YJL-32990-50389

5 vaccinations 26 coded responses 62 check-ins 20 free-text entries 7 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 373 / TN
Registered: 2021-02-23

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

2021-02-23
Registered in v-safe
2021-02-23
Dose 1 — Moderna
2021-02-23
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Nausea, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-24
Survey response — days 1–6 daily, dose 1
MedDRA: Eye pruritus — Feeling: Good · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Itchy eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Good · Site: Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Itchy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Headache

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 1
MedDRA: Hyperhidrosis — Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-02
Health check-in — day 7, dose 1
Feeling: Fair · Site: Itching · Chills, Headache, Nausea

Adult check-in
2021-03-09
Survey response — day 14, dose 1
MedDRA: Arthralgia, Cough, Eye pruritus, Headache, Oropharyngeal pain, Pain, Pruritus, Pyrexia, Rash — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Rash and itch on arm of injection. Itch on hand. Headache, itchy eye, sore throat, cough, body aches & joint pain & slight fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-23
Dose 2 — Moderna
2021-03-23
Health check-in — day 0, dose 2
Feeling: Good · Chills

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Joint pains, Abdominal pain

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-03-30
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-04
Survey response — day 42, dose 2
MedDRA: Arthralgia, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities

Free text: Feet, ankle & calf pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Headache, Rash, Sneezing — 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

Free text: Headache, joint pain, rash & sneezing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
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)
2021-07-02
Call 1 — Could Not Reach Participant
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Chest pain, Flank pain, Headache, Heart rate abnormal, Nausea, Office visit, Pain, Rash, Visual impairment — 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

Free text: Symptoms: Headaches, vision problems, nausea, joints & body aches, rashes, side & chest pain and erratic heartbeats. · Healthcare visit (other): Multiple doctors visits & testing.

MedDRA releases: 2024-11 · check-in free text available
2021-09-23
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-24
Dose 3 — Moderna
2021-10-24
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Pruritus, Rash — Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Rash & itching on face

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Chills, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-10-31
Health check-in — day 7, dose 3
Feeling: Fair · Site: Itching · Fever · Chills, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-07
Survey response — day 14, dose 3
MedDRA: Exposure to SARS-CoV-2, SARS-CoV-2 test negative, Upper respiratory tract infection — 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

Free text: Symptoms. Upper respiratory infection. Test negative Friday after informed close contact Wednesday with person tested positive & is being treated for covid.

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Report sent to call center — day 14, 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)
2021-11-09
Call 1 — Could Not Reach Participant
2021-11-10
Call successful
Does not wish to fill out VAERS report
2021-11-14
Survey response — day 21, dose 3
MedDRA: Chills, Fatigue, Headache, Hyperhidrosis, Medical counselling, Oropharyngeal pain, Paraesthesia, Rash, Sneezing — 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

Free text: Symptoms: Fatigue, sore throat, tingly nose, sneezing, rash, headache, chills & sweats. · Healthcare visit (other): Phone

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Report sent to call center — day 21, 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

1 call case(s)
2021-11-16
Call successful
Does not wish to fill out VAERS report
2021-11-16
Call successful
Does not wish to fill out VAERS report
2021-11-16
Call successful
Does not wish to fill out VAERS report
2021-11-21
Health check-in — day 28, dose 3
Feeling: Poor

Adult check-in
2021-11-28
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-05
Survey response — day 42, dose 3
MedDRA: Arthralgia, Chills, Diarrhoea, Fatigue, Headache, Hyperhidrosis, Oropharyngeal pain, Pain in extremity — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fatigue, sore throat, headache, diarrhea, joint & leg pain with sweats & chills.

MedDRA releases: 2024-11 · check-in free text available
2022-01-23
Survey response — 3 months, dose 3
MedDRA: Heart rate increased, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Rashes come and go various skin areas. Random increase of heart rate with no activity.

MedDRA releases: 2024-11 · check-in free text available
2022-01-23
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-01-24
Call 1 — Left Voicemail
2022-07-10
Dose 4 — Moderna
2022-07-10
Survey response — day 0, dose 4
MedDRA: Urticaria — Feeling: Fair · Site: Pain, Redness · Chills, Headache, Rash, not including the immediate area around the injection site

Free text: Hives on face

MedDRA releases: 2024-11 · check-in free text available
2022-07-11
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain, Toothache — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat and sore teeth

MedDRA releases: 2024-11 · check-in free text available
2022-07-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Vomiting, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-07-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2022-07-14
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-07-15
Survey response — days 1–6 daily, dose 4
MedDRA: Epistaxis — Feeling: Poor · Site: Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Bloody nose

MedDRA releases: 2024-11 · check-in free text available
2022-07-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2022-07-17
Health check-in — day 7, dose 4
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-07-24
Survey response — day 14, dose 4
MedDRA: Arthralgia, Cough, Headache, Oropharyngeal pain, Pain, Pruritus, Rash, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Rash, itching, sore throat, sneezing, some coughing and headache, all over joints & body pain.

MedDRA releases: 2024-11 · check-in free text available
2022-07-31
Survey response — day 21, dose 4
MedDRA: Arthralgia, Myalgia, Rash — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Joint, muscle pain and rash.

MedDRA releases: 2024-11 · check-in free text available
2022-08-07
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-08-14
Survey response — day 35, dose 4
MedDRA: Arthralgia, Chills, Cough, Fatigue, Headache, Hyperhidrosis, Rhinorrhoea, Sneezing — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headache, all over joint pain, running nose, sneezing, chills, sweats, slight coughing spells and fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-08-21
Survey response — day 42, dose 4
MedDRA: Arthralgia, Chills, Cough, Headache, Hyperhidrosis, Rash, Sneezing — Feeling: Poor · Be unable to do your normal daily activities

Free text: Headaches, joint pain, chills, sweats, rashes, sneezing and coughing.

