Y54-13378-30766

5 vaccinations 6 coded responses 36 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 787 / TX
Registered: 2021-03-11

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

2021-03-11
Registered in v-safe
2021-03-11
Dose 1 — Moderna
2021-03-11
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, 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 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness

Free text: Still a little tired, but maybe it's not from the vaccine?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising — Feeling: Good

Free text: I still have a decent bruise at the injection site. It doesnt hurt, but its still dark blue/purple and is raised

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 7, dose 1
MedDRA: Skin discolouration — Feeling: Good · Site: Swelling

Free text: There is still a purple/green/blue bruise on my arm and a little lump

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-09
Dose 2 — Moderna
2021-04-09
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-08
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
2022-04-12
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-15
Dose 4 — Moderna
2022-04-29
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-15
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-22
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-10
Dose 5 — Moderna
Co-administered: Flu
2022-09-23
Survey response — day 7, dose 5
MedDRA: SARS-CoV-2 test positive, Unevaluable event — Feeling: Poor · Fever · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): I tested positive for covid on 2022.09.21 · Healthcare visit (other): I have an appt tomorrow

MedDRA releases: 2024-11 · check-in free text available
2022-09-23
Report sent to call center — day 7, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-09-24
Survey response — day 14, dose 5
MedDRA: COVID-19 — 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 · Outpatient clinic or urgent care clinic visit

Free text: I have COVID

MedDRA releases: 2024-11 · check-in free text available
2022-09-24
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-27
Call 1 — Could Not Reach Participant
2022-09-27
Call 1 — Could Not Reach Participant
2022-10-01
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-10-03
Call 2 — Could Not Reach Participant
2022-10-03
Call 2 — Could Not Reach Participant
2022-10-10
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-10-15
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-10-24
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-12-13
Survey response — 3 months, dose 5
MedDRA: Bronchitis, Malaise, Nasopharyngitis, Sinusitis — Feeling: Fair · 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, Outpatient clinic or urgent care clinic visit

Free text: I got a cold that got really bad. Turned into a sinus infection and bronchitis. I got sick on nov 20th and I'm just now getting over it :(

MedDRA releases: 2024-11 · check-in free text available
2022-12-13
Report sent to call center — 3 months, 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-14
Call 1 — Could Not Reach Participant
2022-12-19
Call 3 — Could Not Reach Participant
2022-12-19
Call 3 — Could Not Reach Participant
2022-12-19
Call 2 — Could Not Reach Participant
2023-03-13
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-09	Moderna
3	2021-10-29	Moderna	No
4	2022-04-15	Moderna	No
5	2022-09-10	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-09-23	Unsuccessful
2022-09-24	Unsuccessful
2022-12-13	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-15

Systemic reaction (other): Still a little tired, but maybe it's not from the vaccine?

2021-03-17

Systemic reaction (other): I still have a decent bruise at the injection site. It doesnt hurt, but its still dark blue/purple and is raised

Release 5 — day 7, dose 1

2021-03-18

Systemic reaction (other): There is still a purple/green/blue bruise on my arm and a little lump

Release 12 — day 7, dose 5

2022-09-23

Systemic reaction (other): I tested positive for covid on 2022.09.21

Healthcare visit (other): I have an appt tomorrow

Release 12 — day 14, dose 5

2022-09-24

Symptoms: I have COVID

Release 12 — 3 months, dose 5

2022-12-13

Symptoms: I got a cold that got really bad. Turned into a sinus infection and bronchitis. I got sick on nov 20th and I'm just now getting over it :(

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	Unevaluable event	·	·	✓
SD	Bronchitis	·	·	✓
SD	COVID-19	·	·	✓
SD	Malaise	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	SARS-CoV-2 test positive	·	·	✓
SRO	Skin discolouration	✓	✓	✓

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