 35, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-10
Call successful
Participant prefers to complete VAERS report online
2022-03-20
Survey response — day 42, dose 3
MedDRA: Adverse drug reaction, Pre-existing disease — Feeling: Fair

Free text: Nausea, diarrhea, and fatigue from a new medication I have started to reduce chance of reoccurrence of my breast cancer.

MedDRA releases: 2024-11 · check-in free text available
2022-05-05
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-08-04
Survey response — 6 months, dose 3
MedDRA: Cough, Fatigue, SARS-CoV-2 test positive — Feeling: Good

Free text: Tested positive for Covid on 5/29. Had fatigue and a cough, no fever.

MedDRA releases: 2024-11 · check-in free text available
2023-02-01
Survey response — 12 months, dose 3
MedDRA: Autoinflammatory disease, Bronchitis, Ear infection, Mitral valve incompetence, Sinusitis, Spinal compression fracture, Tympanic membrane perforation — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-02-01
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-02-02
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2022-02-01	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-16

Systemic reaction (other): I had my weekly chemo today of Taxol and Herceptin.

Release 5 — day 0, dose 2

2021-03-12

Systemic reaction (other): Had chemo on Tuesday

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): I am receiving chemo . My oncologist sent me to the ER to be evaluated

Release 6 — day 14, dose 2

2021-03-26

Symptoms: B/p is running low and pulse is. High

Release 11 — day 35, dose 3

2022-03-08

Symptoms: Elevated blood pressure, dizziness due to medication changes unrelated to Covid vaccine.

Release 11 — day 42, dose 3

2022-03-20

Symptoms: Nausea, diarrhea, and fatigue from a new medication I have started to reduce chance of reoccurrence of my breast cancer.

Release 12 — 6 months, dose 3

2022-08-04

Symptoms: Tested positive for Covid on 5/29. Had fatigue and a cough, no fever.

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	Autoinflammatory disease	·	·	✓
HCVO	Mitral valve incompetence	·	·	✓
SD	Adverse drug reaction	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Bronchitis	·	·	✓
SD	Cough	·	·	✓
SD	Dizziness	·	·	✓
SD	Ear infection	·	·	✓
SD	Fatigue	·	·	✓
SD	Heart rate increased	✓	✓	✓
SD	Hypotension	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sinusitis	·	·	✓
SD	Spinal compression fracture	·	·	✓
SD	Tympanic membrane perforation	·	·	✓
SRO	Chemotherapy	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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