YN9-17490-45065

4 vaccinations 8 coded responses 25 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 492 / MI
Registered: 2021-01-06

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

2021-01-06
Registered in v-safe
2021-01-06
Dose 1 — Moderna
2021-01-06
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Headache, Myalgia, Pyrexia — Feeling: Good · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: day after vacc - for 4 days had fever, muscle aches, major headache and 2 more days of fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-05
Survey response — 6 months, dose 2
MedDRA: Brain fog, COVID-19, Fatigue — Feeling: Fair · Be unable to work or attend school

Free text: got the virus in may. had all symtoms except no breathing problems. lasted 5 or 6 days.since then I suffer from fatigue & foggy brain.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-03
Dose 3 — Moderna
2022-02-04
Survey response — 12 months, dose 2
MedDRA: COVID-19, Cough, Fatigue, Headache, Nausea, Oropharyngeal pain — Feeling: Good

Free text: Positive for omicron. Headache, cough, sore throat. 1day of nausea. Tired.

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Dose 4 — Moderna
2022-05-01
Survey response — days 1–6 daily, dose 4
MedDRA: Thirst — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school

Free text: Thirst

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Survey response — days 1–6 daily, dose 4
MedDRA: Brain fog — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school

Free text: Brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-05-07
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school

Adult check-in
2022-05-14
Survey response — day 14, dose 4
MedDRA: Fatigue, Fluid retention, Gastrointestinal disorder, Movement disorder, Muscle spasms, Muscular weakness — Feeling: Fair · Be unable to work or attend school

Free text: Leg muscles feel like jello & sometimes non responsive. Major fatigue continues. Muscle cramps. Water retention. Continuing digestive issues.

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Survey response — day 35, dose 4
MedDRA: Arthralgia, Fatigue, Injection site pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Joint pain. Pain in injection area. Extreme fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-06-10
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-10-29
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-29
Survey response — 12 months, dose 4
MedDRA: Arthralgia, Fatigue, Tinnitus — Feeling: Poor · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-04-29
Report sent to call center — 12 months, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-05-01
Call 1 — Left Voicemail
2023-05-02
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-04	Moderna
3	2022-02-03	Moderna	No
4	2022-04-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2023-04-29	Successful 2023-05-02	Participant prefers to complete VAERS report online

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): day after vacc - for 4 days had fever, muscle aches, major headache and 2 more days of fatigue

Release 9 — 6 months, dose 2

2021-08-05

Symptoms: got the virus in may. had all symtoms except no breathing problems. lasted 5 or 6 days.since then I suffer from fatigue & foggy brain.

Release 11 — 12 months, dose 2

2022-02-04

Symptoms: Positive for omicron. Headache, cough, sore throat. 1day of nausea. Tired.

Release 11 — days 1–6 daily, dose 4

2022-05-01

Systemic reaction (other): Thirst

2022-05-03

Systemic reaction (other): Brain fog

Release 11 — day 14, dose 4

2022-05-14

Symptoms: Leg muscles feel like jello & sometimes non responsive. Major fatigue continues. Muscle cramps. Water retention. Continuing digestive issues.

Release 11 — day 35, dose 4

2022-06-03

Symptoms: Joint pain. Pain in injection area. Extreme fatigue

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	Arthralgia	·	·	✓
SD	Brain fog	✓	·	✓
SD	Cough	·	·	✓
SD	COVID-19	✓	·	✓
SD	Fatigue	✓	·	✓
SD	Fluid retention	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	·	·	✓
SD	Injection site pain	·	·	✓
SD	Movement disorder	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Muscular weakness	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Tinnitus	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Thirst	·	·	✓

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