4QK-32129-73995

4 vaccinations 19 coded responses 40 check-ins 18 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 190 / PA
Registered: 2021-02-24

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-23
Dose 1 — Moderna
2021-02-24
Registered in v-safe
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Chills

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

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

Adult check-in
2021-03-02
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Survey response — day 14, dose 1
MedDRA: Nasopharyngitis — Feeling: Fair

Free text: Cold

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-23
Dose 2 — Moderna
2021-03-23
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Good · Site: Pain · Abdominal pain

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-30
Survey response — day 7, dose 2
MedDRA: No adverse event — Feeling: Good

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-13
Survey response — day 21, dose 2
MedDRA: Chills — Feeling: Fair

Free text: I sometimes have chills but they don't last long.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-27
Survey response — day 35, dose 2
MedDRA: Unevaluable event — Feeling: Fair

Free text: My oxygen level has drop. When l got the vaccine it really when up higher.

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

Adult check-in
2021-06-22
Survey response — 3 months, dose 2
MedDRA: Alopecia, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: My hair is falling out and l have a large knot on my face between my eyes It has to be surgically remove. I don't know if it has anything to do with the vaccine. · Healthcare visit (other): CT scan, doctor's visits

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-22
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-29
Call successful
Participant prefers to complete VAERS report online
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Mass excision — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Mass that had to be removed feom my face.

MedDRA releases: 2024-11 · check-in free text available
2021-09-23
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2021-09-27
Call 1 — Left Voicemail
2021-10-26
Dose 3 — Moderna
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Chills

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Chills · Be unable to work or attend school

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-16
Survey response — day 21, dose 3
MedDRA: Office visit, Skin mass — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: I developed a lump in the side of my nose. · Healthcare visit (other): In office visit

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2021-11-17
Call successful
Participant prefers to complete VAERS report online
2021-11-23
Survey response — day 28, dose 3
MedDRA: Headache — Feeling: Fair

Free text: I am having headaches.

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Survey response — day 35, dose 3
MedDRA: Nasopharyngitis — Feeling: Fair

Free text: I have a cold

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Survey response — day 42, dose 3
MedDRA: Oxygen saturation abnormal — Feeling: Fair · Be unable to do your normal daily activities

Free text: Oxygen level is fluctuating.

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Survey response — 3 months, dose 3
MedDRA: Dyspnoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-01
Call 1 — Left Voicemail
2022-04-06
Dose 4 — Moderna
2022-04-20
Survey response — day 14, dose 4
MedDRA: Chills, Cough — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I got my booster 4/6, and l have been having chills every since especially at night and coughing.

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-21
Call successful
Participant prefers to complete VAERS report online
2022-04-28
Survey response — day 21, dose 4
MedDRA: Chills, Cough, Dyspnoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chills, coughing and heavy breathing

MedDRA releases: 2024-11 · check-in free text available
2022-05-08
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-13
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-05-20
Survey response — day 42, dose 4
MedDRA: Dyspnoea, Fatigue — Feeling: Fair

Free text: Very tired and sometimes short of breath

MedDRA releases: 2024-11 · check-in free text available
2023-04-06
Survey response — 12 months, dose 4
MedDRA: Chills, Cough, Office visit, Pneumonia — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-06
Report sent to call center — 12 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-07
Call 1 — Left Voicemail
2023-04-07
Callback requested for
03:30PM ET
2023-04-07
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-23	Moderna
2	2021-03-23	Moderna
3	2021-10-26	Moderna	No
4	2022-04-06	Moderna	No

Call center

6 call center cases

6 successful

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-11

Symptoms: Cold

Release 6 — day 0, dose 2

2021-03-23

Systemic reaction (other): No

Release 6 — days 1–6 daily, dose 2

2021-03-24

Systemic reaction (other): No

2021-03-26

Systemic reaction (other): No

2021-03-27

Systemic reaction (other): No

Release 6 — day 7, dose 2

2021-03-30

Systemic reaction (other): No

Release 7 — day 21, dose 2

2021-04-13

Symptoms: I sometimes have chills but they don't last long.

Release 8 — day 35, dose 2

2021-04-27

Symptoms: My oxygen level has drop. When l got the vaccine it really when up higher.

Release 9 — 3 months, dose 2

2021-06-22

Symptoms: My hair is falling out and l have a large knot on my face between my eyes It has to be surgically remove. I don't know if it has anything to do with the vaccine.

Healthcare visit (other): CT scan, doctor's visits

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: Mass that had to be removed feom my face.

Release 10 — day 21, dose 3

2021-11-16

Symptoms: I developed a lump in the side of my nose.

Healthcare visit (other): In office visit

Release 10 — day 28, dose 3

2021-11-23

Symptoms: I am having headaches.

Release 10 — day 35, dose 3

2021-12-01

Symptoms: I have a cold

Release 10 — day 42, dose 3

2021-12-07

Symptoms: Oxygen level is fluctuating.

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: Shortness of breath

Release 11 — day 14, dose 4

2022-04-20

Symptoms: I got my booster 4/6, and l have been having chills every since especially at night and coughing.

Release 11 — day 21, dose 4

2022-04-28

Symptoms: Chills, coughing and heavy breathing

Release 11 — day 42, dose 4

2022-05-20

Symptoms: Very tired and sometimes short of breath

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	Alopecia	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Mass excision	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Oxygen saturation abnormal	·	·	✓
SD	Pneumonia	·	·	✓
SD	Skin mass	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	No adverse event	✓	✓	✓

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