YPV-13276-04667

3 vaccinations 6 coded responses 27 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 453 / OH
Registered: 2021-02-25

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

2021-02-25
Registered in v-safe
2021-02-25
Dose 1 — Moderna
2021-02-25
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 1
MedDRA: Malaise — Feeling: Good · Site: Pain, Itching

Free text: Feeling slightly off

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-25
Dose 2 — Moderna
2021-03-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Chills

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Poor · Site: Pain, 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: I am a long term (40+ yr) childhood cancer survivor if you need me for any antibody studies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Musculoskeletal chest pain — Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Chest wall pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Chills — Feeling: Good · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Had chills late last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-17
Dose 3 — Moderna
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Ear infection, Nasopharyngitis, Sinusitis — Feeling: Good

Free text: Had sinus infection and ear infection symptoms that may be secondary to a dental infection. One day with mild cold symptoms, better next day, no loss of smell or taste

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-02-15
Survey response — 6 months, dose 3
MedDRA: Breakthrough COVID-19, Dysgeusia, Fatigue, Headache, Pyrexia — 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

Free text: Had breakthrough Covid in mid January 2022. Fatigue, headache, fever, bitter food aftertaste.

MedDRA releases: 2024-11 · check-in free text available
2022-02-15
Report sent to call center — 6 months, dose 3
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 · 1 call case(s)
2022-02-17
Call 1 — Left Voicemail
2022-02-17
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Moderna
2	2021-03-25	Moderna
3	2021-08-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-15	Successful 2022-02-17	Participant prefers to complete VAERS report online

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-26

Systemic reaction (other): Feeling slightly off

Release 6 — days 1–6 daily, dose 2

2021-03-26

Systemic reaction (other): I am a long term (40+ yr) childhood cancer survivor if you need me for any antibody studies

2021-03-27

Systemic reaction (other): Chest wall pain

2021-03-30

Systemic reaction (other): Had chills late last night

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: Had sinus infection and ear infection symptoms that may be secondary to a dental infection. One day with mild cold symptoms, better next day, no loss of smell or taste

Release 11 — 6 months, dose 3

2022-02-15

Symptoms: Had breakthrough Covid in mid January 2022. Fatigue, headache, fever, bitter food aftertaste.

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	Breakthrough COVID-19	·	·	✓
SD	Dysgeusia	·	·	✓
SD	Ear infection	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pyrexia	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Musculoskeletal chest pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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