YC2-91100-78609

3 vaccinations 11 coded responses 38 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 761 / TX
Registered: 2021-01-14

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

2021-01-13
Dose 1 — Moderna
2021-01-14
Registered in v-safe
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Pain, Reaction to previous exposure to any vaccine — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Just feel very drained, achey, tiered like the flu shot makes me feel the day after.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Headache, Pre-existing disease, Respiratory tract congestion — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Stuffy head, which I have allergies though. Was feeling good when I woke up did some chores around the house and feeling fatigue and tiered this afternoon.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-17
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea, Headache, Nausea — Feeling: Good · Headache

Free text: Last night got very nauseated and had diarrhea for about 5 hours and had bad headache. Went away after small nap..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Stuffy nose and feel a little congested. I do have allergies and change of weather here could be the cause, not the vacc

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Survey response — day 7, dose 1
MedDRA: Headache, Injection site pruritus — Feeling: Fair · Site: Itching · Headache

Free text: Mild headache again and started itching at vaccine site briefly like it did right after being vaccinated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — day 14, dose 1
MedDRA: Diarrhoea, Headache, Nausea — Feeling: Poor

Free text: Headache, diarrhea, and nausea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Sinus congestion — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Sinus congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Epistaxis, Nasal dryness — Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Free text: Dry sinusis. Had a nose bleed. Had that with first vaccine as well. Under control now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — day 7, dose 2
MedDRA: Adverse reaction — Feeling: Good · Headache, Fatigue or tiredness

Free text: Feeling this way due to stress from freezing weather here in Fort Worth all week, not the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-18
Dose 3 — Moderna
2022-01-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-01-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2022-01-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2022-01-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-01-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-01-25
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-02-01
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-08
Survey response — day 21, dose 3
MedDRA: Rash, Rash pruritic, Self-medication — Feeling: Good

Free text: Itchy rash under right wrist, same side that I was vaccinated with. May or may not be associated with the booster vaccine. I'm treating it with antihistamine cream. I don't normally break out in rashes. It's a mild rash and is starting to go away.

MedDRA releases: 2024-11 · check-in free text available
2022-02-15
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-02-22
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-03-01
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-19
Survey response — 3 months, dose 3
MedDRA: Cough, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Good

Free text: Severe congestion and cough. Negative per COVID test.

MedDRA releases: 2024-11 · check-in free text available
2022-07-21
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2023-01-20
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-11	Moderna
3	2022-01-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-17	priority 2/3

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): Just feel very drained, achey, tiered like the flu shot makes me feel the day after.

2021-01-17

Systemic reaction (other): Stuffy head, which I have allergies though. Was feeling good when I woke up did some chores around the house and feeling fatigue and tiered this afternoon.

2021-01-18

Systemic reaction (other): Last night got very nauseated and had diarrhea for about 5 hours and had bad headache. Went away after small nap..

2021-01-19

Systemic reaction (other): Stuffy nose and feel a little congested. I do have allergies and change of weather here could be the cause, not the vacc

Release 2 — day 7, dose 1

2021-01-21

Systemic reaction (other): Mild headache again and started itching at vaccine site briefly like it did right after being vaccinated.

Release 2 — day 14, dose 1

2021-01-27

Symptoms: Headache, diarrhea, and nausea.

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Sinus congestion

2021-02-13

Systemic reaction (other): Dry sinusis. Had a nose bleed. Had that with first vaccine as well. Under control now.

Release 4 — day 7, dose 2

2021-02-18

Systemic reaction (other): Feeling this way due to stress from freezing weather here in Fort Worth all week, not the vaccine.

Release 11 — day 21, dose 3

2022-02-08

Symptoms: Itchy rash under right wrist, same side that I was vaccinated with. May or may not be associated with the booster vaccine. I'm treating it with antihistamine cream. I don't normally break out in rashes. It's a mild rash and is starting to go away.

Release 11 — 3 months, dose 3

2022-04-19

Symptoms: Severe congestion and cough. Negative per COVID test.

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	Cough	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Rash	·	·	✓
SD	Rash pruritic	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Self-medication	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Epistaxis	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Nasal dryness	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Reaction to previous exposure to any vaccine	✓	·	✓
SRO	Respiratory tract congestion	✓	·	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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