YUT-57076-77394

4 vaccinations 10 coded responses 52 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 984 / WA
Registered: 2021-02-19

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

UQ5-50427-03515 Child or adolescent in my care · Male · 2022-11-10

Timeline

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

2021-02-19
Registered in v-safe
2021-02-19
Dose 1 — Moderna
2021-02-19
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-23
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Fatigue or tiredness

Free text: Slight sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Headache, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-26
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-12
Survey response — day 21, dose 1
MedDRA: Office visit, Pre-existing disease, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Sinus infection, but it has been going on since before the initial vaccine dose. I only just saw a doctor about it this week. · Healthcare visit (other): In person doctor visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-17
Dose 2 — Moderna
2021-03-17
Health check-in — day 0, dose 2
Feeling: Good · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Ear pain — Feeling: Good · Site: Pain, Redness · Headache, Fatigue or tiredness

Free text: Ear pain and slight cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-24
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-31
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-16
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-15
Survey response — 6 months, dose 2
MedDRA: Epistaxis, Pregnancy — 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, Emergency room or emergency department visit

Free text: Massive nose bleeds, cauterization procedure for nose bleeds, and became pregnant.

MedDRA releases: 2024-11 · check-in free text available
2021-09-15
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)
2021-09-16
Call 1 — Left Voicemail
2021-11-26
Dose 3 — Moderna
2021-11-26
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Abdominal pain

Adult check-in
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-11-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Nausea

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Nausea

Adult check-in
2021-12-03
Health check-in — day 7, dose 3
Feeling: Good · Headache, Nausea

Adult check-in
2021-12-10
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-27
Survey response — 6 months, dose 3
MedDRA: Complication of delivery — 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 · Emergency room or emergency department visit, Hospitalization

Free text: I had a baby with a complicated delivery.

MedDRA releases: 2024-11 · check-in free text available
2022-05-27
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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-05-31
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-26
Survey response — 12 months, dose 3
MedDRA: Delivery, Respiratory syncytial virus infection, Sinusitis, Streptococcal infection — Feeling: Fair

Free text: Child birth, sinus infection, RSV, strep

MedDRA releases: 2024-11 · check-in free text available
2022-12-16
Dose 4 — Moderna
2022-12-17
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-12-18
Survey response — days 1–6 daily, dose 4
MedDRA: Tinnitus — Feeling: Fair · Site: Pain · Headache, Joint pains

Free text: Ringing in the ear

MedDRA releases: 2024-11 · check-in free text available
2022-12-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache

Adult check-in
2022-12-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Diarrhea

Adult check-in
2022-12-22
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain — Feeling: Good · Headache

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-12-23
Survey response — day 7, dose 4
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Congestion

MedDRA releases: 2024-11 · check-in free text available
2022-12-30
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2023-01-06
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2023-01-13
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-01-22
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-01-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-03-19
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-06-18
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-19	Moderna
2	2021-03-17	Moderna
3	2021-11-26	Moderna	No
4	2022-12-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-12	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-15	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-27	Successful 2022-05-31	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-23

Systemic reaction (other): Slight sore throat

2021-02-24

Systemic reaction (other): Sore throat

Release 5 — day 21, dose 1

2021-03-12

Symptoms: Sinus infection, but it has been going on since before the initial vaccine dose. I only just saw a doctor about it this week.

Healthcare visit (other): In person doctor visit

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Ear pain and slight cough

Release 9 — 6 months, dose 2

2021-09-15

Symptoms: Massive nose bleeds, cauterization procedure for nose bleeds, and became pregnant.

Release 11 — 6 months, dose 3

2022-05-27

Symptoms: I had a baby with a complicated delivery.

Release 12 — 12 months, dose 3

2022-11-26

Symptoms: Child birth, sinus infection, RSV, strep

Release 12 — days 1–6 daily, dose 4

2022-12-18

Systemic reaction (other): Ringing in the ear

2022-12-22

Systemic reaction (other): Sore throat

Release 12 — day 7, dose 4

2022-12-23

Systemic reaction (other): Congestion

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	Complication of delivery	·	·	✓
SD	Delivery	·	·	✓
SD	Epistaxis	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Respiratory syncytial virus infection	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Streptococcal infection	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Tinnitus	·	·	✓

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