6DU-28913-07023

4 vaccinations 13 coded responses 55 check-ins 13 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 891 / NV
Registered: 2021-01-13

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Nausea

Adult check-in
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction, Unevaluable event — Feeling: Fair · Site: Redness, Swelling, Itching · Abdominal pain · Be unable to do your normal daily activities

Free text: Improved as day has progressed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-01-27
Survey response — day 14, dose 1
MedDRA: Pruritus, Swelling — Feeling: Good

Free text: Increased itching and swelling near injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-10
Dose 2 — Moderna
2021-02-10
Survey response — day 0, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good · Site: Redness, Swelling, Itching

Free text: Slight congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-17
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-12
Survey response — 3 months, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: -

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-11
Survey response — 6 months, dose 2
MedDRA: Oral surgery, Sinus disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sinus issues following oral surgery

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-11
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-17
Call 3 — Left Voicemail
2021-10-24
Dose 3 — Moderna
2021-10-24
Health check-in — day 0, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness · Muscle or body aches

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

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 — day 7, dose 3
Feeling: Fair · Headache, Abdominal pain

Adult check-in
2021-11-07
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-14
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-28
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-23
Survey response — 3 months, dose 3
MedDRA: Cough, Headache, Nasal congestion, Oropharyngeal pain, Sneezing — Feeling: Good

Free text: Sneezing Coughing Sore throat Headache Mild nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Survey response — 6 months, dose 3
MedDRA: Dizziness, Dyspnoea, Fatigue, Headache, Oropharyngeal pain, Respiratory tract congestion — Feeling: Good · Be unable to do your normal daily activities

Free text: Headaches, dizzy, sore throat, extreme fatigue, mild congestion, SOB

MedDRA releases: 2024-11 · check-in free text available
2022-05-25
Dose 4 — Moderna
2022-05-25
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-05-26
Survey response — days 1–6 daily, dose 4
MedDRA: Dyspnoea — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: SOB

MedDRA releases: 2024-11 · check-in free text available
2022-05-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Swelling · Joint pains, Muscle or body aches, Nausea, Diarrhea

Adult check-in
2022-05-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Itching · Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2022-05-29
Survey response — days 1–6 daily, dose 4
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness

Free text: Still having some SOB problems

MedDRA releases: 2024-11 · check-in free text available
2022-05-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · None

Adult check-in
2022-05-31
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-01
Survey response — day 7, dose 4
MedDRA: Dyspnoea — Feeling: Good · Fatigue or tiredness

Free text: SOB

MedDRA releases: 2024-11 · check-in free text available
2022-06-08
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-06-15
Survey response — day 21, dose 4
MedDRA: Discomfort, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue and breath support discomfort

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-06-29
Survey response — day 35, dose 4
MedDRA: Office visit, Renal disorder — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Kidney isdues · Healthcare visit (other): In office, outpatient testing

MedDRA releases: 2024-11 · check-in free text available
2022-06-29
Report sent to call center — day 35, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-30
Call 1 — Requested Callback
2022-06-30
Call 1 — Requested Callback
2022-07-06
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-07
Call 2 — Left Voicemail
2022-07-07
Call 2 — Left Voicemail
2022-07-07
Callback requested for
2022-07-07
Call successful
Does not wish to fill out VAERS report
2022-08-24
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-11-23
Survey response — 6 months, dose 4
MedDRA: Unevaluable event — Feeling: Good · Be unable to do your normal daily activities

Free text: Cardiovasculature, Digestive, muscularure

MedDRA releases: 2024-11 · check-in free text available
2023-05-26
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna
3	2021-10-24	Moderna	No
4	2022-05-25	Moderna	No

Call center

3 call center cases

2 successful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-16

Systemic reaction (other): Improved as day has progressed

Release 2 — day 14, dose 1

2021-01-27

Symptoms: Increased itching and swelling near injection site

Release 4 — day 0, dose 2

2021-02-10

Systemic reaction (other): Slight congestion

Release 8 — 3 months, dose 2

2021-05-12

Symptoms: -

Release 9 — 6 months, dose 2

2021-08-11

Symptoms: Sinus issues following oral surgery

Release 11 — 3 months, dose 3

2022-01-23

Symptoms: Sneezing Coughing Sore throat Headache Mild nasal congestion

Release 11 — 6 months, dose 3

2022-04-24

Symptoms: Headaches, dizzy, sore throat, extreme fatigue, mild congestion, SOB

Release 11 — days 1–6 daily, dose 4

2022-05-26

Systemic reaction (other): SOB

2022-05-29

Systemic reaction (other): Still having some SOB problems

Release 11 — day 7, dose 4

2022-06-01

Systemic reaction (other): SOB

Release 12 — day 21, dose 4

2022-06-15

Symptoms: Fatigue and breath support discomfort

Release 12 — day 35, dose 4

2022-06-29

Symptoms: Kidney isdues

Healthcare visit (other): In office, outpatient testing

Release 12 — 6 months, dose 4

2022-11-23

Symptoms: Cardiovasculature, Digestive, muscularure

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	Cough	·	·	✓
SD	Discomfort	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Oral surgery	✓	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Renal disorder	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinus disorder	✓	·	✓
SD	Sneezing	·	·	✓
SD	Swelling	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Adverse reaction	✓	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Unevaluable event	○	✓	○

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