XYF-18261-84670

4 vaccinations 14 coded responses 33 check-ins 14 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 906 / CA
Registered: 2021-03-03

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

2021-03-01
Dose 1 — Moderna
2021-03-03
Registered in v-safe
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Diarrhoea, Fatigue, Pain in extremity — Feeling: Good · Site: Pain · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Neck pain — Feeling: Good · Chills, Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Survey response — 14 day, dose 1
MedDRA: Tinnitus — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-22
Survey response — 21 day, dose 1
MedDRA: Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-29
Survey response — 28 day, dose 1
MedDRA: Tinnitus — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-30
Dose 2 — Moderna
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Thirst — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Nasopharyngitis — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Nasopharyngitis — Feeling: Good · Fatigue or tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling cold — Feeling: Fair · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-06
Survey response — 7 day, dose 2
MedDRA: Feeling cold — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-13
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-04-20
Survey response — 21 day, dose 2
MedDRA: Abdominal discomfort, Back pain, Decreased appetite, Fatigue, Feeling cold, Thirst — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-27
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-06-29
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-09-29
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2021-11-01
Dose 3 — Moderna
2022-03-30
Survey response — 12 month, dose 2
MedDRA: Blood glucose increased, Office visit — Feeling: Good · 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
2022-03-30
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)
2022-04-04
Call 1 — Left Voicemail
2022-05-18
Dose 4 — Moderna
2022-05-23
Survey response — days 1–6 daily, dose 4
MedDRA: Pain, Unevaluable event — Feeling: Good · Chills

MedDRA releases: 2024-11 · check-in answers available
2022-05-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-25
Health check-in — 7 day, dose 4
Feeling: Good · None

Adult check-in
2022-06-01
Health check-in — 14 day, dose 4
Feeling: Good

Adult check-in
2022-06-08
Health check-in — 21 day, dose 4
Feeling: Good

Adult check-in
2022-06-15
Health check-in — 28 day, dose 4
Feeling: Good

Adult check-in
2022-06-22
Health check-in — 35 day, dose 4
Feeling: Good

Adult check-in
2022-06-29
Health check-in — 42 day, dose 4
Feeling: Good

Adult check-in
2022-08-17
Health check-in — 3 month, dose 4
Feeling: Good

Adult check-in
2022-11-23
Health check-in — 6 month, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-03-30	Moderna
3	2021-11-01	Moderna	No
4	2022-05-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-03-30	Unsuccessful

Free text

Release 5

Systemic reaction (other): Day after injection: fatigue, diarrhea, few chills, arm mildly sore

Systemic reaction (other): Standing in line for 2 1/2 hours in the sun and then 15 min to register for the shot made my back and neck hurt to the point of going to bed. After three days of rest, ice and stretching I now feel better

Symptoms: Ringing/buzzing in my ears

Release 6

Symptoms: Headaches and tired

Symptoms: Ringing/ buzzing ears

Systemic reaction (other): Very Thirsty

Systemic reaction (other): Lack of appetite

Systemic reaction (other): Just generally cold. Sweater and turning on the heater works

Systemic reaction (other): Just cold

Release 7

Systemic reaction (other): Just cold

Symptoms: Cold, tired, lower back ache, upset stomach, lack of appetite, thirsty

Release 11

Symptoms: Sugar levels increased 5.9 to 6.3

Healthcare visit (other): Reg Dr visit in person

Systemic reaction (other): I had the shot last week. Slightly sore stem for 48 hours. No other symptoms

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	Abdominal discomfort	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Blood glucose increased	·	·	✓
SD	Decreased appetite	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling cold	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Thirst	✓	✓	✓
SD	Tinnitus	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Thirst	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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