YEU-29172-58870

3 vaccinations 14 coded responses 25 check-ins 13 free-text entries 7 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 845 / UT
Registered: 2021-01-07

Relationship: Self
Race: American Indian or Alaska Native
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
2021-01-07
Survey response — day 0, dose 1
MedDRA: Fatigue — Feeling: Fair · Fatigue or tiredness

Free text: Exhausted

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · 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
2021-01-08
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Pre-existing disease — Feeling: Poor · Site: Pain · Fever · 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: Some coughing and note* previously covid positive in July 2020.

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

1 call case(s)
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Fair · Site: Pain

Free text: Slightly coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Survey response — day 14, dose 1
MedDRA: Arthralgia, Fatigue, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Joints aching & Fatigue. · Healthcare visit (other): PCP visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Was dizzy the day after vaccine shot.

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

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Emergency care — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): Rt shoulder pain. · Healthcare visit (other): Seen in ED last night.

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

1 call case(s)
2021-02-12
Survey response — day 7, dose 2
MedDRA: Pain in extremity — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Rt arm pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-26
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-05
Survey response — day 28, dose 2
MedDRA: Cough, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Coughing and body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 35, dose 2
MedDRA: Fatigue, Pain, Pyrexia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Body aches w fatigue and low grade fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — day 42, dose 2
MedDRA: Arthralgia, Pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Body and joint aches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Call 2 — Left Voicemail
2021-05-09
Survey response — 3 months, dose 2
MedDRA: Adverse reaction — Feeling: Good · Be unable to do your normal daily activities

Free text: Same as last symptoms. No changes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-04
Call 3 — Left Voicemail
2021-08-06
Survey response — 6 months, dose 2
MedDRA: Ear infection, Pyrexia, Sinusitis — Feeling: Fair · 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

Free text: Sinus and ear infection w fever.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-06
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)
2021-08-16
Call 3 — Left Voicemail
2022-02-05
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-02-15
Dose 3 — Moderna
2022-05-17
Survey response — 3 months, dose 3
MedDRA: Malaise, Nasopharyngitis, Pyrexia — Feeling: Fair · 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

Free text: Sick 2 weeks ago w cold sx w fever. Tested negative everything.

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-18
Call 3 — Left Voicemail
2022-05-18
Call 2 — Left Voicemail
2022-05-18
Call 2 — Left Voicemail
2022-05-18
Call 2 — Left Voicemail
2022-08-16
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2023-02-15
Survey response — 12 months, dose 3
MedDRA: Autoimmune disorder, Malaise — Feeling: Poor · 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

MedDRA releases: 2024-11
2023-02-15
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-02-16
Call 1 — Left Voicemail
2023-02-16
Call 1 — Left Voicemail
2023-02-16
Call 1 — Left Voicemail
2023-02-16
Call 1 — Left Voicemail
2023-02-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-05	Moderna
3	2022-02-15	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-08	Unsuccessful
2021-01-09	Unsuccessful
2021-01-21	Unsuccessful
2021-02-11	Unsuccessful
2021-08-06	Unsuccessful
2022-05-17	Unsuccessful
2023-02-15	Unsuccessful

Free text

Release 1 — day 0, dose 1

2021-01-07

Systemic reaction (other): Exhausted

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): Some coughing and note* previously covid positive in July 2020.

2021-01-10

Systemic reaction (other): Slightly coughing

Release 2 — day 14, dose 1

2021-01-21

Symptoms: Joints aching & Fatigue.

Healthcare visit (other): PCP visit

Release 3 — days 1–6 daily, dose 2

2021-02-08

Systemic reaction (other): Was dizzy the day after vaccine shot.

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): Rt shoulder pain.

Healthcare visit (other): Seen in ED last night.

Release 4 — day 7, dose 2

2021-02-12

Systemic reaction (other): Rt arm pain.

Release 5 — day 28, dose 2

2021-03-05

Symptoms: Coughing and body aches

Release 5 — day 35, dose 2

2021-03-12

Symptoms: Body aches w fatigue and low grade fever

Release 6 — day 42, dose 2

2021-03-19

Symptoms: Body and joint aches.

Release 8 — 3 months, dose 2

2021-05-09

Symptoms: Same as last symptoms. No changes

Release 9 — 6 months, dose 2

2021-08-06

Symptoms: Sinus and ear infection w fever.

Release 11 — 3 months, dose 3

2022-05-17

Symptoms: Sick 2 weeks ago w cold sx w fever. Tested negative everything.

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	Emergency care	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Adverse reaction	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Autoimmune disorder	·	·	✓
SD	Cough	✓	✓	✓
SD	Ear infection	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Malaise	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Sinusitis	✓	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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