XUH-29671-95213

4 vaccinations 6 coded responses 41 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 954 / CA
Registered: 2021-03-15

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

2021-03-05
Dose 1 — Moderna
2021-03-15
Registered in v-safe
2021-03-15
Health check-in — 7 day, dose 1
Feeling: Fair · Site: Redness, Swelling, Itching · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-19
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-03-26
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-02
Health check-in — 0 day, dose 2
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-04-09
Health check-in — 7 day, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-07-02
Survey response — 3 month, dose 2
MedDRA: Fatigue, Malaise, Palpitations — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-07-02
Report sent to call center — 3 month, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-07
Call 1 — Left Voicemail
2021-08-21
Dose 3 — Moderna
2021-08-22
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-08-23
Survey response — days 1–6 daily, dose 3
MedDRA: Cold sweat — Feeling: Fair · Site: Pain · Chills, Headache · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-24
Survey response — days 1–6 daily, dose 3
MedDRA: Cold sweat — Feeling: Good · Site: Pain

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-08-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-08-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-08-28
Health check-in — 7 day, dose 3
Feeling: Good · None

Adult check-in
2021-09-04
Survey response — 14 day, dose 3
MedDRA: Herpes simplex, Oral herpes, Reaction to previous exposure to any vaccine, Vaccine positive rechallenge — Feeling: Good

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-09-11
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-09-18
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2021-09-25
Survey response — 35 day, dose 3
MedDRA: Cold sweat, Cough, Nasopharyngitis, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-10-02
Health check-in — 42 day, dose 3
Feeling: Fair

Adult check-in
2021-11-20
Health check-in — 3 month, dose 3
Feeling: Good

Adult check-in
2022-02-19
Survey response — 6 month, dose 3
MedDRA: Campylobacter infection — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

MedDRA releases: 2024-11 · check-in answers available
2022-02-19
Report sent to call center — 6 month, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-02-24
Call 1 — Left Voicemail
2022-05-09
Dose 4 — Moderna
2022-05-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-05-16
Health check-in — 7 day, dose 4
Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-23
Health check-in — 14 day, dose 4
Feeling: Good

Adult check-in
2022-05-30
Health check-in — 21 day, dose 4
Feeling: Good

Adult check-in
2022-06-06
Health check-in — 28 day, dose 4
Feeling: Good

Adult check-in
2022-06-13
Health check-in — 35 day, dose 4
Feeling: Good

Adult check-in
2022-06-20
Health check-in — 42 day, dose 4
Feeling: Good

Adult check-in
2022-08-08
Health check-in — 3 month, dose 4
Feeling: Good

Adult check-in
2022-11-07
Health check-in — 6 month, dose 4
Feeling: Good

Adult check-in
2023-05-09
Health check-in — 12 month, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-02	Moderna
3	2021-08-21	Moderna	No
4	2022-05-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-02	Unsuccessful
2022-02-19	Unsuccessful

Free text

Release 9

Symptoms: Funny heart palpitations, intense fatigue, and general malaise. Saw my internist who did an EKG and blood work (checking heart, thyroid and glucose) but noted all tests were normal. But I still dont feel quite right. Doubt its related to vaccin

Systemic reaction (other): SEVERE cold sweats for over 18 hours

Systemic reaction (other): Cold sweats

Symptoms: I got a cold sore/Heroes Simplex on my lip - I only decided to mention it because the same thing happened after my 2nd vaccine!

Symptoms: Bad cold, cold sweats, sore throat and cough. Got a Covid Test as a precaution and it was negative.

Release 11

Symptoms: Campylobacteriosis. Really affected my liver.

Free-text releases are not linked to a specific 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	Campylobacter infection	·	·	✓
SD	Cold sweat	·	·	✓
SD	Cough	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Herpes simplex	✓	·	✓
SD	Malaise	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Oral herpes	✓	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Palpitations	✓	✓	✓
SD	Reaction to previous exposure to any vaccine	✓	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vaccine positive rechallenge	✓	·	✓
SRO	Cold sweat	✓	·	✓

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