4Q2-25687-70554

3 vaccinations 7 coded responses 38 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 920 / CA
Registered: 2021-03-25

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

2021-03-25
Registered in v-safe
2021-03-25
Dose 1 — Moderna
2021-03-25
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Good · Site: Pain · Headache

Free text: Mild headache for about an hour upon awaking.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-26
Dose 2 — Moderna
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Malaise, Myalgia, Pain, Pain in extremity, Pyrexia — Feeling: Good · Site: Pain · Headache, Nausea

Free text: The 2nd day I was very ill. Fever 101 body aches muscle pain painful arm. Unable to get out of bed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-05-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-04
Dose 3 — Moderna
2021-12-04
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains

Adult check-in
2021-12-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-11
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-18
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-25
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-01
Survey response — day 28, dose 3
MedDRA: Headache, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Neausia, headache

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Survey response — day 35, dose 3
MedDRA: Flank pain, Nausea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Just feeling sick to stomach, pain in left side under rib cage.

MedDRA releases: 2024-11 · check-in free text available
2022-01-15
Survey response — day 42, dose 3
MedDRA: Office visit, Pancreatitis, Rash — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Pancreatitis and rash · Healthcare visit (other): Doctor visit

MedDRA releases: 2024-11 · check-in free text available
2022-01-15
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-18
Call 1 — Could Not Reach Participant
2022-01-21
Call 2 — Could Not Reach Participant
2022-03-07
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-06-04
Survey response — 6 months, dose 3
MedDRA: Hospitalisation, Immunisation reaction, Nervous system disorder, Pericardial effusion — 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 · Emergency room or emergency department visit, Hospitalization

Free text: Hospitalized 4 days with Covid booster injury. Have the water around heart between sack that holds heart. It also attacked my nervous system. Now on neuronton.

MedDRA releases: 2024-11 · check-in free text available
2022-06-04
Report sent to call center — 6 months, 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-06-06
Call 3 — Left Voicemail
2022-06-06
Call 1 — Left Voicemail
2022-06-06
Call successful
Participant prefers to complete VAERS report online
2022-06-06
Call successful
Participant prefers to complete VAERS report online
2022-12-04
Survey response — 12 months, dose 3
MedDRA: Arthralgia, Diverticulitis, Eye infection, Pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Diverticulitis, eye infection, fever, aches and pains, shoulder pain in left and right shoulder

MedDRA releases: 2024-11 · check-in free text available
2022-12-04
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · 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)
2022-12-05
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-25	Moderna
2	2021-04-26	Moderna
3	2021-12-04	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-26

Systemic reaction (other): Mild headache for about an hour upon awaking.

Release 8 — days 1–6 daily, dose 2

2021-04-29

Systemic reaction (other): The 2nd day I was very ill. Fever 101 body aches muscle pain painful arm. Unable to get out of bed.

Release 10 — day 28, dose 3

2022-01-01

Symptoms: Neausia, headache

Release 10 — day 35, dose 3

2022-01-08

Symptoms: Just feeling sick to stomach, pain in left side under rib cage.

Release 10 — day 42, dose 3

2022-01-15

Symptoms: Pancreatitis and rash

Healthcare visit (other): Doctor visit

Release 11 — 6 months, dose 3

2022-06-04

Symptoms: Hospitalized 4 days with Covid booster injury. Have the water around heart between sack that holds heart. It also attacked my nervous system. Now on neuronton.

Release 12 — 12 months, dose 3

2022-12-04

Symptoms: Diverticulitis, eye infection, fever, aches and pains, shoulder pain in left and right shoulder

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	Arthralgia	·	·	✓
SD	Diverticulitis	·	·	✓
SD	Eye infection	·	·	✓
SD	Flank pain	·	·	✓
SD	Headache	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Immunisation reaction	·	·	✓
SD	Nausea	·	·	✓
SD	Nervous system disorder	·	·	✓
SD	Pain	·	·	✓
SD	Pancreatitis	·	·	✓
SD	Pericardial effusion	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rash	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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