Y4V-30808-97351

2 vaccinations 7 coded responses 25 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 806 / CO
Registered: 2021-02-08

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
Registered in v-safe
2021-02-08
Dose 1 — Moderna
2021-02-08
Survey response — day 0, dose 1
MedDRA: Rash macular — Feeling: Good · Chills

Free text: Blotchy skin all over, kind of like a rash, but it doesnt itch.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Injection site pain kept me awake the last two nights, but didnt limit daytime activities.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-02-15
Health check-in — day 7, dose 1
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-02-22
Survey response — day 14, dose 1
MedDRA: Headache, Lymphadenopathy — Feeling: Fair · Be unable to do your normal daily activities

Free text: I think I have swollen lymph nodes in my neck, and I have a headache (since yesterday). Not sure if it could be vaccine related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — day 21, dose 1
MedDRA: Dyspnoea, SARS-CoV-2 test negative — Feeling: Good · 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: Had shortness of breath, but I think it was due to a new medication. I stopped the med and it got better. Had a negative Covid test.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-08
Dose 2 — Moderna
2021-03-08
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Chest discomfort — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Chest discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Survey response — day 7, dose 2
MedDRA: Chest discomfort, Cough — Feeling: Poor · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Coughing, chest discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 14, dose 2
Feeling: Good

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

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

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

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

Adult check-in
2021-06-07
Health check-in — 3 months, dose 2
Feeling: Fair

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

Adult check-in
2022-01-20
Call 1 — Left Voicemail
2022-03-08
Survey response — 12 months, dose 2
MedDRA: Asthenia, Fatigue, Headache, Lymphadenopathy, Malaise, Nausea, Pyrexia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: After my booster in December, I was sick for a week. Very swollen lymph nodes, fever, headache, severe fatigue, some nausea, etc. I gradually gained my strength back over a month or so. Each vaccine has caused unceasingly worse symptoms.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-08	Moderna
2	2021-03-08	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-01	Unsuccessful

Free text

Release 3 — day 0, dose 1

2021-02-08

Systemic reaction (other): Blotchy skin all over, kind of like a rash, but it doesnt itch.

Release 3 — days 1–6 daily, dose 1

2021-02-10

Systemic reaction (other): Injection site pain kept me awake the last two nights, but didnt limit daytime activities.

Release 4 — day 14, dose 1

2021-02-22

Symptoms: I think I have swollen lymph nodes in my neck, and I have a headache (since yesterday). Not sure if it could be vaccine related.

Release 4 — day 21, dose 1

2021-03-01

Symptoms: Had shortness of breath, but I think it was due to a new medication. I stopped the med and it got better. Had a negative Covid test.

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): Chest discomfort

Release 5 — day 7, dose 2

2021-03-15

Systemic reaction (other): Coughing, chest discomfort

Release 11 — 12 months, dose 2

2022-03-08

Symptoms: After my booster in December, I was sick for a week. Very swollen lymph nodes, fever, headache, severe fatigue, some nausea, etc. I gradually gained my strength back over a month or so. Each vaccine has caused unceasingly worse symptoms.

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
SD	Asthenia	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Malaise	·	·	✓
SD	Nausea	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Rash macular	✓	✓	✓

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