YN5-55882-29620

4 vaccinations 18 coded responses 37 check-ins 18 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 982 / WA
Registered: 2021-02-11

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

2021-02-11
Registered in v-safe
2021-02-11
Dose 1 — Moderna
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Arthritis, Fatigue, Pre-existing disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Im very tired. Can fall asleep just by sitting down in a chair. My headphones are on fire, I mean the joints. My arthritis has flared up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Arthritis, Headache, Musculoskeletal discomfort, Pre-existing disease, Tension — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: I have a terrible headache it hasnt gone away since my first day. My body seems to be very tense, but that could be because of the headache. Arthritis has flared up And my hip joints are very uncomfortable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Fatigue, Headache, Sinusitis — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Severe headache, hip joints are on fire, I have a sinus infection and I am extremely tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Fatigue, Headache, Pain — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Ive been exhausted since I got up from a restful night. Headache, joint pain and body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Hunger, Influenza, Mobility decreased, Nasopharyngitis — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Feel like I have the flu and a bad cold at the same time spent most of my time in bed today. Hungry but dont feel like eating. Very tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — day 7, dose 1
MedDRA: Fatigue — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Today I feel pretty good! I am a little tired even though I got a great nights sleep. Ive been filling out these health checks every day since I got the shot. My profile doesnt show that Ive done it every day. It shows one report

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — day 14, dose 1
MedDRA: Fatigue, Headache, Self-medication — Feeling: Fair · Be unable to do your normal daily activities

Free text: I had a constant headache and right now it is about 5:30 PM and the headache has increased. Ive had to take medication for it now. The only other thing that Ive noticed is how very tired I am today.

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

Adult check-in
2021-03-11
Dose 2 — Moderna
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Myalgia, Vaccination site warmth — Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Free text: The area that I got the vaccine in is very hot. The muscle is tender to touch. And is a little uncomfortable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Good · Site: Swelling · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Just tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Joint pains, Muscle or body aches

Free text: I wasnt able to send in yesterdays survey. It said my time had timed out. But, I did fill it out just couldnt send it

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 7, dose 2
MedDRA: Fatigue — Feeling: Good · Joint pains, Muscle or body aches

Free text: Just tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 14, dose 2
MedDRA: Injection site pain — Feeling: Good · Be unable to work

Free text: The muscle that receive the injection is tender and sore Even in a relaxed state.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-10
Survey response — 3 months, dose 2
MedDRA: Fatigue, Headache, Insomnia, Office visit, Pain — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Severe headaches. Unable to sleep Body aches, And Im tired all the time · Healthcare visit (other): Nurse practitioner

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
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)
2021-06-28
Call 2 — Left Voicemail
2021-09-09
Survey response — 6 months, dose 2
MedDRA: Back pain, Bronchitis, Office visit, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Going through a bout of bronchitis. I havent had it since I was in my early 20s and that was the only time Ive had it other than right now. I still have lower back pain that is causing me some problems. · Healthcare visit (other): I went to (b)(6) which is a low income clinic

MedDRA releases: 2024-11 · check-in free text available
2021-09-09
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-14
Call 2 — Left Voicemail
2022-02-19
Dose 3 — Moderna
2022-03-11
Survey response — 12 months, dose 2
MedDRA: Back pain, Office visit — Feeling: Good · 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: Lower back pain in the lumbar area. At times very severe. · Healthcare visit (other): A regular doctors appointment

MedDRA releases: 2024-11 · check-in free text available
2022-03-11
Report sent to call center — 12 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

1 call case(s)
2022-03-13
Survey response — day 21, dose 3
MedDRA: Back pain — Feeling: Good · 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: Lumbar pain

MedDRA releases: 2024-11 · check-in free text available
2022-03-13
Report sent to call center — day 21, dose 3
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)
2022-03-14
Call 1 — Left Voicemail
2022-03-20
Dose 4 — Moderna
2022-03-20
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-03-20
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-03-21
Survey response — days 1–6 daily, dose 4
MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I got 2 Of the Moderno shots and one Moderna booster. I could not enter that on the page that asked how many shots I had gotten it would've been three not four

MedDRA releases: 2024-11 · check-in free text available
2022-03-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-03-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-03-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-03-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · None

