6YB-25230-95914

5 vaccinations 6 coded responses 24 check-ins 5 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 423 / KY
Registered: 2021-02-17

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
Dose 1 — Moderna
2021-02-17
Registered in v-safe
2021-02-17
Survey response — day 35, dose 1
MedDRA: Herpes zoster, Office visit, Pain, Pruritus, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: @2 1/2 weeks after my 1st shot I started noticing a breakout with itching/stinging. Went to the Dr. and was diagnosed with shingles. · Healthcare visit (other): Dr office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Report sent to call center — day 35, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-01
Dose 2 — Moderna
2021-03-01
Survey response — day 0, dose 2
MedDRA: Pain in extremity — Feeling: Fair · Headache

Free text: Soreness of the arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Headache

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-13
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-02
Survey response — 3 months, dose 2
MedDRA: Hypoacusis, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Having issues with hearing, but have no idea if theres any connection. Seems to have come on quickly. Have a Dr appt scheduled for Friday 6-4. · Healthcare visit (other): Scheduled appt with family Dr.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-24
Call successful
Does not wish to fill out VAERS report
2021-06-24
Call successful
Does not wish to fill out VAERS report
2021-08-30
Survey response — 6 months, dose 2
MedDRA: Back disorder, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Issues with back problems · Healthcare visit (other): Family doctor visit

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-30
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call 2 — Left Voicemail
2021-08-31
Call successful
Participant prefers to complete VAERS report online
2021-09-09
Dose 3 — Moderna
2021-10-27
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-10
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-06-03
Dose 4 — Moderna
2022-06-27
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-07-01
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-07-08
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-07-15
Survey response — day 42, dose 4
MedDRA: Ear disorder, Headache, Hypoacusis, Office visit, Tinnitus — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Problem with right ear. Noises in ear which made it difficult to hear. Had been having issue with headache over a period of time Which I thought might be related to problem with ear, but ear problem just started this past week. · Healthcare visit (other): Primary care doctor visit

MedDRA releases: 2024-11 · check-in free text available
2022-07-15
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-18
Call 1 — Left Voicemail
2022-07-18
Call 1 — Left Voicemail
2022-07-18
Call 1 — Left Voicemail
2022-07-18
Call 2 — Left Voicemail
2022-09-23
Dose 5 — Moderna
2023-03-24
Survey response — 6 months, dose 5
MedDRA: Cough, Discharge, Headache, Influenza, Office visit, Sinus pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-24
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-27
Call 1 — Left Voicemail
2023-03-27
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-03-01	Moderna
3	2021-09-09	Moderna	No
4	2022-06-03	Moderna	No
5	2022-09-23	Moderna	No

Call center

5 call center cases

3 successful · 2 unsuccessful

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 4 — day 35, dose 1

2021-02-17

Symptoms: @2 1/2 weeks after my 1st shot I started noticing a breakout with itching/stinging. Went to the Dr. and was diagnosed with shingles.

Healthcare visit (other): Dr office visit

Release 4 — day 0, dose 2

2021-03-01

Systemic reaction (other): Soreness of the arm

Release 8 — 3 months, dose 2

2021-06-02

Symptoms: Having issues with hearing, but have no idea if theres any connection. Seems to have come on quickly. Have a Dr appt scheduled for Friday 6-4.

Healthcare visit (other): Scheduled appt with family Dr.

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: Issues with back problems

Healthcare visit (other): Family doctor visit

Release 12 — day 42, dose 4

2022-07-15

Symptoms: Problem with right ear. Noises in ear which made it difficult to hear. Had been having issue with headache over a period of time Which I thought might be related to problem with ear, but ear problem just started this past week.

Healthcare visit (other): Primary care doctor visit

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	Back disorder	✓	·	✓
SD	Cough	·	·	✓
SD	Discharge	·	·	✓
SD	Ear disorder	·	·	✓
SD	Headache	·	·	✓
SD	Herpes zoster	✓	✓	✓
SD	Hypoacusis	✓	✓	✓
SD	Influenza	·	·	✓
SD	Office visit	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Sinus pain	·	·	✓
SD	Tinnitus	·	·	✓
SRO	Pain in extremity	✓	✓	✓

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