4Y4-81285-57259

3 vaccinations 7 coded responses 37 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 026 / MA
Registered: 2021-02-23

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

2021-02-23
Registered in v-safe
2021-02-23
Dose 1 — Moderna
2021-02-23
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · 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
2021-03-09
Survey response — day 14, dose 1
MedDRA: Injection site pain, Injection site rash, Rash pruritic — Feeling: Good

Free text: On day eight got a very itchy rash around injection site and injection site was very sore. This lasted for two days.

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

Adult check-in
2021-03-23
Dose 2 — Moderna
2021-03-23
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Headache

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-12-01
Dose 3 — Moderna
2021-12-01
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-05
Survey response — days 1–6 daily, dose 3
MedDRA: Nasal congestion, Oropharyngeal pain — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore Throat, Nasal Congestion

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-08
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-15
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-22
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-29
Survey response — day 28, dose 3
MedDRA: Diarrhoea, Pyrexia, Vomiting — Feeling: Poor · Be unable to do your normal daily activities

Free text: Fever, vomiting and diarrhea.

MedDRA releases: 2024-11 · check-in free text available
2022-01-05
Survey response — day 35, dose 3
MedDRA: Diarrhoea, Lethargy, Pyrexia, Vomiting — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fever vomiting diarrhea lethargic

MedDRA releases: 2024-11 · check-in free text available
2022-01-13
Survey response — day 42, dose 3
MedDRA: Lymphadenopathy, Nausea, Oropharyngeal pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Swollen glands and sore throat and nausea · Healthcare visit (other): Negative blood culture for Listeria. Will follow up with primary doctor.

MedDRA releases: 2024-11 · check-in free text available
2022-01-13
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-18
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-04
Survey response — 3 months, dose 3
MedDRA: Lymphadenopathy, Office visit, Salivary gland disorder — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Swollen neck gland for over a month. Biopsy inconclusive but probably a clogged saliva gland. Followup appointment next week. · Healthcare visit (other): Went to primary care office then ENT office.

MedDRA releases: 2024-11 · check-in free text available
2022-03-04
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-07
Call successful
Participant prefers to complete VAERS report online
2022-12-05
Survey response — 12 months, dose 3
MedDRA: Ageusia, COVID-19, Fatigue, Oropharyngeal pain, Pneumonia, SARS-CoV-2 test positive — Feeling: Poor · 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: Pneumonia , sore throat currently. Loss of taste since testing positive for Covid. General fatigue since contracting Covid.

MedDRA releases: 2024-11 · check-in free text available
2022-12-05
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 · 1 call case(s)
2022-12-06
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-23	Moderna
2	2021-03-23	Moderna
3	2021-12-01	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-09

Symptoms: On day eight got a very itchy rash around injection site and injection site was very sore. This lasted for two days.

Release 10 — days 1–6 daily, dose 3

2021-12-05

Systemic reaction (other): Sore Throat, Nasal Congestion

Release 10 — day 28, dose 3

2021-12-29

Symptoms: Fever, vomiting and diarrhea.

Release 10 — day 35, dose 3

2022-01-05

Symptoms: Fever vomiting diarrhea lethargic

Release 10 — day 42, dose 3

2022-01-13

Symptoms: Swollen glands and sore throat and nausea

Healthcare visit (other): Negative blood culture for Listeria. Will follow up with primary doctor.

Release 11 — 3 months, dose 3

2022-03-04

Symptoms: Swollen neck gland for over a month. Biopsy inconclusive but probably a clogged saliva gland. Followup appointment next week.

Healthcare visit (other): Went to primary care office then ENT office.

Release 12 — 12 months, dose 3

2022-12-05

Symptoms: Pneumonia , sore throat currently. Loss of taste since testing positive for Covid. General fatigue since contracting Covid.

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	Ageusia	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Lethargy	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rash pruritic	✓	✓	✓
SD	Salivary gland disorder	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Vomiting	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Oropharyngeal pain	·	·	✓

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