Y9M-21836-11576

3 vaccinations 9 coded responses 27 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 21-25
ZIP prefix: 782 / TX
Registered: 2020-12-31

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-31
Registered in v-safe
2020-12-31
Dose 1 — Moderna
2020-12-31
Survey response — day 0, dose 1
MedDRA: Heart rate increased, Immediate post-injection reaction — Feeling: Good · Headache

Free text: Increase heart rate for the 15 mins after additional 15 mins it subsided

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

Adult check-in
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Neck pain, Night sweats, Tonsillar hypertrophy — Feeling: Fair · Site: Pain, Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Sweating at night, tonsil on right swollen, neck pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Oropharyngeal pain — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Tonsil pain on right, dry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Night sweats — Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Sweating at night

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

1 call case(s)
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-01-07
Health check-in — day 7, dose 1
Feeling: Good · None

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

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

Adult check-in
2021-01-28
Dose 2 — Moderna
2021-01-28
Survey response — day 0, dose 2
MedDRA: Pruritus — Feeling: Fair · Fever · Headache

Free text: Itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-04
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

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

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
2021-03-11
Survey response — day 42, dose 2
MedDRA: Arthralgia, Fatigue, Injection site pain, Pain — Feeling: Good

Free text: More fatigue and aches in shoulder. Injection shoulder aches and throbs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-29
Dose 3 — Moderna
2022-01-28
Survey response — 12 months, dose 2
MedDRA: Brain fog, COVID-19, Cough, Fatigue, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Diagnosed positive COVID 1/1/22 and tested negative 1/10/22 Dry cough still, fatigue, foggy

MedDRA releases: 2024-11 · check-in free text available
2022-02-28
Survey response — 3 months, dose 3
MedDRA: Alopecia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Bald spot and losing hair

MedDRA releases: 2024-11 · check-in free text available
2022-02-28
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-01
Call 1 — Left Voicemail
2022-05-30
Survey response — 6 months, dose 3
MedDRA: Asthma, Brain fog, Depressed level of consciousness, Fatigue, Laboratory test abnormal, Liver function test increased, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue, foggy, not alert, increase liver functions, change of ANA pattern, asthma not the same · Healthcare visit (other): PCP

MedDRA releases: 2024-11 · check-in free text available
2022-05-30
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-01
Call 2 — Left Voicemail
2022-06-01
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-28	Moderna
3	2021-11-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-04	priority 2/3
2022-02-28	Unsuccessful
2022-05-30	Unsuccessful

Free text

Release 1 — day 0, dose 1

2020-12-31

Systemic reaction (other): Increase heart rate for the 15 mins after additional 15 mins it subsided

Release 1 — days 1–6 daily, dose 1

2021-01-02

Systemic reaction (other): Sweating at night, tonsil on right swollen, neck pain

2021-01-03

Systemic reaction (other): Tonsil pain on right, dry cough

2021-01-04

Systemic reaction (other): Sweating at night

Release 2 — day 0, dose 2

2021-01-28

Systemic reaction (other): Itching

Release 5 — day 42, dose 2

2021-03-11

Symptoms: More fatigue and aches in shoulder. Injection shoulder aches and throbs

Release 11 — 12 months, dose 2

2022-01-28

Symptoms: Diagnosed positive COVID 1/1/22 and tested negative 1/10/22 Dry cough still, fatigue, foggy

Release 11 — 3 months, dose 3

2022-02-28

Symptoms: Bald spot and losing hair

Release 11 — 6 months, dose 3

2022-05-30

Symptoms: Fatigue, foggy, not alert, increase liver functions, change of ANA pattern, asthma not the same

Healthcare visit (other): PCP

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	·	·	✓
SD	Alopecia	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Asthma	·	·	✓
SD	Brain fog	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Depressed level of consciousness	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Laboratory test abnormal	·	·	✓
SD	Liver function test increased	·	·	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Tonsillar hypertrophy	✓	✓	✓

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