XY7-44567-62594

4 vaccinations 5 coded responses 35 check-ins 4 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 948 / CA
Registered: 2021-03-08

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

2021-02-08
Dose 1 — Moderna
2021-03-08
Registered in v-safe
2021-03-08
Dose 2 — Moderna
2021-03-08
Health check-in — 0 day, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches

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

Adult check-in
2021-03-15
Health check-in — 7 day, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — 21 day, dose 2
Feeling: Fair

Adult check-in
2021-04-05
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — 35 day, dose 2
Feeling: Fair

Adult check-in
2021-04-19
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-06-07
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-09-06
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Moderna
2021-10-28
Health check-in — 0 day, dose 3
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-04
Health check-in — 7 day, dose 3
Feeling: Good · None

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

Adult check-in
2021-11-18
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — 35 day, dose 3
Feeling: Fair

Adult check-in
2021-12-09
Health check-in — 42 day, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — 3 month, dose 3
Feeling: Good

Adult check-in
2022-04-28
Survey response — 6 month, dose 3
MedDRA: Dyspnoea, SARS-CoV-2 test negative — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2022-04-28
Report sent to call center — 6 month, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-29
Call 1 — Left Voicemail
2022-04-29
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-16
Dose 4 — Moderna
2022-06-26
Survey response — 35 day, dose 4
MedDRA: Fatigue, SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-06-27
Survey response — 42 day, dose 4
MedDRA: Malaise, SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend school, 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
2022-06-27
Report sent to call center — 42 day, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-06-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-15
Health check-in — 3 month, dose 4
Feeling: Fair

Adult check-in
2022-11-14
Survey response — 6 month, dose 4
MedDRA: Depressed mood, Depression, Discomfort, Dyspnoea, Post-acute COVID-19 syndrome, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2023-05-16
Survey response — 12 month, dose 4
MedDRA: Fatigue, Post-acute COVID-19 syndrome — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Moderna
2	2021-03-08	Moderna
3	2021-10-28	Moderna	No
4	2022-05-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-04-28	Successful 2022-04-29	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-27	Successful 2022-06-28	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 11

Symptoms: Some shortness of breath, possibly related either to hayfever or a very mild cold. Not Covid, I have home health tested and PCR negative for Covid

Release 12

Symptoms: Was infected with SARS to virus apparently on June 12 or 13th, 2022. PCR on the morning of June 13 came back as "presumptive positive". Covid symptoms began the evening of June 14. Mild to moderate symptoms , No fever, but still extremely fatigued. cut off by CDC

Symptoms: COVID positive by PCR On June 13, 2022 and 14 days later I am still mildly symptomatic and mildly positive by home rapid antigen test.

Symptoms: Now have less trouble breathing, and some days can exercise BUT the day after exercise I feel very heavy physically and sad. I have started anti- depressants to treat my long COVID induced depression.

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	Depressed mood	·	·	✓
SD	Depression	·	·	✓
SD	Discomfort	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Malaise	·	·	✓
SD	Post-acute COVID-19 syndrome	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓

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