Y2E-29258-33854

4 vaccinations 10 coded responses 35 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 950 / CA
Registered: 2021-01-08

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-07
Dose 1 — Moderna
2021-01-08
Registered in v-safe
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-14
Survey response — day 7, dose 1
MedDRA: Joint stiffness — Feeling: Good · Joint pains

Free text: AM joint stiffness in 1st fingers of R hand x ~5 days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Survey response — day 14, dose 1
MedDRA: Fatigue, Nasal congestion, Seasonal allergy — Feeling: Good

Free text: Stuffy nose, tiredness. Likely from seasonal allergies due to warm weather & windy conditions locally.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-04
Survey response — day 0, dose 2
MedDRA: Fatigue, Rhinorrhoea, Sneezing — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: 2/3 Runny nose, sneezing 1/29+ Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-18
Survey response — day 14, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Some continuing fatigue, not consistent.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-05
Survey response — 6 months, dose 2
MedDRA: Fatigue, Office visit, Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional

Free text: Symptoms: A few Sore throats & congestion. Some extreme fatigue for about 10 days, but it resolved with rest. All COVIDtests have been negative. · Healthcare visit (other): Lab tests, then in-person physical with PCP.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-20
Dose 3 — Moderna
2021-11-22
Call successful
Participant prefers to complete VAERS report online
2022-02-04
Survey response — 12 months, dose 2
MedDRA: Injection site swelling, Oropharyngeal pain, Respiratory tract congestion — Feeling: Good · Be unable to work or attend school

Free text: Swollen arm at injection site after booster c 4 days. Mid Nov Congestion/sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-02-19
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-21
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-06-10
Dose 4 — Moderna
2022-06-17
Health check-in — day 7, dose 4
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-06-24
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-08
Survey response — day 28, dose 4
MedDRA: Fatigue, Headache, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: 7/3/22 Headache , mild sore throat, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-07-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-22
Survey response — day 42, dose 4
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-09-09
Survey response — 3 months, dose 4
MedDRA: Fatigue, Headache, Oropharyngeal pain, Pain, Pyrexia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: More headaches over the past weeks. COVID symptoms this week: sore throat, mild fever, body aches, head aches, fatigue; recovering quickly.

MedDRA releases: 2024-11 · check-in free text available
2022-12-09
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-06-10
Survey response — 12 months, dose 4
MedDRA: Chest discomfort, Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2021-11-20	Moderna	No
4	2022-06-10	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-05	Successful 2021-11-22	Participant prefers to complete VAERS report online

Free text

Release 1 — day 7, dose 1

2021-01-14

Systemic reaction (other): AM joint stiffness in 1st fingers of R hand x ~5 days.

Release 2 — day 14, dose 1

2021-01-21

Symptoms: Stuffy nose, tiredness. Likely from seasonal allergies due to warm weather & windy conditions locally.

Release 3 — day 0, dose 2

2021-02-04

Systemic reaction (other): 2/3 Runny nose, sneezing 1/29+ Fatigue

Release 4 — day 14, dose 2

2021-02-18

Symptoms: Some continuing fatigue, not consistent.

Release 9 — 6 months, dose 2

2021-08-05

Symptoms: A few Sore throats & congestion. Some extreme fatigue for about 10 days, but it resolved with rest. All COVIDtests have been negative.

Healthcare visit (other): Lab tests, then in-person physical with PCP.

Release 11 — 12 months, dose 2

2022-02-04

Symptoms: Swollen arm at injection site after booster c 4 days. Mid Nov Congestion/sore throat

Release 12 — day 28, dose 4

2022-07-08

Symptoms: 7/3/22 Headache , mild sore throat, fatigue

Release 12 — day 42, dose 4

2022-07-22

Symptoms: Fatigue

Release 12 — 3 months, dose 4

2022-09-09

Symptoms: More headaches over the past weeks. COVID symptoms this week: sore throat, mild fever, body aches, head aches, fatigue; recovering quickly.

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that 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	Chest discomfort	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Injection site swelling	·	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	✓	·	✓
SD	SARS-CoV-2 test negative	✓	·	✓
SD	Seasonal allergy	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Joint stiffness	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sneezing	✓	✓	✓

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