5XX-12936-19727

4 vaccinations 8 coded responses 33 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 190 / PA
Registered: 2021-02-11

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

2021-02-11
Registered in v-safe
2021-02-11
Dose 1 — Moderna
2021-02-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-25
Survey response — day 14, dose 1
MedDRA: Arthralgia — Feeling: Good

Free text: Joint pain

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

Adult check-in
2021-03-11
Dose 2 — Moderna
2021-03-11
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperhidrosis — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Sweaty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · 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
2021-03-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-22
Survey response — day 42, dose 2
MedDRA: Cough, Nasopharyngitis, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: I think its a bad cold, congestion, runny nose, cough. Caught it from my grandbaby, as did her mother who is also fully vaccinated . Getting a Covid test today just to put minds at ease

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-28
Dose 3 — Moderna
2021-09-09
Survey response — 6 months, dose 2
MedDRA: Fall, Hospitalisation, Joint arthroplasty, Joint injury — 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: Fell and shattered elbow. Recovering from 2 hospitalizations (one in Covid infested Florida) and elbow replacement surgery 9/1

MedDRA releases: 2024-11 · check-in free text available
2021-09-09
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-09-13
Call 1 — Left Voicemail
2022-03-11
Survey response — 12 months, dose 2
MedDRA: COVID-19, Cough, Nasopharyngitis — 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, Outpatient clinic or urgent care clinic visit

Free text: COVID 1/26/22, recovered but currently have cold and cough

MedDRA releases: 2024-11 · check-in free text available
2022-03-11
Report sent to call center — 12 months, dose 2
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-14
Call successful
Does not wish to fill out VAERS report
2022-03-14
Call successful
Does not wish to fill out VAERS report
2022-04-14
Dose 4 — Moderna
2022-04-29
Health check-in — day 14, dose 4
Feeling: Good

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

Adult check-in
2022-05-12
Survey response — day 28, dose 4
MedDRA: Adverse reaction, Nasopharyngitis — Feeling: Good

Free text: Cold or allergy symptoms but not covid

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-26
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-14
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-13
Survey response — 6 months, dose 4
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I don't remember last time I did this. I was COVID +again 7/19 and got rebound COVID on 8/1

MedDRA releases: 2024-11 · check-in free text available
2023-04-14
Survey response — 12 months, dose 4
MedDRA: Ear infection, Office visit, Pre-existing disease, Sinusitis — 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

MedDRA releases: 2024-11
2023-04-14
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-04-17
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-11	Moderna
3	2021-08-28	Moderna	No
4	2022-04-14	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-25

Symptoms: Joint pain

Release 5 — days 1–6 daily, dose 2

2021-03-12

Systemic reaction (other): Sweaty

Release 7 — day 42, dose 2

2021-04-22

Symptoms: I think its a bad cold, congestion, runny nose, cough. Caught it from my grandbaby, as did her mother who is also fully vaccinated . Getting a Covid test today just to put minds at ease

Release 9 — 6 months, dose 2

2021-09-09

Symptoms: Fell and shattered elbow. Recovering from 2 hospitalizations (one in Covid infested Florida) and elbow replacement surgery 9/1

Release 11 — 12 months, dose 2

2022-03-11

Symptoms: COVID 1/26/22, recovered but currently have cold and cough

Release 11 — day 28, dose 4

2022-05-12

Symptoms: Cold or allergy symptoms but not covid

Release 12 — 6 months, dose 4

2022-10-13

Symptoms: I don't remember last time I did this. I was COVID +again 7/19 and got rebound COVID on 8/1

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	Adverse reaction	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Ear infection	·	·	✓
SD	Fall	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Joint arthroplasty	·	·	✓
SD	Joint injury	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sinusitis	·	·	✓
SRO	Hyperhidrosis	✓	✓	✓

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