Y2F-33519-88938

3 vaccinations 6 coded responses 24 check-ins 6 free-text entries 4 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 985 / WA
Registered: 2021-01-04

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

2021-01-04
Registered in v-safe
2021-01-04
Dose 1 — Moderna
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Anxiety — Feeling: Fair · Site: Pain

Free text: Anxiety

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · None

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

Adult check-in
2021-01-11
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-18
Survey response — day 14, dose 1
MedDRA: Rhinorrhoea — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — day 14, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Moderna
2021-02-01
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Office visit, Pain, Pyrexia — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Missed yesterday's report: I felt feverish and had body aches · Healthcare visit (other): Visit was yesterday- missed report due to sleeping

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

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

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

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

Adult check-in
2021-02-08
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-22
Survey response — day 21, dose 2
MedDRA: Anxiety, Back pain, Nausea — Feeling: Fair

Free text: Nausea most likely due to anxietyIncreased back pain that is unrelated as well

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-03-18
Call 1 — Left Voicemail
2021-03-18
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-02
Survey response — 6 months, dose 2
MedDRA: Impaired work ability, Office visit, Respiratory tract congestion, Rhinitis, SARS-CoV-2 test negative, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Congestion & rhinitis. Negative covid test last week, but employee health still won't let me come back to work. 7 year old daughter tested positive for covid 2 Sundays ago, and still has a bit of a cough. · Healthcare visit (other): Appointment tomorrow

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-02
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)
2021-08-12
Call 1 — Left Voicemail
2021-08-26
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-11
Dose 3 — Moderna
2022-02-01
Survey response — 12 months, dose 2
MedDRA: Fatigue, Malaise, Pain, Sinusitis — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sinus infection for many weeks. Body aches, fatigue & general malaise that started 2 weeks ago and lasted for a week.

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-02
Call 1 — Left Voicemail
2022-05-12
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-11-13
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-02-01	Moderna
3	2021-11-11	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-18	Successful 2021-03-18	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-02-03	Successful
2021-08-02	Successful 2021-08-26	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-01	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-05

Systemic reaction (other): Anxiety

Release 2 — day 14, dose 1

2021-01-18

Symptoms: Runny nose

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): Missed yesterday's report: I felt feverish and had body aches

Healthcare visit (other): Visit was yesterday- missed report due to sleeping

Release 4 — day 21, dose 2

2021-02-22

Symptoms: Nausea most likely due to anxietyIncreased back pain that is unrelated as well

Release 9 — 6 months, dose 2

2021-08-02

Symptoms: Congestion & rhinitis. Negative covid test last week, but employee health still won't let me come back to work. 7 year old daughter tested positive for covid 2 Sundays ago, and still has a bit of a cough.

Healthcare visit (other): Appointment tomorrow

Release 11 — 12 months, dose 2

2022-02-01

Symptoms: Sinus infection for many weeks. Body aches, fatigue & general malaise that started 2 weeks ago and lasted for a week.

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	✓	✓	✓
HCVO	Unevaluable event	✓	·	✓
SD	Anxiety	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Impaired work ability	✓	·	✓
SD	Malaise	·	·	✓
SD	Nausea	✓	✓	✓
SD	Office visit	✓	·	✓
SD	Pain	·	·	✓
SD	Respiratory tract congestion	✓	·	✓
SD	Rhinitis	✓	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	·	✓
SD	Sinusitis	·	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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