Y62-30084-17853

3 vaccinations 15 coded responses 34 check-ins 15 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 212 / MD
Registered: 2021-01-12

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

2021-01-12
Registered in v-safe
2021-01-12
Dose 1 — Moderna
2021-01-12
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-09
Survey response — day 0, dose 2
MedDRA: Fatigue, Poor quality sleep — Feeling: Good · Site: Itching · Fatigue or tiredness

Free text: I didnt sleep that well last night which may be why I am little tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good · Site: Redness · Fatigue or tiredness

Free text: I am 66plus and am often tired wirh my routine and I maybe more tired rhan usual , perhaps just from stress of getting vaccine in addition to other daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Insomnia — Feeling: Good · Site: Redness · Fatigue or tiredness

Free text: I am tired due to not enough sleep and long work hrs.today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Fair · Site: Itching · Fatigue or tiredness

Free text: slight itching in anal area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — day 7, dose 2
MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness

Free text: Tiredness due to not enough sleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-14
Survey response — day 28, dose 2
MedDRA: Ear pain — Feeling: Fair

Free text: Slight ear ache after work at clinic.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — day 35, dose 2
MedDRA: Pruritus — Feeling: Good

Free text: Not sure if related to vaccine. Itching maybe a bite.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-10
Survey response — 6 months, dose 2
MedDRA: Nasopharyngitis, Oropharyngeal pain, Sinus headache — 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: Sinus Headaches, Slight sore throat, and cold symptoms

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-10
Report sent to call center — 6 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

1 call case(s)
2021-08-17
Call 1 — Left Voicemail
2021-10-29
Dose 3 — Moderna
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Fatigue, Insomnia — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Tiredness may be from trouble sleeping.

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness

Free text: Only because I only slept a few hrs.

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Fatigue, Insomnia — Feeling: Good · Fatigue or tiredness

Free text: Tired because I did not get enough rest.

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · 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
Survey response — day 28, dose 3
MedDRA: Headache, Nasopharyngitis, Oropharyngeal pain — Feeling: Fair

Free text: Sinus Cold symptoms, headache, sore thoat

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-10
Survey response — day 42, dose 3
MedDRA: Abdominal discomfort, Fatigue, Sinus headache — Feeling: Good · Be unable to do your normal daily activities

Free text: Fatgue , sinus headache, stomach bothering me. ( possibly from stress)

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Survey response — 3 months, dose 3
MedDRA: Fatigue, Nausea — Feeling: Good

Free text: Feeling of Nausea but no fever and did not get sick to stomach .exhaustion probably due to not enough rest.

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Survey response — 6 months, dose 3
MedDRA: Chest pain, Emergency care, Gastrooesophageal reflux disease, Telemedicine — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Symptoms: Chest pain said to be acid reflux or GERD · Healthcare visit (other): Telehealth then chestv pain ER for tests

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Report sent to call center — 6 months, dose 3
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 · Emergency room or emergency department visit · 1 call case(s)
2022-05-02
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-09	Moderna
3	2021-10-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-08-10	Unsuccessful
2022-04-29	Unsuccessful

Free text

Release 3 — day 0, dose 2

2021-02-09

Systemic reaction (other): I didnt sleep that well last night which may be why I am little tired.

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): I am 66plus and am often tired wirh my routine and I maybe more tired rhan usual , perhaps just from stress of getting vaccine in addition to other daily activities

2021-02-13

Systemic reaction (other): I am tired due to not enough sleep and long work hrs.today

2021-02-15

Systemic reaction (other): slight itching in anal area

Release 4 — day 7, dose 2

2021-02-16

Systemic reaction (other): Tiredness due to not enough sleep

Release 5 — day 28, dose 2

2021-03-14

Symptoms: Slight ear ache after work at clinic.

Release 5 — day 35, dose 2

2021-03-16

Symptoms: Not sure if related to vaccine. Itching maybe a bite.

Release 9 — 6 months, dose 2

2021-08-10

Symptoms: Sinus Headaches, Slight sore throat, and cold symptoms

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): Tiredness may be from trouble sleeping.

2021-11-01

Systemic reaction (other): Only because I only slept a few hrs.

2021-11-03

Systemic reaction (other): Tired because I did not get enough rest.

Release 10 — day 28, dose 3

2021-11-26

Symptoms: Sinus Cold symptoms, headache, sore thoat

Release 10 — day 42, dose 3

2021-12-10

Symptoms: Fatgue , sinus headache, stomach bothering me. ( possibly from stress)

Release 11 — 3 months, dose 3

2022-01-28

Symptoms: Feeling of Nausea but no fever and did not get sick to stomach .exhaustion probably due to not enough rest.

Release 11 — 6 months, dose 3

2022-04-29

Symptoms: Chest pain said to be acid reflux or GERD

Healthcare visit (other): Telehealth then chestv pain ER for tests

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	Chest pain	·	·	✓
HCVO	Emergency care	·	·	✓
HCVO	Telemedicine	·	·	✓
SD	Abdominal discomfort	·	·	✓
SD	Chest pain	·	·	✓
SD	Ear pain	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Headache	·	·	✓
SD	Nasopharyngitis	✓	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pruritus	✓	✓	✓
SD	Sinus headache	✓	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Poor quality sleep	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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