EXD-18594-07472

4 vaccinations 6 coded responses 45 check-ins 4 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 113 / NY
Registered: 2021-02-13

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-16
Dose 1 — Moderna
2021-02-13
Registered in v-safe
2021-02-13
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-14
Dose 2 — Moderna
2021-02-14
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-15
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-18
Dose 3 — Moderna
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-20
Survey response — days 1–6 daily, dose 3
MedDRA: SARS-CoV-2 test — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: For COVID testing as my husband tested positive

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2021-12-21
Survey response — days 1–6 daily, dose 3
MedDRA: Emergency care, SARS-CoV-2 test positive — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): Tested positive for COVID on 12/19/2021 received vaccine on 12/18/2021 · Healthcare visit (other): ER for testing and received an infusion of monocloidal antibodies

MedDRA releases: 2024-11 · check-in free text available
2021-12-21
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2021-12-22
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-12-22
Call 2 — Could Not Reach Participant
2021-12-23
Survey response — days 1–6 daily, dose 3
MedDRA: Dysphonia, Nasal congestion — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Some hoarseness, stuffy nose

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-25
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-28
Call 3 — Could Not Reach Participant
2022-01-01
Survey response — day 14, dose 3
MedDRA: Productive cough, Rhinorrhoea — Feeling: Good

Free text: Runny nose and productive cough

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-15
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-22
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-01-29
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-19
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-18
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-30
Dose 4 — Moderna
2022-11-30
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-12-01
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-12-02
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-12-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-12-04
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-12-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-12-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-12-07
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-12-14
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-12-21
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-12-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-01-06
Survey response — day 35, dose 4
MedDRA: Cough, Headache, Hyperhidrosis, Nasal congestion — Feeling: Good

MedDRA releases: 2024-11
2023-01-11
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-03-01
Survey response — 3 months, dose 4
MedDRA: Office visit, Postmenopausal haemorrhage, Uterine dilation and curettage — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-03-01
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-03-02
Call 1 — Left Voicemail
2023-03-02
Call 1 — Left Voicemail
2023-03-02
Call 1 — Left Voicemail
2023-05-31
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-16	Moderna
2	2021-02-14	Moderna
3	2021-12-18	Moderna	No
4	2022-11-30	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-12-20	Unsuccessful
2021-12-21	Unsuccessful
2023-03-01	Unsuccessful

Free text

Release 10 — days 1–6 daily, dose 3

2021-12-20

Healthcare visit (other): For COVID testing as my husband tested positive

2021-12-21

Systemic reaction (other): Tested positive for COVID on 12/19/2021 received vaccine on 12/18/2021

Healthcare visit (other): ER for testing and received an infusion of monocloidal antibodies

2021-12-23

Systemic reaction (other): Some hoarseness, stuffy nose

Release 10 — day 14, dose 3

2022-01-01

Symptoms: Runny nose and productive cough

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	Emergency care	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	SARS-CoV-2 test	·	·	✓
SD	Cough	·	·	✓
SD	Headache	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Postmenopausal haemorrhage	·	·	✓
SD	Productive cough	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Uterine dilation and curettage	·	·	✓
SRO	Dysphonia	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	SARS-CoV-2 test positive	·	·	✓

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