YDH-21928-58378

4 vaccinations 9 coded responses 29 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 300 / GA
Registered: 2021-01-07

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-02-04
Dose 2 — Moderna
2021-02-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Itching · Muscle or body aches

Free text: Symptoms are ongoing before shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Fever · Fatigue or tiredness

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Good · Muscle or body aches

Free text: Normal aches andPains

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-11
Survey response — day 7, dose 2
MedDRA: Unevaluable event — Feeling: Good · Muscle or body aches

Free text: Are these today meaning since this morning or the last 24 hours?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Survey response — day 21, dose 2
MedDRA: Headache, Neck pain — Feeling: Good

Free text: Neck ache and headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Survey response — 3 months, dose 2
MedDRA: Hepatic enzyme abnormal — Feeling: Fair

Free text: Elevated liver enzymes - February, 2021 annual physical and again in blood work April, 2021. PCP thinks maybe fatty deposits from my weight. Ultrasound this week. Also, started atorvastatin, 40 mg/day in October 2020.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-05
Survey response — 6 months, dose 2
MedDRA: Rash macular — Feeling: Good

Free text: No new health conditions but I have noticed that in my chest area I am very splotchy looking. It seems to look worse as the day goes on. Have not been to dr. about it. May or may not be related to vaccine. Dont know.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-23
Dose 3 — Moderna
2021-10-25
Survey response — days 1–6 daily, dose 3
MedDRA: Body temperature increased — Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness

Free text: Had low grade 99.2 temp yesterday evening

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Rash macular — Feeling: Good · Site: Itching

Free text: The one thing I would say is that I have splotchiness on my chest area now which is worse at night.this showed up since we started the vaccines. Not sure if they are related to vaccine es or not but thought I would let you all know.

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-10-30
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-20
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Survey response — day 35, dose 3
MedDRA: Office visit, Sinus disorder, Skin disorder, Skin haemorrhage — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Yes and no. Bit of sinus issue right now. First precancerous place.on leg. Looked like veins on upper leg but in a circle. I accidentally pulled something from that spot and LOTS of blood before going to dermatologist and she biopsied it. TMI? · Healthcare visit (other): PCP office visit, then dermatologist

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-02
Call 1 — Left Voicemail
2021-12-04
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-04
Dose 4 — Moderna
2022-04-18
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-25
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2021-10-23	Moderna	No
4	2022-04-04	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-29	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): Symptoms are ongoing before shot

2021-02-07

Systemic reaction (other): Normal aches andPains

Release 4 — day 7, dose 2

2021-02-11

Systemic reaction (other): Are these today meaning since this morning or the last 24 hours?

Release 4 — day 21, dose 2

2021-02-25

Symptoms: Neck ache and headache.

Release 8 — 3 months, dose 2

2021-05-06

Symptoms: Elevated liver enzymes - February, 2021 annual physical and again in blood work April, 2021. PCP thinks maybe fatty deposits from my weight. Ultrasound this week. Also, started atorvastatin, 40 mg/day in October 2020.

Release 9 — 6 months, dose 2

2021-08-05

Symptoms: No new health conditions but I have noticed that in my chest area I am very splotchy looking. It seems to look worse as the day goes on. Have not been to dr. about it. May or may not be related to vaccine. Dont know.

Release 10 — days 1–6 daily, dose 3

2021-10-25

Systemic reaction (other): Had low grade 99.2 temp yesterday evening

2021-10-28

Systemic reaction (other): The one thing I would say is that I have splotchiness on my chest area now which is worse at night.this showed up since we started the vaccines. Not sure if they are related to vaccine es or not but thought I would let you all know.

Release 10 — day 35, dose 3

2021-11-29

Symptoms: Yes and no. Bit of sinus issue right now. First precancerous place.on leg. Looked like veins on upper leg but in a circle. I accidentally pulled something from that spot and LOTS of blood before going to dermatologist and she biopsied it. TMI?

Healthcare visit (other): PCP office visit, then dermatologist

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	Headache	✓	✓	✓
SD	Hepatic enzyme abnormal	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Office visit	·	·	✓
SD	Rash macular	✓	·	✓
SD	Sinus disorder	·	·	✓
SD	Skin disorder	·	·	✓
SD	Skin haemorrhage	·	·	✓
SRO	Body temperature increased	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Rash macular	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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