Y9P-26231-88876

2 vaccinations 7 coded responses 19 check-ins 7 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 630 / MO
Registered: 2021-01-19

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

2021-01-19
Registered in v-safe
2021-01-19
Dose 1 — Moderna
2021-01-19
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · Joint pains, Muscle or body aches

Adult check-in
2021-02-02
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Injection site warmth — Feeling: Good

Free text: My upper arm thAt was vaccinated developed a red , warm, itchy spot about 3X4 that was initially raised little around the edges. It was below the injection site. This evening it had increased to about 6 in height .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-16
Dose 2 — Moderna
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling — Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Nurse at assisted living called doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling — Feeling: Good · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Nurse at assisted living contacted doc again, got more meds.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Adult check-in
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling, Urinary tract infection — Feeling: Good · Site: Redness, Itching · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Urinary tract infection · Healthcare visit (other): Nurse called Dr.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-23
Survey response — day 7, dose 2
MedDRA: Office visit, Urinary tract infection — Feeling: Good · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): UTI · Healthcare visit (other): Had to do urine sample and Dr. gave me antibiotics.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-09
Survey response — day 21, dose 2
MedDRA: Constipation, Medical counselling — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe constipation · Healthcare visit (other): Nurse contacted Doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-16
Survey response — day 28, dose 2
MedDRA: Constipation, Medical counselling — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe constipation · Healthcare visit (other): Nurse called Dr

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-10
Call 1 — Left Voicemail
2022-02-16
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-19	Moderna
2	2021-02-16	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-18	Unsuccessful
2021-02-19	Unsuccessful
2021-02-22	Unsuccessful
2021-02-23	Unsuccessful
2021-03-09	Unsuccessful
2021-03-16	Unsuccessful

Free text

Release 3 — day 14, dose 1

2021-02-02

Symptoms: My upper arm thAt was vaccinated developed a red , warm, itchy spot about 3X4 that was initially raised little around the edges. It was below the injection site. This evening it had increased to about 6 in height .

Release 4 — days 1–6 daily, dose 2

2021-02-18

Healthcare visit (other): Nurse at assisted living called doctor

2021-02-19

Healthcare visit (other): Nurse at assisted living contacted doc again, got more meds.

2021-02-22

Systemic reaction (other): Urinary tract infection

Healthcare visit (other): Nurse called Dr.

Release 4 — day 7, dose 2

2021-02-23

Systemic reaction (other): UTI

Healthcare visit (other): Had to do urine sample and Dr. gave me antibiotics.

Release 5 — day 21, dose 2

2021-03-09

Symptoms: Severe constipation

Healthcare visit (other): Nurse contacted Doctor

Release 5 — day 28, dose 2

2021-03-16

Symptoms: Severe constipation

Healthcare visit (other): Nurse called Dr

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Constipation	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SRO	Urinary tract infection	✓	✓	✓

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