YK9-22728-41837

4 vaccinations 8 coded responses 53 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 286 / NC
Registered: 2021-02-24

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

2021-02-24
Registered in v-safe
2021-02-24
Dose 1 — Moderna
2021-02-24
Survey response — day 0, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Joint pains, Muscle or body aches

Free text: These may be due to my arthritis and not being able to take my aleeve

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease, Unevaluable event — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches

Free text: These may be enhanced due to not resuming my Aleeve yet for arthritis and degenerative disk disease.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches

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 — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-26
Dose 2 — Moderna
2021-03-26
Survey response — day 0, dose 2
MedDRA: Swollen tongue — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: My tongue swelled a little

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
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 · Be unable to do your normal daily activities

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-02
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-09
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-04-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Dose 3 — Moderna
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Itching · Abdominal pain

Adult check-in
2021-11-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-04
Survey response — 3 months, dose 3
MedDRA: Sinusitis — Feeling: Good · 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
2022-02-04
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-16
Call 1 — Left Voicemail
2022-05-08
Survey response — 6 months, dose 3
MedDRA: Body temperature increased — Feeling: Good · Be unable to work or attend school

Free text: 10 day low grade fever. 99.9 degrees, my usual temp is 97.0

MedDRA releases: 2024-11 · check-in free text available
2022-06-16
Dose 4 — Moderna
2022-06-16
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-06-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fever · Muscle or body aches

Adult check-in
2022-06-18
Survey response — days 1–6 daily, dose 4
MedDRA: SARS-CoV-2 test positive — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I tested positive today for covid

MedDRA releases: 2024-11 · check-in free text available
2022-06-19
Survey response — days 1–6 daily, dose 4
MedDRA: SARS-CoV-2 test positive — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tested positive for Covid Saturday

MedDRA releases: 2024-11 · check-in free text available
2022-06-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-06-23
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-06-30
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-07
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-07-14
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-21
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-30
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-16
Survey response — 6 months, dose 4
MedDRA: COVID-19, Gastroenteritis viral, Hypertension, Respiratory tract infection, Vertigo — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Covid, stomach virus, respiratory infection, high blood pressure, vertigo

MedDRA releases: 2024-11 · check-in free text available
2022-12-16
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2022-12-19
Call 1 — Requested Callback
2022-12-20
Callback requested for
11:30AM ET
2022-12-22
Call 2 — Left Voicemail
2023-06-18
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-24	Moderna
2	2021-03-26	Moderna
3	2021-11-05	Moderna	No
4	2022-06-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-04	Unsuccessful
2022-12-16	Unsuccessful

Free text

Release 4 — day 0, dose 1

2021-02-24

Systemic reaction (other): These may be due to my arthritis and not being able to take my aleeve

Release 4 — days 1–6 daily, dose 1

2021-02-25

Systemic reaction (other): These may be enhanced due to not resuming my Aleeve yet for arthritis and degenerative disk disease.

Release 6 — day 0, dose 2

2021-03-26

Systemic reaction (other): My tongue swelled a little

Release 11 — 3 months, dose 3

2022-02-04

Symptoms: Sinus infection

Release 11 — 6 months, dose 3

2022-05-08

Symptoms: 10 day low grade fever. 99.9 degrees, my usual temp is 97.0

Release 12 — days 1–6 daily, dose 4

2022-06-18

Systemic reaction (other): I tested positive today for covid

2022-06-19

Systemic reaction (other): Tested positive for Covid Saturday

Release 12 — 6 months, dose 4

2022-12-16

Symptoms: Covid, stomach virus, respiratory infection, high blood pressure, vertigo

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	Body temperature increased	·	·	✓
SD	COVID-19	·	·	✓
SD	Gastroenteritis viral	·	·	✓
SD	Hypertension	·	·	✓
SD	Respiratory tract infection	·	·	✓
SD	Sinusitis	·	·	✓
SD	Vertigo	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	SARS-CoV-2 test positive	·	·	✓
SRO	Swollen tongue	✓	✓	✓
SRO	Unevaluable event	○	✓	○

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