YJP-21757-49077

2 vaccinations 10 coded responses 25 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 481 / MI
Registered: 2021-02-26

Relationship: Self
Race: N/A
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-26
Registered in v-safe
2021-02-26
Dose 1 — Moderna
2021-02-26
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-19
Survey response — day 21, dose 1
MedDRA: Pruritus — Feeling: Fair

Free text: Itchy skin on lower extremities.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Dose 2 — Moderna
2021-03-26
Health check-in — day 0, dose 2
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Epistaxis — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Blood in nostrils

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Site: Pain · Muscle or body aches, Nausea

Free text: Problem falling asleep & staying asleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Good

Free text: Still having sleep issues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Somnolence — Feeling: Fair

Free text: Falling asleep & staying asleep.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 7, dose 2
MedDRA: Insomnia — Feeling: Good

Free text: Sleeping issues

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

Adult check-in
2021-04-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-23
Survey response — day 28, dose 2
MedDRA: Chills, Diarrhoea, Pyrexia, Vomiting — Feeling: Fair · 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: Just a few hours after last Friday's check-in I endured 4 hours of simultaneous vomiting, diarrhea and chills which were teeth- chattering. That was interspersed with fever, and I continued to have an elevated temp until 6 am on 4-19-21. It was awful

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Report sent to call center — day 28, 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)
2021-04-30
Survey response — day 35, dose 2
MedDRA: Joint swelling, Peripheral swelling — Feeling: Good

Free text: Most evenings I've noticed that my right foot and ankle have been swelling. It subsides by the time I wake up the next morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Insomnia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Worsening problems trying to fall asleep and staying asleep for more than 4 hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-24
Survey response — 6 months, dose 2
MedDRA: Headache, Weight increased — Feeling: Fair

Free text: 1) Headaches nearly every week - not too intense, but definitely not the prior norm for me.2) Weight gain - about 7 lbs gained since April 2021.

MedDRA releases: 2024-11 · check-in free text available
2022-03-26
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-04-04
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-26	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-23	Unsuccessful

Free text

Release 5 — day 21, dose 1

2021-03-19

Symptoms: Itchy skin on lower extremities.

Release 6 — days 1–6 daily, dose 2

2021-03-27

Systemic reaction (other): Blood in nostrils

2021-03-30

Systemic reaction (other): Problem falling asleep & staying asleep

2021-03-31

Systemic reaction (other): Still having sleep issues.

2021-04-01

Systemic reaction (other): Falling asleep & staying asleep.

Release 6 — day 7, dose 2

2021-04-02

Systemic reaction (other): Sleeping issues

Release 7 — day 28, dose 2

2021-04-23

Symptoms: Just a few hours after last Friday's check-in I endured 4 hours of simultaneous vomiting, diarrhea and chills which were teeth- chattering. That was interspersed with fever, and I continued to have an elevated temp until 6 am on 4-19-21. It was awful cut off by CDC

Release 8 — day 35, dose 2

2021-04-30

Symptoms: Most evenings I've noticed that my right foot and ankle have been swelling. It subsides by the time I wake up the next morning.

Release 8 — day 42, dose 2

2021-05-09

Symptoms: Worsening problems trying to fall asleep and staying asleep for more than 4 hours.

Release 9 — 6 months, dose 2

2021-09-24

Symptoms: 1) Headaches nearly every week - not too intense, but definitely not the prior norm for me.2) Weight gain - about 7 lbs gained since April 2021.

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	Chills	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Headache	·	·	✓
SD	Insomnia	✓	✓	✓
SD	Joint swelling	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Vomiting	✓	✓	✓
SD	Weight increased	·	·	✓
SRO	Epistaxis	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Somnolence	✓	✓	✓

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