XWU-17933-27696

3 vaccinations 7 coded responses 33 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 773 / TX
Registered: 2021-01-05

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Survey response — 0 day, dose 1
MedDRA: Dizziness — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-06
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Muscular weakness — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Muscular weakness — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-12
Health check-in — 7 day, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-12
Report sent to call center — 7 day, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-01-26
Health check-in — 21 day, dose 1
Feeling: Good

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — 7 day, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — 28 day, dose 2
Feeling: Fair

Adult check-in
2021-03-09
Survey response — 35 day, dose 2
MedDRA: Back pain, Chills, Dehydration, Diarrhoea, Dizziness, Fatigue, Headache, Norovirus infection, Pain, Pain in extremity, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-16
Survey response — 42 day, dose 2
MedDRA: Chills, Dehydration, Diarrhoea, Pain, Pyrexia — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-06
Survey response — 3 month, dose 2
MedDRA: Unevaluable event — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-08-03
Survey response — 6 month, dose 2
MedDRA: Cough, Self-medication, Sinus disorder — Feeling: Good

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-10-29
Dose 3 — Moderna
2021-10-29
Health check-in — 0 day, dose 3
Feeling: Good · Site: Redness · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None · Be unable to work or attend school

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None · Be unable to do your normal daily activities

Adult check-in
2021-11-05
Health check-in — 7 day, dose 3
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-02	Moderna
3	2021-10-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-06	priority 2/3
2021-01-12	priority 2/3

Free text

Release 1

Systemic reaction (other): A little dizzy (mild)

Systemic reaction (other): Just a little weakness in left hip and leg.

Systemic reaction (other): Still a little weakness in left leg

Release 5

Symptoms: I believe I have norovirus. It came on suddenly yesterday. I had diarrhea low grade fever, chills, aching back and legs arms hands feet, faint felling, mild headache, dehydrated. Feeling little better today still aches fatigue fatigue

Symptoms: Seemed like a virus diarrhea slight fever chills body hurting 1st day. Dehydrated the 2nd and 3rd. day. Felt ok on 4 th day

Release 8

Symptoms: This has nothing to do with COVID 19 vaccines. I have had 3 infusions with my oncologist at treatment center. Did fine with first 2 but the 3 rd one I Had a reactionSite of abdomen where infusion went swelled itched. Didnt rest. Had dehydration

Release 9

Symptoms: About 10 days ago had a cough and sinus problem. Not bad but it lasted over a week. I am doing okay. Took Flonase spray and Benadryl so I didnt cough at night.

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	Back pain	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	·	✓
SD	Dehydration	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Norovirus infection	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Self-medication	✓	·	✓
SD	Sinus disorder	✓	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓

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