XV6-84124-47696

6 vaccinations 13 coded responses 47 check-ins 8 free-text entries 8 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 537 / WI
Registered: 2021-02-22

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

2021-02-12
Dose 1 — Moderna
2021-02-22
Registered in v-safe
2021-02-22
Health check-in — 7 day, dose 1
Feeling: Fair · Muscle or body aches

Adult check-in
2021-02-26
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-03-05
Survey response — 21 day, dose 1
MedDRA: Ear infection, Fatigue, Lacrimation increased, Lymphadenopathy, SARS-CoV-2 test, Sinus congestion, Upper-airway cough syndrome — Feeling: Fair · 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
2021-03-05
Report sent to call center — 21 day, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-12
Dose 2 — Moderna
2021-03-12
Survey response — 0 day, dose 2
MedDRA: Ear congestion — Feeling: Fair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Muscle or body aches

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — 7 day, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-04-09
Survey response — 28 day, dose 2
MedDRA: Laboratory test, Unevaluable event, Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-09
Report sent to call center — 28 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-16
Survey response — 35 day, dose 2
MedDRA: Breast pain, Unevaluable event — Feeling: Good · 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
2021-04-16
Report sent to call center — 35 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-23
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-06-17
Call 1 — Left Voicemail
2021-09-10
Survey response — 6 month, dose 2
MedDRA: Oropharyngeal pain, SARS-CoV-2 test — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2021-09-10
Report sent to call center — 6 month, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-13
Call successful
Not applicable - Accidental Reporting
2021-09-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-24
Dose 3 — Moderna
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — 7 day, dose 3
Feeling: Good · None

Adult check-in
2021-11-07
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-11-14
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2021-11-28
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — 42 day, dose 3
Feeling: Good

Adult check-in
2022-01-23
Survey response — 3 month, dose 3
MedDRA: Fatigue, Nasal congestion, Pyrexia, SARS-CoV-2 test negative, Sinus congestion, Sneezing — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11 · check-in answers available
2022-01-23
Report sent to call center — 3 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 · 1 call case(s)
2022-01-24
Call 1 — Could Not Reach Participant
2022-01-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-24
Survey response — 6 month, dose 3
MedDRA: Chills, Fatigue, Nasal congestion, Pyrexia, Sinus congestion, Sneezing — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-04-28
Dose 4 — Moderna
2022-05-18
Health check-in — 14 day, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — 21 day, dose 4
Feeling: Good

Adult check-in
2022-05-26
Health check-in — 28 day, dose 4
Feeling: Good

Adult check-in
2022-06-02
Health check-in — 35 day, dose 4
Feeling: Good

Adult check-in
2022-06-09
Health check-in — 42 day, dose 4
Feeling: Good

Adult check-in
2022-07-28
Health check-in — 3 month, dose 4
Feeling: Good

Adult check-in
2022-09-13
Dose 5 — Moderna
2022-10-27
Survey response — 6 month, dose 4
MedDRA: Cough, Respiratory tract congestion, Sneezing — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2022-10-27
Report sent to call center — 6 month, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-29
Survey response — 12 month, dose 4
MedDRA: COVID-19 — 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, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2023-04-29
Report sent to call center — 12 month, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-05-01
Call 1 — Left Voicemail
2023-05-05
Dose 6 — Moderna
2023-05-08
Health check-in — days 1–6 daily, dose 6
Feeling: Good · Site: Pain · None

Adult check-in
2023-05-09
Health check-in — days 1–6 daily, dose 6
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2023-05-10
Survey response — days 1–6 daily, dose 6
MedDRA: Medical counselling, Paraesthesia — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2023-05-10
Report sent to call center — days 1–6 daily, dose 6
Get care from a doctor or other healthcare professional

1 call case(s)
2023-05-11
Survey response — days 1–6 daily, dose 6
MedDRA: Paraesthesia — Feeling: Good · Site: Pain

MedDRA releases: 2024-11 · check-in answers available
2023-05-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-13
Health check-in — 7 day, dose 6
Feeling: Good · None

Adult check-in
2023-05-28
Health check-in — 21 day, dose 6
Feeling: Good

Adult check-in
2023-06-04
Survey response — 28 day, dose 6
MedDRA: SARS-CoV-2 test negative, Sneezing, Upper respiratory tract infection — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2023-06-09
Survey response — 35 day, dose 6
MedDRA: Respiratory symptom — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2023-06-16
Health check-in — 42 day, dose 6
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2021-10-24	Moderna	No
4	2022-04-28	Moderna	No
5	2022-09-13	Moderna	No
6	2023-05-05	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-05	Successful 2021-09-13	Not applicable - Accidental Reporting
2021-04-09	Successful 2021-09-13	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-04-16	Successful 2021-09-13	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-10	Successful 2021-09-14	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-01-23	Successful 2022-01-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-27	Successful 2022-10-28	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-29	Successful 2023-05-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-10	Successful 2023-05-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5

Symptoms: Ear infection, starting Tuesday, March 2, for which I am taking antibiotic drops. Beginning this morning, drippy eyes, some sinus congestion, post-nasal dripping, swollen glands., & fatigue. Just went for a covid-19 test.

Systemic reaction (other): Ear congestion

Release 7

Symptoms: Urinary tract infection

Healthcare visit (other): Lab visit to leave urine sample

Symptoms: Soreness in my breast. I did not mention this before because i didn't realize it could be related, but i subsequently read that it might be.

Healthcare visit (other): Scheduled mammogram.

Release 9

Symptoms: Sore throat

Healthcare visit (other): Covid test; steep test

Release 11

Symptoms: Fever, sneezing, fatigue, sinus and nasel congestion for 3 weeks, still have some symptoms. I had 3 covid tests, 2 of them PCR, over 1st 2 weeks of this; all came back negative

Symptoms: Sneezing, nasal and sinus congestion, fatigue, chills, slight fever

Release 12

Symptoms: Sneezing, congestion, dry cough

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	Laboratory test	✓	✓	○
HCVO	Medical counselling	·	·	✓
HCVO	SARS-CoV-2 test	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Breast pain	✓	✓	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Ear infection	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Lacrimation increased	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory symptom	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus congestion	✓	✓	✓
SD	Sneezing	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Upper-airway cough syndrome	✓	✓	✓
SD	Urinary tract infection	✓	✓	✓
SRO	Ear congestion	✓	✓	✓
SRO	Paraesthesia	·	·	✓

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