YVM-21903-42333

4 vaccinations 14 coded responses 43 check-ins 14 free-text entries 2 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 553 / MN
Registered: 2021-02-02

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

2021-02-02
Registered in v-safe
2021-02-02
Dose 1 — Moderna
2021-02-02
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Fair · Site: Pain · Headache

Free text: Hx of chronic headaches, so may or may not be related to the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Diarrhea

Adult check-in
2021-02-09
Survey response — day 7, dose 1
MedDRA: Headache — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Headache is stress/anxiety induced, not related to covid vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — day 14, dose 1
MedDRA: Body temperature increased, Pyrexia — Feeling: Fair

Free text: Mildly Feverish, slightly elevated temp

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-02
Dose 2 — Moderna
2021-03-02
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

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

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: As of the last several hours all my symptoms have reduced and Im feeling better than I was.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Good · Diarrhea

Free text: Most likely related to menstruation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 7, dose 2
MedDRA: Fatigue — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Fatigue is most likely menstrual related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-01
Survey response — 3 months, dose 2
MedDRA: Dysmenorrhoea — Feeling: Good · Be unable to do your normal daily activities

Free text: Noticeably worse than usual menstrual cramps

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-31
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-22
Dose 3 — Moderna
2021-12-22
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-24
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Sore throat and congestion

MedDRA releases: 2024-11 · check-in free text available
2021-12-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-27
Survey response — days 1–6 daily, dose 3
MedDRA: Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair

Free text: Sore throat, runny nose, congestion. Probably just a cold, rapid test this morning was negative.

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair

Free text: Sore throat, runny nose, congestion. Rapid test negative.

MedDRA releases: 2024-11 · check-in free text available
2021-12-29
Survey response — day 7, dose 3
MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Good

Free text: Still runny nose and congestion, but better

MedDRA releases: 2024-11 · check-in free text available
2022-01-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-19
Survey response — day 28, dose 3
MedDRA: Injection site pain — Feeling: Good

Free text: Site of injection had some pain, mild but noticeable

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-02
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-23
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-22
Survey response — 6 months, dose 3
MedDRA: Intervertebral disc protrusion — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Herniated disc, most likely L5

MedDRA releases: 2024-11 · check-in free text available
2022-06-22
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-23
Call 1 — Left Voicemail
2022-06-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-14
Dose 4 — Moderna
Co-administered: Flu
2022-12-22
Survey response — 12 months, dose 3
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Cold virus, negative COVID test result

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-23
Call 1 — Requested Callback
2022-12-23
Callback requested for
03:30PM ET
2022-12-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-13
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-14
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-02	Moderna
2	2021-03-02	Moderna
3	2021-12-22	Moderna	No
4	2022-10-14	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-06-22	Successful 2022-06-23	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-22	Successful 2022-12-23	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-03

Systemic reaction (other): Hx of chronic headaches, so may or may not be related to the vaccine

Release 3 — day 7, dose 1

2021-02-09

Systemic reaction (other): Headache is stress/anxiety induced, not related to covid vaccine

Release 4 — day 14, dose 1

2021-02-16

Symptoms: Mildly Feverish, slightly elevated temp

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): As of the last several hours all my symptoms have reduced and Im feeling better than I was.

2021-03-08

Systemic reaction (other): Most likely related to menstruation

Release 5 — day 7, dose 2

2021-03-09

Systemic reaction (other): Fatigue is most likely menstrual related

Release 8 — 3 months, dose 2

2021-06-01

Symptoms: Noticeably worse than usual menstrual cramps

Release 10 — days 1–6 daily, dose 3

2021-12-24

Systemic reaction (other): Sore throat and congestion

2021-12-27

Systemic reaction (other): Sore throat, runny nose, congestion. Probably just a cold, rapid test this morning was negative.

2021-12-28

Systemic reaction (other): Sore throat, runny nose, congestion. Rapid test negative.

Release 10 — day 7, dose 3

2021-12-29

Systemic reaction (other): Still runny nose and congestion, but better

Release 10 — day 28, dose 3

2022-01-19

Symptoms: Site of injection had some pain, mild but noticeable

Release 12 — 6 months, dose 3

2022-06-22

Symptoms: Herniated disc, most likely L5

Release 12 — 12 months, dose 3

2022-12-22

Symptoms: Cold virus, negative COVID test result

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	Body temperature increased	✓	✓	✓
SD	Dysmenorrhoea	✓	✓	✓
SD	Injection site pain	·	·	✓
SD	Intervertebral disc protrusion	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Nasopharyngitis	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Rhinorrhoea	·	·	✓

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