Y7S-28128-82002

3 vaccinations 7 coded responses 28 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 325 / FL
Registered: 2020-12-30

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

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Pain, Pyrexia, Self-medication — Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I would like to report that last night I felt the worse. Felt feverish, body aches, add to take an aleeve.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Constipation — Feeling: Good · Fever · Fatigue or tiredness

Free text: I would like to add that I had no bowel movements for 4 days after shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Survey response — day 7, dose 1
MedDRA: Pain, Pyrexia — Feeling: Good · Fever · Muscle or body aches

Free text: Felt aches and fever like yesterday early evening. Feeling fine today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Survey response — day 14, dose 1
MedDRA: Chills, Fatigue, Influenza like illness, Nasopharyngitis, Pain, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities

Free text: I had a couple of days where I felt flu like symptoms - body aches , chills. Head cold like, fatigue Actually went and got tested for Covid this last Monday. It was negative

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-20
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-01-27
Dose 2 — Moderna
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

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

Adult check-in
2021-02-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-17
Survey response — day 21, dose 2
MedDRA: Pain — Feeling: Fair

Free text: I had body aches late this afternoon. Thought it was unusual. No fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 28, dose 2
Feeling: Good

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

Adult check-in
2021-03-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-30
Survey response — 6 months, dose 2
MedDRA: Pain in extremity — Feeling: Good · Be unable to do your normal daily activities

Free text: Something that I dont think I shared was length of time arms both hurt. I didnt attribute it to the vaccine shot - but both arms had long periods of pain. The left armTook well over 2Months to subside. I believe these were associated w/sho

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-09
Dose 3 — Moderna
2022-01-27
Survey response — 12 months, dose 2
MedDRA: Nasopharyngitis, Unevaluable event — Feeling: Good

Free text: Sinus, cold symptom,

MedDRA releases: 2024-11 · check-in free text available
2022-03-12
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-09
Health check-in — 6 months, dose 3
Feeling: Fair

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

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-27	Moderna
3	2021-12-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-01	priority 2/3
2021-01-13	priority 2/3

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-01

Systemic reaction (other): I would like to report that last night I felt the worse. Felt feverish, body aches, add to take an aleeve.

2021-01-05

Systemic reaction (other): I would like to add that I had no bowel movements for 4 days after shot

Release 1 — day 7, dose 1

2021-01-06

Systemic reaction (other): Felt aches and fever like yesterday early evening. Feeling fine today.

Release 1 — day 14, dose 1

2021-01-13

Symptoms: I had a couple of days where I felt flu like symptoms - body aches , chills. Head cold like, fatigue Actually went and got tested for Covid this last Monday. It was negative

Release 4 — day 21, dose 2

2021-02-17

Symptoms: I had body aches late this afternoon. Thought it was unusual. No fever.

Release 9 — 6 months, dose 2

2021-07-30

Symptoms: Something that I dont think I shared was length of time arms both hurt. I didnt attribute it to the vaccine shot - but both arms had long periods of pain. The left armTook well over 2Months to subside. I believe these were associated w/sho

Release 11 — 12 months, dose 2

2022-01-27

Symptoms: Sinus, cold symptom,

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	Chills	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Influenza like illness	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	·	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Unevaluable event	·	·	✓
SRO	Constipation	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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