YD7-28784-20217

2 vaccinations 7 coded responses 25 check-ins 7 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 430 / OH
Registered: 2021-01-15

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

2021-01-14
Dose 1 — Moderna
2021-01-15
Registered in v-safe
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Fatigue or tiredness

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

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Survey response — day 14, dose 1
MedDRA: Headache — Feeling: Good

Free text: Headaches

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

Adult check-in
2021-02-11
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-18
Dose 2 — Moderna
2021-02-18
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good · Fatigue or tiredness

Free text: Mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Tinnitus — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Extremely Increased Tinnitus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-25
Survey response — day 7, dose 2
MedDRA: Dizziness, Office visit, Tinnitus — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Intensified tinnitus and dizziness · Healthcare visit (other): Made off. appt with ENT for 3/3

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Report sent to call center — day 7, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-04
Survey response — day 14, dose 2
MedDRA: Disturbance in attention, Hypoacusis, Office visit — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Excessive intermittent loud sounds that were different than my regular tinnitus and disrupted my thoughts and actionsSaw ENT yesterday · Healthcare visit (other): ENT office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Report sent to call center — day 14, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-19
Survey response — 6 months, dose 2
MedDRA: Asthma, Malaise, Office visit, Pre-existing disease, SARS-CoV-2 test negative — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Symptoms: Asthma exacerbation which had COVID like symptoms but COVID test was negative · Healthcare visit (other): Office appointment

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-19
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

1 call case(s)
2021-08-20
Call 1 — Could Not Reach Participant
2021-08-25
Call 2 — Left Voicemail
2022-02-18
Survey response — 12 months, dose 2
MedDRA: Office visit, Pain in extremity — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: A searing pain running down my left arm from the point of my third vaccine to my fingers · Healthcare visit (other): My physician

MedDRA releases: 2024-11 · check-in free text available
2022-02-18
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-18	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-02-24	Unsuccessful
2021-02-25	Unsuccessful
2021-03-04	Unsuccessful
2021-08-19	Unsuccessful
2022-02-18	Unsuccessful

Free text

Release 2 — day 14, dose 1

2021-01-28

Symptoms: Headaches

Release 4 — days 1–6 daily, dose 2

2021-02-23

Systemic reaction (other): Mild

2021-02-24

Systemic reaction (other): Extremely Increased Tinnitus

Release 4 — day 7, dose 2

2021-02-25

Systemic reaction (other): Intensified tinnitus and dizziness

Healthcare visit (other): Made off. appt with ENT for 3/3

Release 5 — day 14, dose 2

2021-03-04

Symptoms: Excessive intermittent loud sounds that were different than my regular tinnitus and disrupted my thoughts and actionsSaw ENT yesterday

Healthcare visit (other): ENT office visit

Release 9 — 6 months, dose 2

2021-08-19

Symptoms: Asthma exacerbation which had COVID like symptoms but COVID test was negative

Healthcare visit (other): Office appointment

Release 11 — 12 months, dose 2

2022-02-18

Symptoms: A searing pain running down my left arm from the point of my third vaccine to my fingers

Healthcare visit (other): My physician

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	Asthma	✓	·	✓
SD	Disturbance in attention	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypoacusis	✓	✓	✓
SD	Malaise	✓	·	✓
SD	Pain in extremity	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	SARS-CoV-2 test negative	✓	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Tinnitus	✓	✓	✓

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