Adult check-in
2022-03-27
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-03
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-10
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-17
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-04-24
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-03
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-06-19
Survey response — 3 months, dose 4
MedDRA: Arthritis, Back disorder — Feeling: Good · 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: Right now I'm having terrible back issues. Nothing to do with Covid though. I have extensive arthritis. I've had one steroid treatment on both sides of my spine. And I will need more intense treatment on my right side. They'll know what they're going

MedDRA releases: 2024-11 · check-in free text available
2022-06-19
Report sent to call center — 3 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call 2 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-09-18
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-03-20
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-11	Moderna
3	2022-02-19	Moderna	No
4	2022-03-20	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-10	Unsuccessful
2021-09-09	Unsuccessful
2022-03-11	Unsuccessful
2022-03-13	Unsuccessful
2022-06-19	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-13

Systemic reaction (other): Im very tired. Can fall asleep just by sitting down in a chair. My headphones are on fire, I mean the joints. My arthritis has flared up.

2021-02-14

Systemic reaction (other): I have a terrible headache it hasnt gone away since my first day. My body seems to be very tense, but that could be because of the headache. Arthritis has flared up And my hip joints are very uncomfortable

2021-02-15

Systemic reaction (other): Severe headache, hip joints are on fire, I have a sinus infection and I am extremely tired

2021-02-16

Systemic reaction (other): Ive been exhausted since I got up from a restful night. Headache, joint pain and body aches

2021-02-17

Systemic reaction (other): Feel like I have the flu and a bad cold at the same time spent most of my time in bed today. Hungry but dont feel like eating. Very tired

Release 4 — day 7, dose 1

2021-02-20

Systemic reaction (other): Today I feel pretty good! I am a little tired even though I got a great nights sleep. Ive been filling out these health checks every day since I got the shot. My profile doesnt show that Ive done it every day. It shows one report

Release 4 — day 14, dose 1

2021-02-25

Symptoms: I had a constant headache and right now it is about 5:30 PM and the headache has increased. Ive had to take medication for it now. The only other thing that Ive noticed is how very tired I am today.

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): The area that I got the vaccine in is very hot. The muscle is tender to touch. And is a little uncomfortable

2021-03-14

Systemic reaction (other): Just tired

2021-03-17

Systemic reaction (other): I wasnt able to send in yesterdays survey. It said my time had timed out. But, I did fill it out just couldnt send it

Release 5 — day 7, dose 2

2021-03-18

Systemic reaction (other): Just tired

Release 6 — day 14, dose 2

2021-03-25

Symptoms: The muscle that receive the injection is tender and sore Even in a relaxed state.

Release 9 — 3 months, dose 2

2021-06-10

Symptoms: Severe headaches. Unable to sleep Body aches, And Im tired all the time

Healthcare visit (other): Nurse practitioner

Release 9 — 6 months, dose 2

2021-09-09

Symptoms: Going through a bout of bronchitis. I havent had it since I was in my early 20s and that was the only time Ive had it other than right now. I still have lower back pain that is causing me some problems.

Healthcare visit (other): I went to (b)(6) which is a low income clinic

redacted (b)(6)

Release 11 — 12 months, dose 2

2022-03-11

Symptoms: Lower back pain in the lumbar area. At times very severe.

Healthcare visit (other): A regular doctors appointment

Release 11 — day 21, dose 3

2022-03-13

Symptoms: Lumbar pain

Release 11 — days 1–6 daily, dose 4

2022-03-21

Systemic reaction (other): I got 2 Of the Moderno shots and one Moderna booster. I could not enter that on the page that asked how many shots I had gotten it would've been three not four

Release 12 — 3 months, dose 4

2022-06-19

Symptoms: Right now I'm having terrible back issues. Nothing to do with Covid though. I have extensive arthritis. I've had one steroid treatment on both sides of my spine. And I will need more intense treatment on my right side. They'll know what they're going cut off by CDC

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	Office visit	✓	✓	✓
SD	Arthritis	·	·	✓
SD	Back disorder	·	·	✓
SD	Back pain	·	·	✓
SD	Bronchitis	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Self-medication	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hunger	✓	✓	✓
SRO	Influenza	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Musculoskeletal discomfort	✓	·	✓
SRO	Myalgia	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sinusitis	✓	✓	✓
SRO	Tension	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Vaccination site warmth	✓	✓	✓

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