UYK-16960-44457

2 vaccinations 7 coded responses 14 check-ins 7 free-text entries 7 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 212 / MD
Registered: 2021-01-12

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

2021-01-12
Registered in v-safe
2021-01-12
Dose 1 — Moderna
2021-01-12
Health check-in — day 0, dose 1
Feeling: Fair · Headache

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-13
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Poor · Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-16
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Oxygen saturation decreased — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Shortness of breath, lower pulse ox

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 work · Be unable to do your normal daily activities

1 call case(s)
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Oxygen saturation decreased — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shortness of breath, low SP02

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Survey response — day 7, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Intermittent shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — day 14, dose 1
MedDRA: Anaemia, Deep vein thrombosis, Pulmonary embolism — Feeling: Poor · Be unable to work, 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: Bilateral Pulmonary embolism, DVT in entire left leg, severe anemias

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Report sent to call center — day 14, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-17
Dose 2 — Moderna
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-26
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

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

Adult check-in
2021-05-19
Survey response — 3 months, dose 2
MedDRA: Deep vein thrombosis, Pulmonary embolism — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Bilateral PEs and Left DVT complete leg, two veins

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-31
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-17	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-13	priority 2/3
2021-01-15	priority 2/3
2021-01-16	priority 2/3
2021-01-17	priority 2/3
2021-01-18	priority 2/3
2021-01-26	Successful	Does not wish to fill out VAERS report
2021-05-19	Successful 2021-05-31	Does not wish to fill out VAERS report

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Shortness of breath

2021-01-16

Systemic reaction (other): Shortness of breath, lower pulse ox

2021-01-17

Systemic reaction (other): Shortness of breath, low SP02

2021-01-18

Systemic reaction (other): Shortness of breath

Release 2 — day 7, dose 1

2021-01-19

Systemic reaction (other): Intermittent shortness of breath

Release 2 — day 14, dose 1

2021-01-26

Symptoms: Bilateral Pulmonary embolism, DVT in entire left leg, severe anemias

Release 8 — 3 months, dose 2

2021-05-19

Symptoms: Bilateral PEs and Left DVT complete leg, two veins

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
SD	Anaemia	✓	✓	✓
SD	Deep vein thrombosis	✓	✓	✓
SD	Pulmonary embolism	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Oxygen saturation decreased	✓	✓	✓

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