Y8G-68020-20415

5 vaccinations 11 coded responses 60 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 750 / TX
Registered: 2021-01-03

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

2021-01-03
Registered in v-safe
2021-01-03
Dose 1 — Moderna
2021-01-03
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Pain — Feeling: Good

Free text: I hurt a little Sunday night after I got the short. But I got in a hot shower about 5 hours after that & I have felt okay since then.at

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Headache, Muscle or body aches, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-07
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-28
Dose 2 — Moderna
2021-01-28
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Fair · Headache, Muscle or body aches · Be unable to work

Free text: Shot area just I know I got a shot. Not bad. Migraine, weather change, so ---. I feel okay. but

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · Headache, Muscle or body aches

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

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Hypersensitivity, Pre-existing disease, Unevaluable event — Feeling: Fair · Headache, Joint pains

Free text: Think its allergy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-02-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-31
Survey response — 6 months, dose 2
MedDRA: SARS-CoV-2 test negative, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have a sinus infection . Was tested for Covid. It was negative. I'm on an antibiotic. It makes me sick to my stomach.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-09
Dose 3 — Moderna
2021-09-09
Health check-in — day 0, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-09-10
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-09-11
Survey response — days 1–6 daily, dose 3
MedDRA: Musculoskeletal stiffness — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Neck stiff

MedDRA releases: 2024-11 · check-in free text available
2021-09-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-09-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-09-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-09-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-09-16
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-09-23
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-09-30
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-10-07
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-10-14
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-21
Health check-in — day 42, dose 3
Feeling: Poor

Adult check-in
2021-12-11
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-02-22
Dose 4 — Moderna
2022-02-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-02-25
Survey response — days 1–6 daily, dose 4
MedDRA: Paranasal sinus hypersecretion — Feeling: Fair · Headache

Free text: Sinus drainage

MedDRA releases: 2024-11 · check-in free text available
2022-02-26
Survey response — days 1–6 daily, dose 4
MedDRA: Paranasal sinus hypersecretion — Feeling: Fair · Headache

Free text: Sinus drainage from yesterday, is much better. Still there but better.

MedDRA releases: 2024-11 · check-in free text available
2022-02-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Nausea

Adult check-in
2022-02-28
Survey response — days 1–6 daily, dose 4
MedDRA: Paranasal sinus hypersecretion — Feeling: Fair · Headache

Free text: Sinus drainage got appt. W/ tell a doc

MedDRA releases: 2024-11 · check-in free text available
2022-03-01
Survey response — day 7, dose 4
MedDRA: Sinus pain — Feeling: Fair · Headache

Free text: Sinus pain. On antibiotics.

MedDRA releases: 2024-11 · check-in free text available
2022-03-08
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-03-15
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-03-22
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-03-29
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-04-05
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — 3 months, dose 4
Feeling: Poor

Adult check-in
2022-09-12
Dose 5 — Moderna
2022-09-12
Health check-in — day 0, dose 5
Feeling: Good · None

Adult check-in
2022-09-16
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Adult check-in
2022-09-17
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · None

Adult check-in
2022-09-19
Survey response — day 7, dose 5
MedDRA: Office visit, SARS-CoV-2 test — Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Get care from a doctor or other healthcare professional

Free text: Went to Dr. Got covud tested & back on shots & antibiotics.

MedDRA releases: 2024-11 · check-in free text available
2022-09-19
Report sent to call center — day 7, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2022-09-20
Call 1 — Left Voicemail
2022-09-20
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-26
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-03
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-10-11
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-10-17
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-10-24
Survey response — day 42, dose 5
MedDRA: Migraine, Sinusitis — Feeling: Poor · 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 infection a migraine for over a week.

MedDRA releases: 2024-11 · check-in free text available
2022-10-24
Report sent to call center — day 42, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-25
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-12
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-03-15
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-03	Moderna
2	2021-01-28	Moderna
3	2021-09-09	Moderna	No
4	2022-02-22	Moderna	No
5	2022-09-12	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-07	priority 2/3
2022-09-19	Successful 2022-09-20	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-24	Successful 2022-10-25	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-05

Systemic reaction (other): I hurt a little Sunday night after I got the short. But I got in a hot shower about 5 hours after that & I have felt okay since then.at

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): Shot area just I know I got a shot. Not bad. Migraine, weather change, so ---. I feel okay. but

2021-02-01

Systemic reaction (other): Think its allergy

Release 9 — 6 months, dose 2

2021-07-31

Symptoms: I have a sinus infection . Was tested for Covid. It was negative. I'm on an antibiotic. It makes me sick to my stomach.

Release 9 — days 1–6 daily, dose 3

2021-09-11

Systemic reaction (other): Neck stiff

Release 11 — days 1–6 daily, dose 4

2022-02-25

Systemic reaction (other): Sinus drainage

2022-02-26

Systemic reaction (other): Sinus drainage from yesterday, is much better. Still there but better.

2022-02-28

Systemic reaction (other): Sinus drainage got appt. W/ tell a doc

Release 11 — day 7, dose 4

2022-03-01

Systemic reaction (other): Sinus pain. On antibiotics.

Release 12 — day 7, dose 5

2022-09-19

Healthcare visit (other): Went to Dr. Got covud tested & back on shots & antibiotics.

Release 12 — day 42, dose 5

2022-10-24

Symptoms: Sinus infection a migraine for over a week.

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	Office visit	·	·	✓
HCVO	SARS-CoV-2 test	·	·	✓
SD	Migraine	·	·	✓
SD	SARS-CoV-2 test negative	✓	·	✓
SD	Sinusitis	✓	·	✓
SRO	Hypersensitivity	○	✓	○
SRO	Migraine	✓	✓	✓
SRO	Musculoskeletal stiffness	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Paranasal sinus hypersecretion	·	·	✓
SRO	Pre-existing disease	○	✓	○
SRO	Sinus pain	·	·	✓
SRO	Unevaluable event	✓	·	✓

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