YDQ-12949-71186

3 vaccinations 7 coded responses 35 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 804 / CO
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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Moderna
2021-01-14
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fever · Headache

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

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 · Fatigue or tiredness

Adult check-in
2021-01-18
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
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Survey response — day 0, dose 2
MedDRA: Hypoaesthesia oral — Feeling: Good · Headache

Free text: Lips were numb

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia oral — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Numbness of Lips

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia oral — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Numbness of tongue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 2
MedDRA: Medical counselling — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, 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: Call with Regular Physician for Direction

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Report sent to call center — days 1–6 daily, 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)
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-20
Survey response — day 7, dose 2
MedDRA: Night sweats — Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Night Sweats

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

Adult check-in
2021-03-04
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-11
Survey response — day 28, dose 2
MedDRA: Fatigue, Influenza like illness, Office visit, Pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I have days that I still have flu like symptoms, fatigue, and aches that I hadwhen I received the Vaccine over a month ago. · Healthcare visit (other): Primary Care & Eye Dr.

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

1 call case(s)
2021-03-18
Health check-in — day 35, dose 2
Feeling: Fair

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

Adult check-in
2021-05-13
Survey response — 3 months, dose 2
MedDRA: Office visit, Pain — Feeling: Fair · 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, Hospitalization

Free text: Symptoms: Achy all over, knees and Back. Doing PT, and had Cortisone shots in knees. Could this be result of Vaccine?I had Shingles shot with symptoms that lasted a year. Did not have 2nd shot at Drs recommendation Had 2 Moderna vaccine. · Healthcare visit (other): To check for blood clot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-02
Call 1 — Left Voicemail
2021-08-02
Call 1 — Left Voicemail
2021-08-02
Call 1 — Left Voicemail
2021-08-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-14
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna
3	2021-10-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-15	Unsuccessful
2021-03-11	Unsuccessful
2021-05-13	Unsuccessful

Free text

Release 4 — day 0, dose 2

2021-02-11

Systemic reaction (other): Lips were numb

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Numbness of Lips

2021-02-14

Systemic reaction (other): Numbness of tongue

2021-02-15

Healthcare visit (other): Call with Regular Physician for Direction

Release 4 — day 7, dose 2

2021-02-20

Systemic reaction (other): Night Sweats

Release 5 — day 28, dose 2

2021-03-11

Symptoms: I have days that I still have flu like symptoms, fatigue, and aches that I hadwhen I received the Vaccine over a month ago.

Healthcare visit (other): Primary Care & Eye Dr.

Release 8 — 3 months, dose 2

2021-05-13

Symptoms: Achy all over, knees and Back. Doing PT, and had Cortisone shots in knees. Could this be result of Vaccine?I had Shingles shot with symptoms that lasted a year. Did not have 2nd shot at Drs recommendation Had 2 Moderna vaccine.

Healthcare visit (other): To check for blood clot

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	Fatigue	✓	✓	✓
SD	Influenza like illness	✓	✓	✓
SD	Pain	✓	✓	✓
SRO	Hypoaesthesia oral	✓	✓	✓
SRO	Night sweats	✓	✓	✓

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