YBQ-26224-31391

4 vaccinations 16 coded responses 42 check-ins 15 free-text entries 5 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 112 / NY
Registered: 2021-02-25

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

2021-02-25
Registered in v-safe
2021-02-25
Dose 1 — Moderna
2021-02-25
Survey response — day 0, dose 1
MedDRA: Pyrexia — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Feverish

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 1
MedDRA: Parosmia, Taste disorder — Feeling: Good · Fatigue or tiredness

Free text: I've noticed a minor change in taste and smell

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia, Parosmia — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Abdominal pain

Free text: Taste and smell a bit off but better than yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-04
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-25
Dose 2 — Moderna
2021-03-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Nasal congestion, Nasopharyngitis — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Symptoms like a cold - stuffy, coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Nasal congestion, Respiratory tract congestion — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Stuffy cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion, Nasopharyngitis — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Abdominal pain

Free text: Cold symptoms stuffy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — day 7, dose 2
MedDRA: Nasal congestion, Respiratory tract congestion — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Stuffy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-24
Survey response — 3 months, dose 2
MedDRA: Chills, Cough, Diarrhoea, Dyspnoea, Headache, Respiratory tract congestion, Sinusitis — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sinus infectionDifficulty breathingCoughHeadacheCongestionChills Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Dry throat, Lymphadenopathy, Office visit — 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: Swollen glands in neck. Dry throat. · Healthcare visit (other): Doctor visits, CTs, MRIs

MedDRA releases: 2024-11 · check-in free text available
2021-09-23
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-09-27
Call 2 — Left Voicemail
2021-11-11
Dose 3 — Moderna
Co-administered: Shingles
2022-03-27
Survey response — 12 months, dose 2
MedDRA: Pre-existing disease — 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: Chronic sinus infections

MedDRA releases: 2024-11 · check-in free text available
2022-03-27
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-28
Call 1 — Left Voicemail
2022-04-30
Dose 4 — Moderna
2022-04-30
Health check-in — day 0, dose 4
Feeling: Good · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-05-02
Survey response — days 1–6 daily, dose 4
MedDRA: Balance disorder — Feeling: Poor · Fever · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Off balance

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-04
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-07
Health check-in — day 7, dose 4
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-14
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-21
Survey response — day 21, dose 4
MedDRA: Headache, Respiratory tract congestion — Feeling: Fair

Free text: Congestion and headache

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-04
Survey response — day 35, dose 4
MedDRA: Viral infection — 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

Free text: Viral infection

MedDRA releases: 2024-11 · check-in free text available
2022-06-04
Report sent to call center — day 35, dose 4
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 · 1 call case(s)
2022-06-06
Call 1 — Left Voicemail
2022-06-06
Call 2 — Left Voicemail
2022-06-06
Call 1 — Left Voicemail
2022-06-11
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-30
Survey response — 3 months, dose 4
MedDRA: Unevaluable event — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I'm dying

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Survey response — 6 months, dose 4
MedDRA: Cough, Upper respiratory tract infection — 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: Cough, upper respiratory infection

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Report sent to call center — 6 months, dose 4
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-30
Survey response — 12 months, dose 4
MedDRA: Infection, Office visit, Sinusitis, Upper respiratory tract infection — 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 · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-30
Report sent to call center — 12 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-05-01
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Moderna
2	2021-03-25	Moderna
3	2021-11-11	Moderna	Shingles
4	2022-04-30	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-23	Successful 2022-11-01	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-03-27	Successful 2022-11-01	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-04	Successful 2022-11-01	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-31	Successful 2022-11-01	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-30	Successful 2023-05-01	Does not wish to fill out VAERS report

Free text

Release 4 — day 0, dose 1

2021-02-25

Systemic reaction (other): Feverish

Release 4 — days 1–6 daily, dose 1

2021-03-01

Systemic reaction (other): I've noticed a minor change in taste and smell

2021-03-02

Systemic reaction (other): Taste and smell a bit off but better than yesterday

Release 6 — days 1–6 daily, dose 2

2021-03-27

Systemic reaction (other): Symptoms like a cold - stuffy, coughing

2021-03-28

Systemic reaction (other): Stuffy cough

2021-03-31

Systemic reaction (other): Cold symptoms stuffy

Release 6 — day 7, dose 2

2021-04-01

Systemic reaction (other): Stuffy

Release 9 — 3 months, dose 2

2021-06-24

Symptoms: Sinus infectionDifficulty breathingCoughHeadacheCongestionChills Diarrhea

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: Swollen glands in neck. Dry throat.

Healthcare visit (other): Doctor visits, CTs, MRIs

Release 11 — 12 months, dose 2

2022-03-27

Symptoms: Chronic sinus infections

Release 11 — days 1–6 daily, dose 4

2022-05-02

Systemic reaction (other): Off balance

Release 11 — day 21, dose 4

2022-05-21

Symptoms: Congestion and headache

Release 11 — day 35, dose 4

2022-06-04

Symptoms: Viral infection

Release 12 — 3 months, dose 4

2022-07-30

Symptoms: I'm dying

Release 12 — 6 months, dose 4

2022-10-31

Symptoms: Cough, upper respiratory infection

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	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dry throat	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Infection	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SD	Unevaluable event	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Viral infection	·	·	✓
SRO	Balance disorder	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Parosmia	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Respiratory tract congestion	✓	·	✓
SRO	Taste disorder	✓	✓	✓

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