XUU-16028-62357

2 vaccinations 9 coded responses 18 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 853 / AZ
Registered: 2021-02-08

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

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

2021-02-04
Dose 1 — Moderna
2021-02-08
Registered in v-safe
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Fatigue or tiredness

Adult check-in
2021-02-11
Survey response — 7 day, dose 1
MedDRA: Office visit — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-11
Report sent to call center — 7 day, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-18
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-02-26
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-04
Health check-in — 0 day, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Gastritis — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-08
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Gastritis, Laboratory test abnormal, Vitamin B12 abnormal, Vitamin B12 increased — Feeling: Poor · Site: Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-11
Survey response — 7 day, dose 2
MedDRA: Cardiac disorder, Gastritis, Renal disorder — Feeling: Poor · Site: Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-18
Survey response — 14 day, dose 2
MedDRA: Arthralgia, Asthenia, Diverticulum, Fatigue, Gastritis, Headache, Spinal pain — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-25
Health check-in — 21 day, dose 2
Feeling: Fair

Adult check-in
2021-04-01
Survey response — 28 day, dose 2
MedDRA: Diverticulum, Tinnitus — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-08
Health check-in — 35 day, dose 2
Feeling: Fair

Adult check-in
2021-04-15
Survey response — 42 day, dose 2
MedDRA: Diverticulum intestinal, Gastritis, Tinnitus — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-07-21
Call 1 — Left Voicemail
2021-09-03
Survey response — 6 month, dose 2
MedDRA: Dysuria, Fatigue, Throat irritation — Feeling: Poor · 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: 2021-09,2024-11 · check-in answers available
2021-09-03
Report sent to call center — 6 month, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-08
Call 1 — Left Voicemail
2022-03-06
Survey response — 12 month, dose 2
MedDRA: Ageusia, Anosmia, Office visit, Tinnitus — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-03-06
Report sent to call center — 12 month, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-08
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-04	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-11	Unsuccessful
2021-03-08	Successful	Does not wish to fill out VAERS report
2021-09-03	Successful	Does not wish to fill out VAERS report
2022-03-06	Successful 2022-03-08	Does not wish to fill out VAERS report

Free text

Release 4

Healthcare visit (other): Primary doctor

Release 5

Systemic reaction (other): Gastritis

Systemic reaction (other): High vitamin b-12, high lactase, gastritis

Systemic reaction (other): Heart, gastritis and kidney

Symptoms: Diverticulosis of the colon, gastritis, spine pain, weakness and fatigue, joint pain, bad headaches!

Release 6

Symptoms: Diverticulosis of the colon, wringing in ears

Release 7

Symptoms: Wringing in ears , gastritis, colon diverticulosis

Release 9

Symptoms: Burning urine, irritation in my throat, fatique

Release 11

Symptoms: Can't smell, can't taste anything, stronger tinnitus

Healthcare visit (other): Ear Nose & Throat Specialist

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
HCVO	Office visit	✓	✓	✓
SD	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Diverticulum	✓	✓	✓
SD	Diverticulum intestinal	✓	✓	✓
SD	Dysuria	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastritis	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Spinal pain	✓	✓	✓
SD	Throat irritation	✓	·	✓
SD	Tinnitus	✓	✓	✓
SRO	Cardiac disorder	✓	✓	✓
SRO	Gastritis	✓	✓	✓
SRO	Laboratory test abnormal	✓	✓	✓
SRO	Renal disorder	✓	✓	✓
SRO	Vitamin B12 abnormal	○	✓	○
SRO	Vitamin B12 increased	✓	·	✓

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