Y2W-28719-43619

5 vaccinations 10 coded responses 56 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 598 / MT
Registered: 2021-02-19

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

2021-01-22
Dose 1 — Moderna
2021-02-19
Registered in v-safe
2021-02-19
Dose 2 — Moderna
2021-02-19
Health check-in — day 0, dose 2
Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Sopor — Feeling: Poor · Site: Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Soporific

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema — Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Free text: Swelling now in forearm. Ive been icing it

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-03-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-20
Survey response — 6 months, dose 2
MedDRA: Pre-existing disease, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I am getting chemotherapy for long-standing CLL · Healthcare visit (other): Infusion therapy

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-20
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-26
Call 1 — Left Voicemail
2021-10-29
Dose 3 — Moderna
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · Site: Redness · None

Adult check-in
2021-11-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-28
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-06-18
Dose 4 — Moderna
2022-06-18
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-06-19
Survey response — days 1–6 daily, dose 4
MedDRA: Insomnia, Myalgia — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Difficulty sleeping last night due to muscle aches

MedDRA releases: 2024-11 · check-in free text available
2022-06-20
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-06-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-06-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-06-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness, Diarrhea

Adult check-in
2022-06-24
Survey response — days 1–6 daily, dose 4
MedDRA: Night sweats — Feeling: Good · Fatigue or tiredness, Nausea

Free text: I should have told you I've had full-body night sweats pretty much every night although progressively better

MedDRA releases: 2024-11 · check-in free text available
2022-06-25
Health check-in — day 7, dose 4
Feeling: Good · Diarrhea

Adult check-in
2022-07-02
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-09
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-16
Survey response — day 28, dose 4
MedDRA: Diarrhoea — Feeling: Good

Free text: Intermittent diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-07-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-30
Survey response — day 42, dose 4
MedDRA: Decreased appetite, Dumping syndrome — Feeling: Good

Free text: Difficulty eating without a kind of dumping syndrome. I'm seeing my PCP on August 3

MedDRA releases: 2024-11 · check-in free text available
2022-09-19
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-11
Dose 5 — Pfizer-BioNTech
2022-11-11
Health check-in — day 0, dose 5
Feeling: Good · Site: Swelling · Chills, Fatigue or tiredness

Adult check-in
2022-11-12
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-11-13
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-14
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-11-15
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2022-11-16
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-17
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-18
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-11-25
Survey response — day 14, dose 5
MedDRA: Ageusia, Anosmia, Nasopharyngitis, 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

Free text: I tested positive for Covid on Tuesday. Bad cold symptoms and loss of sens of taste and smell

MedDRA releases: 2024-11 · check-in free text available
2022-11-25
Report sent to call center — day 14, dose 5
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)
2022-11-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-02
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-12-09
Survey response — day 28, dose 5
MedDRA: Ageusia, Anosmia, COVID-19, Cough, Fatigue, Malaise, Medical counselling, Respiratory tract congestion, SARS-CoV-2 test positive, Sinus headache — 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

Free text: Symptoms: I've t st d positive for rebound Covid ( on 12/06. I am sicker than when I was on Paxlovid. Loss of smell and taste. Congestion, cough, sinus headache, extreme fatigue. · Healthcare visit (other): Telephone

MedDRA releases: 2024-11 · check-in free text available
2022-12-09
Report sent to call center — day 28, dose 5
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)
2022-12-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-16
Survey response — day 35, dose 5
MedDRA: COVID-19, SARS-CoV-2 test negative — Feeling: Good

Free text: I still had reboundcovid. I'm now negative

MedDRA releases: 2024-11 · check-in free text available
2022-12-23
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-02-10
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-19	Moderna
3	2021-10-29	Moderna	No
4	2022-06-18	Moderna	No
5	2022-11-11	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-20	Successful 2022-11-28	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-25	Successful 2022-11-28	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-09	Successful 2022-12-13	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): Soporific

2021-02-25

Systemic reaction (other): Swelling now in forearm. Ive been icing it

Release 9 — 6 months, dose 2

2021-08-20

Symptoms: I am getting chemotherapy for long-standing CLL

Healthcare visit (other): Infusion therapy

Release 12 — days 1–6 daily, dose 4

2022-06-19

Systemic reaction (other): Difficulty sleeping last night due to muscle aches

2022-06-24

Systemic reaction (other): I should have told you I've had full-body night sweats pretty much every night although progressively better

Release 12 — day 28, dose 4

2022-07-16

Symptoms: Intermittent diarrhea

Release 12 — day 42, dose 4

2022-07-30

Symptoms: Difficulty eating without a kind of dumping syndrome. I'm seeing my PCP on August 3

Release 12 — day 14, dose 5

2022-11-25

Symptoms: I tested positive for Covid on Tuesday. Bad cold symptoms and loss of sens of taste and smell

Release 12 — day 28, dose 5

2022-12-09

Symptoms: I've t st d positive for rebound Covid ( on 12/06. I am sicker than when I was on Paxlovid. Loss of smell and taste. Congestion, cough, sinus headache, extreme fatigue.

Healthcare visit (other): Telephone

Release 12 — day 35, dose 5

2022-12-16

Symptoms: I still had reboundcovid. I'm now negative

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	Medical counselling	·	·	✓
HCVO	Unevaluable event	✓	·	✓
SD	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dumping syndrome	·	·	✓
SD	Fatigue	·	·	✓
SD	Malaise	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sinus headache	·	·	✓
SRO	Insomnia	·	·	✓
SRO	Myalgia	·	·	✓
SRO	Night sweats	·	·	✓
SRO	Oedema	✓	✓	✓
SRO	Sopor	✓	✓	✓

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