YHZ-27607-70022

5 vaccinations 11 coded responses 55 check-ins 9 free-text entries 5 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 440 / OH
Registered: 2021-03-15

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

2021-03-15
Registered in v-safe
2021-03-15
Dose 1 — Moderna
2021-03-15
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain

Free text: Lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Paranasal sinus hypersecretion, Pollakiuria — Feeling: Good · Site: Pain

Free text: Anti-inflammatory effects - sinus drainage, more frequent urination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-12
Dose 2 — Moderna
2021-04-12
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · None

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-17
Survey response — day 35, dose 2
MedDRA: Office visit, Tooth infection — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Tooth infection · Healthcare visit (other): Dentist office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-02
Dose 3 — Moderna
2022-04-13
Survey response — 12 months, dose 2
MedDRA: Malaise — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Covid symptoms last fall (10/21)

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-14
Call 1 — Left Voicemail
2022-04-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-19
Dose 4 — Moderna
2022-05-19
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2022-05-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-05-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-26
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-02
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-09
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-16
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-23
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-18
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-10
Dose 5 — Moderna
2022-11-10
Health check-in — day 0, dose 5
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2022-11-11
Survey response — days 1–6 daily, dose 5
MedDRA: Brain fog, Dizziness, Vision blurred — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lightheaded, brain fog, blurry vision

MedDRA releases: 2024-11 · check-in free text available
2022-11-12
Survey response — days 1–6 daily, dose 5
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: Lightheaded

MedDRA releases: 2024-11 · check-in free text available
2022-11-13
Survey response — days 1–6 daily, dose 5
MedDRA: Contusion, Hypoaesthesia, Pre-existing disease, Therapeutic response unexpected — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Middle finger on left hand bruising at middle joint & numbness at finger tip (bruising since vaccine received), slight relief of chronic sinusitis issues, clearer complexion (facial skin & around eyes)

MedDRA releases: 2024-11 · check-in free text available
2022-11-14
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-11-15
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-11-16
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-17
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-11-25
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-12-01
Survey response — day 21, dose 5
MedDRA: Head discomfort, Headache, Massage, Pain, Reaction to previous exposure to any vaccine — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Consistent pressure and dull pain on left side of head, intermittent headaches on left side of head with greater frequency than prior to last booster. · Healthcare visit (other): Massage therapy

MedDRA releases: 2024-11 · check-in free text available
2022-12-01
Report sent to call center — day 21, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2022-12-02
Call successful
Does not wish to fill out VAERS report
2022-12-09
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-15
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-22
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-02-09
Survey response — 3 months, dose 5
MedDRA: Lymph node pain, Massage, Neck pain — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-02-09
Report sent to call center — 3 months, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2023-02-10
Call 1 — Left Voicemail
2023-02-10
Call successful
Does not wish to fill out VAERS report
2023-05-11
Survey response — 6 months, dose 5
MedDRA: Ear infection, Sinusitis, Syncope — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-05-11
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2023-05-12
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Moderna
2	2021-04-12	Moderna
3	2021-12-02	Moderna	No
4	2022-05-19	Moderna	No
5	2022-11-10	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-17	Successful 2022-04-14	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-13	Successful 2022-04-14	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-01	Successful 2022-12-02	Does not wish to fill out VAERS report
2023-02-09	Successful 2023-02-10	Does not wish to fill out VAERS report
2023-05-11	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-15

Systemic reaction (other): Lightheaded

Release 5 — days 1–6 daily, dose 1

2021-03-16

Systemic reaction (other): Anti-inflammatory effects - sinus drainage, more frequent urination

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): Lightheaded

Release 8 — day 35, dose 2

2021-05-17

Symptoms: Tooth infection

Healthcare visit (other): Dentist office

Release 11 — 12 months, dose 2

2022-04-13

Symptoms: Covid symptoms last fall (10/21)

Release 12 — days 1–6 daily, dose 5

2022-11-11

Systemic reaction (other): Lightheaded, brain fog, blurry vision

2022-11-12

Systemic reaction (other): Lightheaded

2022-11-13

Systemic reaction (other): Middle finger on left hand bruising at middle joint & numbness at finger tip (bruising since vaccine received), slight relief of chronic sinusitis issues, clearer complexion (facial skin & around eyes)

Release 12 — day 21, dose 5

2022-12-01

Symptoms: Consistent pressure and dull pain on left side of head, intermittent headaches on left side of head with greater frequency than prior to last booster.

Healthcare visit (other): Massage therapy

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	Massage	·	·	✓
HCVO	Office visit	✓	✓	✓
SD	Ear infection	·	·	✓
SD	Head discomfort	·	·	✓
SD	Headache	·	·	✓
SD	Lymph node pain	·	·	✓
SD	Malaise	·	·	✓
SD	Neck pain	·	·	✓
SD	Pain	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	Sinusitis	·	·	✓
SD	Syncope	·	·	✓
SD	Tooth infection	✓	✓	✓
SRO	Brain fog	·	·	✓
SRO	Contusion	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Paranasal sinus hypersecretion	✓	✓	✓
SRO	Pollakiuria	✓	✓	✓
SRO	Pre-existing disease	·	·	✓
SRO	Therapeutic response unexpected	·	·	✓
SRO	Vision blurred	·	·	✓

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