YQ3-42052-84008

2 vaccinations 11 coded responses 23 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 759 / TX
Registered: 2021-03-11

Relationship: Self
Race: Black or African American
Ethnicity: N/A

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-11
Registered in v-safe
2021-03-11
Dose 1 — Moderna
2021-03-11
Survey response — day 0, dose 1
MedDRA: Pain in extremity — Feeling: Good

Free text: Im ok arm a little sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling cold, Pain in extremity, Self-medication — Feeling: Fair · Site: Pain · Chills

Free text: I did good today at work. When I got home had to lye down, had few chilled. But Im ok. Arm still soar. Took Tylenol twice.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good

Free text: Im good today. Thankful

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: Im doing good, when I get home from work I just wanna lye down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good · Site: Swelling · Fatigue or tiredness

Free text: A little tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-01
Survey response — day 21, dose 1
MedDRA: Sinus disorder — Feeling: Fair

Free text: Sinus problem. But Im a Alergy patient. I think its the pollen. Im good, its not bad that I need to see Dr. temperature is normal.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-04-13
Dose 2 — Moderna
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Sinus disorder — Feeling: Fair · Site: Swelling · Chills, Muscle or body aches · Be unable to work

Free text: Sinus in my throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Im better than I was yesterday. Ive been laying down for 2 days now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good · Site: Itching · Fatigue or tiredness

Free text: Better Im out the bed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-04
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-12
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-13
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-12
Survey response — 6 months, dose 2
MedDRA: Office visit, Sinus 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

Free text: Symptoms: I just got over sinus problem about 2weeks ago · Healthcare visit (other): Dr office, came to my car

MedDRA releases: 2024-11 · check-in free text available
2021-10-12
Report sent to call center — 6 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)
2021-11-12
Call 1 — Could Not Reach Participant
2021-11-17
Call 2 — Could Not Reach Participant
2022-04-15
Survey response — 12 months, dose 2
MedDRA: Sinus disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sinus problem

MedDRA releases: 2024-11 · check-in free text available
2022-04-15
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-19
Call 1 — Could Not Reach Participant
2022-04-22
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-13	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-10-12	Unsuccessful
2022-04-15	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-11

Systemic reaction (other): Im ok arm a little sore

Release 5 — days 1–6 daily, dose 1

2021-03-12

Systemic reaction (other): I did good today at work. When I got home had to lye down, had few chilled. But Im ok. Arm still soar. Took Tylenol twice.

2021-03-13

Systemic reaction (other): Im good today. Thankful

2021-03-15

Systemic reaction (other): Im doing good, when I get home from work I just wanna lye down

2021-03-16

Systemic reaction (other): A little tired

Release 6 — day 21, dose 1

2021-04-01

Symptoms: Sinus problem. But Im a Alergy patient. I think its the pollen. Im good, its not bad that I need to see Dr. temperature is normal.

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Sinus in my throat

2021-04-16

Systemic reaction (other): Im better than I was yesterday. Ive been laying down for 2 days now

2021-04-17

Systemic reaction (other): Better Im out the bed

Release 10 — 6 months, dose 2

2021-10-12

Symptoms: I just got over sinus problem about 2weeks ago

Healthcare visit (other): Dr office, came to my car

Release 11 — 12 months, dose 2

2022-04-15

Symptoms: Sinus problem

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	Sinus disorder	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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