MedDRA releases: 2024-11 · check-in free text available
2022-10-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-01-08
Survey response — 6 months, dose 4
MedDRA: Rash — 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

MedDRA releases: 2024-11
2023-01-08
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-10
Call successful
Participant prefers to complete VAERS report online
2023-01-10
Call successful
Participant prefers to complete VAERS report online
2023-01-26
Dose 5 — Moderna
2023-02-01
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Itching · Fever · Joint pains

Adult check-in
2023-02-02
Health check-in — day 7, dose 5
Feeling: Good · Site: Itching · Joint pains

Adult check-in
2023-02-09
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2023-02-16
Survey response — day 21, dose 5
MedDRA: Arthralgia, Chills, Fatigue, Headache, Hyperhidrosis, Oropharyngeal pain, Pain, Rash, Unevaluable event — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-02-23
Survey response — day 28, dose 5
MedDRA: Arthralgia, Headache, Nausea, Sneezing — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-03-02
Survey response — day 35, dose 5
MedDRA: Office visit, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-03-02
Report sent to call center — day 35, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2023-03-03
Call successful
Does not wish to fill out VAERS report
2023-03-09
Survey response — day 42, dose 5
MedDRA: Arthralgia, Headache, Oropharyngeal pain, Rash, Sneezing — Feeling: Poor · Be unable to work or attend school

MedDRA releases: 2024-11
2023-04-28
Survey response — 3 months, dose 5
MedDRA: Fatigue, Headache, Hyperhidrosis, Oropharyngeal pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-23	Moderna
2	2021-03-23	Moderna
3	2021-10-24	Moderna	No
4	2022-07-10	Moderna	No
5	2023-01-26	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-24	Successful 2021-11-16	Does not wish to fill out VAERS report
2021-09-23	Successful 2021-11-16	Does not wish to fill out VAERS report
2021-11-07	Successful 2021-11-10	Does not wish to fill out VAERS report
2021-11-14	Successful 2021-11-16	Does not wish to fill out VAERS report
2022-01-23	Successful 2023-01-10	Participant prefers to complete VAERS report online
2023-01-08	Successful 2023-01-10	Participant prefers to complete VAERS report online
2023-03-02	Successful 2023-03-03	Does not wish to fill out VAERS report

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-24

Systemic reaction (other): Itchy eyes

2021-02-26

Systemic reaction (other): Itchy

2021-02-28

Systemic reaction (other): Sweats

Release 5 — day 14, dose 1

2021-03-09

Symptoms: Rash and itch on arm of injection. Itch on hand. Headache, itchy eye, sore throat, cough, body aches & joint pain & slight fever.

Release 8 — day 42, dose 2

2021-05-04

Symptoms: Feet, ankle & calf pain.

Release 9 — 3 months, dose 2

2021-06-24

Symptoms: Headache, joint pain, rash & sneezing.

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: Headaches, vision problems, nausea, joints & body aches, rashes, side & chest pain and erratic heartbeats.

Healthcare visit (other): Multiple doctors visits & testing.

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Rash & itching on face

Release 10 — day 14, dose 3

2021-11-07

Symptoms: Symptoms. Upper respiratory infection. Test negative Friday after informed close contact Wednesday with person tested positive & is being treated for covid.

Release 10 — day 21, dose 3

2021-11-14

Symptoms: Fatigue, sore throat, tingly nose, sneezing, rash, headache, chills & sweats.

Healthcare visit (other): Phone

Release 10 — day 42, dose 3

2021-12-05

Symptoms: Fatigue, sore throat, headache, diarrhea, joint & leg pain with sweats & chills.

Release 11 — 3 months, dose 3

2022-01-23

Symptoms: Rashes come and go various skin areas. Random increase of heart rate with no activity.

Release 12 — day 0, dose 4

2022-07-10

Systemic reaction (other): Hives on face

Release 12 — days 1–6 daily, dose 4

2022-07-11

Systemic reaction (other): Sore throat and sore teeth

2022-07-14

Systemic reaction (other): Sore throat

2022-07-15

Systemic reaction (other): Bloody nose

Release 12 — day 14, dose 4

2022-07-24

Symptoms: Rash, itching, sore throat, sneezing, some coughing and headache, all over joints & body pain.

Release 12 — day 21, dose 4

2022-07-31

Symptoms: Joint, muscle pain and rash.

Release 12 — day 35, dose 4

2022-08-14

Symptoms: Headache, all over joint pain, running nose, sneezing, chills, sweats, slight coughing spells and fatigue.

Release 12 — day 42, dose 4

2022-08-21

Symptoms: Headaches, joint pain, chills, sweats, rashes, sneezing and coughing.

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	Arthralgia	✓	✓	✓
SD	Chest pain	·	·	✓
SD	Chills	·	·	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Eye pruritus	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Flank pain	·	·	✓
SD	Headache	✓	✓	✓
SD	Heart rate abnormal	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Paraesthesia	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sneezing	✓	✓	✓
SD	Unevaluable event	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Visual impairment	·	·	✓
SRO	Epistaxis	·	·	✓
SRO	Eye pruritus	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	·	·	✓
SRO	Toothache	·	·	✓
SRO	Urticaria	·	·	✓

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