YL5-67861-62016

2 vaccinations 6 coded responses 17 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 950 / CA
Registered: 2021-02-10

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

2021-02-05
Dose 1 — Moderna
2021-02-10
Registered in v-safe
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-14
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-02-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-26
Survey response — day 21, dose 1
MedDRA: Injection site erythema, Pyrexia — Feeling: Fair

Free text: At the beginning of this past week I developed a large red Area a few inches wide at the left arm injection site and a low-grade temp., But by the next day it was completely gone. I am a retired RN.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Dose 2 — Moderna
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Pyrexia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 2
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

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain lower, Abdominal pain upper — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Stomach pain in addition to the lower Abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-12
Survey response — day 7, dose 2
MedDRA: Abdominal discomfort, Asthenia, Body temperature increased, Fatigue, Nausea — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Concerned that Im still running a low-grade temp., Some nausea and stomach discomfort, weakness and fatigue one week after getting the second dose. I am a retired RN. My normal temp since menopause is 97.6Â°

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-03
Survey response — day 28, dose 2
MedDRA: Abdominal discomfort, Asthenia, Body temperature increased, Fatigue — Feeling: Fair

Free text: GI Discomfort, low grade temp of 100.3, recurring weakness and fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Survey response — 3 months, dose 2
MedDRA: Gastritis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Gastritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-14
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-05	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-06-04	Unsuccessful

Free text

Release 4 — day 21, dose 1

2021-02-26

Symptoms: At the beginning of this past week I developed a large red Area a few inches wide at the left arm injection site and a low-grade temp., But by the next day it was completely gone. I am a retired RN.

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): Fever

2021-03-10

Systemic reaction (other): Stomach pain in addition to the lower Abdominal pain

Release 5 — day 7, dose 2

2021-03-12

Systemic reaction (other): Concerned that Im still running a low-grade temp., Some nausea and stomach discomfort, weakness and fatigue one week after getting the second dose. I am a retired RN. My normal temp since menopause is 97.6Â°

Release 6 — day 28, dose 2

2021-04-03

Symptoms: GI Discomfort, low grade temp of 100.3, recurring weakness and fatigue

Release 8 — 3 months, dose 2

2021-06-04

Symptoms: Gastritis

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	Abdominal discomfort	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Body temperature increased	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gastritis	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Abdominal pain lower	✓	✓	✓
SRO	Abdominal pain upper	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Body temperature increased	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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