X58-90559-38565

3 vaccinations 8 coded responses 35 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 921 / CA
Registered: 2021-02-02

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

2021-01-30
Dose 1 — Moderna
2021-02-02
Registered in v-safe
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-01
Dose 2 — Moderna
2021-03-01
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-02
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, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

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

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · 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: Fair · Fatigue or tiredness

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

Adult check-in
2021-03-23
Survey response — day 21, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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: Good

Adult check-in
2021-04-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-01
Survey response — 6 months, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Chronic fatigue

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-01
Dose 3 — Moderna
2021-12-01
Survey response — day 0, dose 3
MedDRA: Office visit, Self-medication — Feeling: Good

Free text: Took prophylactic Zyrtec & ibuprofen on advice of MD

MedDRA releases: 2024-11 · check-in free text available
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-10
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-17
Survey response — day 14, dose 3
MedDRA: Fatigue, Headache — Feeling: Good

Free text: Headache and fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-12-22
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-29
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-12
Survey response — day 42, dose 3
MedDRA: Dyspnoea — Feeling: Good

Free text: Heavy breathing

MedDRA releases: 2024-11 · check-in free text available
2022-03-02
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-03
Survey response — 6 months, dose 3
MedDRA: COVID-19, Echocardiogram abnormal — Feeling: Poor · Be unable to work or attend school, 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

Free text: COVID positive & abnormal EKG

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-06-07
Call 1 — Left Voicemail
2022-12-01
Survey response — 12 months, dose 3
MedDRA: COVID-19, Dyspnoea, Headache, Respiratory symptom — Feeling: Good · Be unable to work or attend school, 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

Free text: COVID-19 dx, difficulty breathing, headache, other URI sx

MedDRA releases: 2024-11 · check-in free text available
2022-12-01
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-12-02
Call 2 — Left Voicemail
2022-12-02
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna
2	2021-03-01	Moderna
3	2021-12-01	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-06-03	Unsuccessful
2022-12-01	Unsuccessful

Free text

Release 4 — day 14, dose 1

2021-02-13

Symptoms: Fatigue

Release 6 — day 21, dose 2

2021-03-23

Symptoms: Fatigue

Release 9 — 6 months, dose 2

2021-09-01

Symptoms: Chronic fatigue

Release 10 — day 0, dose 3

2021-12-01

Systemic reaction (other): Took prophylactic Zyrtec & ibuprofen on advice of MD

Release 10 — day 14, dose 3

2021-12-17

Symptoms: Headache and fatigue

Release 10 — day 42, dose 3

2022-01-12

Symptoms: Heavy breathing

Release 11 — 6 months, dose 3

2022-06-03

Symptoms: COVID positive & abnormal EKG

Release 12 — 12 months, dose 3

2022-12-01

Symptoms: COVID-19 dx, difficulty breathing, headache, other URI sx

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	COVID-19	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Echocardiogram abnormal	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Respiratory symptom	·	·	✓
SRO	Office visit	·	·	✓
SRO	Self-medication	·	·	✓

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