YUS-65916-00849

3 vaccinations 5 coded responses 15 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 900 / CA
Registered: 2021-12-02

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

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

2021-03-24
Dose 1 — Moderna
2021-04-21
Dose 2 — Moderna
2021-12-02
Registered in v-safe
2021-12-02
Dose 3 — Moderna
2021-12-02
Survey response — day 0, dose 3
MedDRA: Dizziness — Feeling: Fair · Site: Pain

Free text: Dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fever · Muscle or body aches

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-09
Health check-in — day 7, dose 3
Feeling: Good · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-16
Survey response — day 14, dose 3
MedDRA: Arthralgia, Oedema peripheral — Feeling: Good

Free text: Mainly joint aches, some swelling on the armpit of the arm that received the vaccine.

MedDRA releases: 2024-11 · check-in free text available
2021-12-23
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-06
Survey response — day 35, dose 3
MedDRA: Chest pain, Hypertension — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Chest pain, high blood pressure compared to before the vaccine. Can't say if its realated but definately noticed these changes.

MedDRA releases: 2024-11 · check-in free text available
2022-01-06
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-10
Call 1 — Could Not Reach Participant
2022-01-13
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-13
Call 2 — Could Not Reach Participant
2022-03-05
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-06-02
Survey response — 6 months, dose 3
MedDRA: Cough, Headache, Nasopharyngitis, Pyrexia, Sneezing — 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, Emergency room or emergency department visit

Free text: Heaches low grade fever, coughing, sneezing, its a cold on steroids?!

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
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 · Emergency room or emergency department visit · 1 call case(s)
2022-06-03
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-03
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-04
Survey response — 12 months, dose 3
MedDRA: Chills, Cough, Hypogeusia, Hyposmia, Influenza, Pyrexia, Unevaluable event — 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: Flu just as bad as covid temp 105 for 4 days sever cough and shivers partial loss of smell and taste. 4 weeks still recouping based on tests not covid?

MedDRA releases: 2024-11 · check-in free text available
2022-12-04
Report sent to call center — 12 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)
2022-12-05
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna	No
2	2021-04-21	Moderna	No
3	2021-12-02	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-06	Successful 2022-06-03	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-02	Successful 2022-06-03	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-04	Unsuccessful

Free text

Release 10 — day 0, dose 3

2021-12-02

Systemic reaction (other): Dizzy

Release 10 — day 14, dose 3

2021-12-16

Symptoms: Mainly joint aches, some swelling on the armpit of the arm that received the vaccine.

Release 10 — day 35, dose 3

2022-01-06

Symptoms: Chest pain, high blood pressure compared to before the vaccine. Can't say if its realated but definately noticed these changes.

Release 11 — 6 months, dose 3

2022-06-02

Symptoms: Heaches low grade fever, coughing, sneezing, its a cold on steroids?!

Release 12 — 12 months, dose 3

2022-12-04

Symptoms: Flu just as bad as covid temp 105 for 4 days sever cough and shivers partial loss of smell and taste. 4 weeks still recouping based on tests not covid?

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	Chest pain	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Headache	·	·	✓
SD	Hypertension	·	·	✓
SD	Hypogeusia	·	·	✓
SD	Hyposmia	·	·	✓
SD	Influenza	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oedema peripheral	·	·	✓
SD	Pyrexia	·	·	✓
SD	Sneezing	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Dizziness	·	·	✓

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