XXX-27069-47482

3 vaccinations 4 coded responses 16 check-ins 4 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 430 / OH
Registered: 2021-12-02

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

2021-02-11
Dose 1 — Moderna
2021-03-11
Dose 2 — Moderna
2021-12-02
Registered in v-safe
2021-12-02
Dose 3 — Moderna
2021-12-02
Health check-in — 0 day, dose 3
Feeling: Good · None

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-12-08
Survey response — days 1–6 daily, dose 3
MedDRA: Brain fog, Somnolence — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-12-09
Health check-in — 7 day, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-12-16
Health check-in — 14 day, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-12-30
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2022-01-06
Survey response — 35 day, dose 3
MedDRA: Cough, Dyspnoea, Oropharyngeal pain, SARS-CoV-2 test negative, Wheezing — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-01-13
Health check-in — 42 day, dose 3
Feeling: Good

Adult check-in
2022-03-03
Health check-in — 3 month, dose 3
Feeling: Good

Adult check-in
2022-06-02
Survey response — 6 month, dose 3
MedDRA: Fatigue, Nausea — Feeling: Fair

MedDRA releases: 2024-11 · check-in answers available
2022-12-03
Survey response — 12 month, dose 3
MedDRA: Multiple sclerosis, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

MedDRA releases: 2024-11 · check-in answers available
2022-12-03
Report sent to call center — 12 month, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-12-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna	No
2	2021-03-11	Moderna	No
3	2021-12-02	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-12-03	Successful 2022-12-05	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 10

Systemic reaction (other): I keep falling asleep during the day even though I am sleeping well at night. I can be in the middle of writing checks, reading, watching tv almost anytisme. When I'm awake I feel foggy. Has anyone else had this problem?

Symptoms: Sore throat, cough, wheeze mild shortness of breath Checked home Covid test. Was negative

Release 11

Symptoms: Had second booster with four days of fatigue and two days of nausea

Release 12

Symptoms: Can't remember when I last did this but I had a major MS relapse in September They have been adjusting my central sleep apnea pacemaker and am ok now

Healthcare visit (other): MS relapse

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	Multiple sclerosis	·	·	✓
HCVO	Pre-existing disease	·	·	✓
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Multiple sclerosis	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Wheezing	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Somnolence	·	·	✓

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