YDY-17356-87233

5 vaccinations 20 coded responses 69 check-ins 17 free-text entries 7 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 452 / OH
Registered: 2021-02-12

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

2021-02-12
Registered in v-safe
2021-02-12
Dose 1 — Moderna
2021-02-12
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Sinus congestion — Feeling: Fair · Fatigue or tiredness

Free text: Sinus congestion -probably unrelated to vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Bronchitis — Feeling: Fair · Fatigue or tiredness

Free text: Bronchitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Bronchitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Still dealing with bronchitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-19
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-12
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain, Injection site pruritus, Injection site rash, Injection site warmth — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Rash that is on the same arm as the injection site, but not directly on the site. Rash is warm, sore to the touch, and itches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Rash, Rash erythematous, Rash pruritic — Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Free text: Rash is on same arm as injection, but not at the exact site. Red, painful, itches. Approximate area 3 or 4 inches square.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Headache, Rash, not including the immediate area around the injection site

Free text: Rash on same arm as injection, but not at site itself. Is improving.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Rash on same arm as injection. Continuing to fade

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 7, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-03-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-11
Survey response — 3 months, dose 2
MedDRA: Sinus congestion — Feeling: Good

Free text: Sinus congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-10
Call 1 — Left Voicemail
2021-09-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-30
Dose 3 — Moderna
2021-10-30
Health check-in — day 0, dose 3
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-11-06
Health check-in — day 7, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-13
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-20
Survey response — day 21, dose 3
MedDRA: Sinus congestion — Feeling: Good

Free text: Sinus congestion

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Survey response — day 28, dose 3
MedDRA: Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sinus infection

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-04
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-11
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-29
Survey response — 3 months, dose 3
MedDRA: Chronic sinusitis, Oropharyngeal pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sinusitis (chronic). Sore throat (just started today, 1/29/22)

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-29
Dose 4 — Moderna
2022-04-29
Survey response — day 0, dose 4
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Survey response — days 1–6 daily, dose 4
MedDRA: Nausea — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Queasiness

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Swelling · Fever · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2022-05-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site

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

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-05-06
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-05-13
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-20
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-10
Survey response — day 42, dose 4
MedDRA: Sinus congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sinus congestion

MedDRA releases: 2024-11 · check-in free text available
2022-06-10
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-13
Call successful
Not applicable - Accidental Reporting
2022-07-29
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-28
Survey response — 6 months, dose 4
MedDRA: Cough, Oropharyngeal pain, Sinus congestion — Feeling: Fair · 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: Sinus congestion, cough, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-31
Call 1 — Left Voicemail
2022-12-16
Dose 5 — Moderna
2022-12-16
Health check-in — day 0, dose 5
Feeling: Good · None

Adult check-in
2022-12-17
Survey response — days 1–6 daily, dose 5
MedDRA: Ear pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: Eat pain

MedDRA releases: 2024-11 · check-in free text available
2022-12-18
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2022-12-19
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2022-12-20
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2022-12-21
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2022-12-22
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-12-23
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-12-30
Survey response — day 14, dose 5
MedDRA: Sinus congestion — Feeling: Good

Free text: Sinus congestion

MedDRA releases: 2024-11 · check-in free text available
2023-01-07
Survey response — day 21, dose 5
MedDRA: Sinus congestion — Feeling: Fair

MedDRA releases: 2024-11
2023-01-13
Survey response — day 28, dose 5
MedDRA: Sinus congestion — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-01-13
Report sent to call center — day 28, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-01-16
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-16
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-20
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2023-01-27
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-03-17
Survey response — 3 months, dose 5
MedDRA: Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-17
Report sent to call center — 3 months, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-20
Call 1 — Left Voicemail
2023-06-16
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2021-10-30	Moderna	No
4	2022-04-29	Moderna	No
5	2022-12-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-18	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-27	Successful 2021-12-01	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-29	Successful 2022-02-01	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-06-10	Successful 2022-06-13	Not applicable - Accidental Reporting
2022-10-28	Successful 2023-01-16	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-13	Successful 2023-01-16	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-17	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-15

Systemic reaction (other): Sinus congestion -probably unrelated to vaccine

2021-02-16

Systemic reaction (other): Bronchitis

2021-02-18

Systemic reaction (other): Still dealing with bronchitis

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): Rash that is on the same arm as the injection site, but not directly on the site. Rash is warm, sore to the touch, and itches.

2021-03-15

Systemic reaction (other): Rash is on same arm as injection, but not at the exact site. Red, painful, itches. Approximate area 3 or 4 inches square.

2021-03-16

Systemic reaction (other): Rash on same arm as injection, but not at site itself. Is improving.

2021-03-17

Systemic reaction (other): Rash on same arm as injection. Continuing to fade

Release 9 — 3 months, dose 2

2021-06-11

Symptoms: Sinus congestion

Release 10 — day 21, dose 3

2021-11-20

Symptoms: Sinus congestion

Release 10 — day 28, dose 3

2021-11-27

Symptoms: Sinus infection

Release 11 — 3 months, dose 3

2022-01-29

Symptoms: Sinusitis (chronic). Sore throat (just started today, 1/29/22)

Release 11 — day 0, dose 4

2022-04-29

Systemic reaction (other): Dizziness

Release 11 — days 1–6 daily, dose 4

2022-04-30

Systemic reaction (other): Queasiness

Release 12 — day 42, dose 4

2022-06-10

Symptoms: Sinus congestion

Release 12 — 6 months, dose 4

2022-10-28

Symptoms: Sinus congestion, cough, sore throat

Release 12 — days 1–6 daily, dose 5

2022-12-17

Systemic reaction (other): Eat pain

Release 12 — day 14, dose 5

2022-12-30

Symptoms: Sinus congestion

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	Chronic sinusitis	·	·	✓
SD	Cough	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Sinus congestion	✓	✓	✓
SD	Sinusitis	·	·	✓
SRO	Bronchitis	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Ear pain	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site rash	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Nausea	·	·	✓
SRO	Rash	✓	✓	✓
SRO	Rash erythematous	✓	✓	✓
SRO	Rash pruritic	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓

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