YVT-64371-50856

4 vaccinations 9 coded responses 43 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 911 / CA
Registered: 2021-03-16

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

2021-02-15
Dose 1 — Moderna
2021-03-15
Dose 2 — Moderna
2021-03-16
Registered in v-safe
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain — Feeling: Poor · 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: Sharp ear pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Pain, Pyrexia — Feeling: Good · Fever · Fatigue or tiredness

Free text: A few moments of feeling a bit feverish and still a little achy and tired, but much better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-29
Survey response — day 14, dose 2
MedDRA: Disturbance in attention, Feeling abnormal — Feeling: Fair

Free text: Just feeling rocky and not able to focus. cant imagine its vaccine related (its been two weeks today)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-13
Survey response — 6 months, dose 2
MedDRA: Diarrhoea, Fatigue, Headache, Pyrexia — Feeling: Good · Be unable to work or attend school

Free text: diarrhea, headache, felt slightly feverish, very tired - in Portland last weekend of July; took test, was negative

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Dose 3 — Moderna
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: Chest discomfort — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Moments (2-3) chest tightbess

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-24
Survey response — 3 months, dose 3
MedDRA: Body temperature increased, Headache, Oropharyngeal pain, Pain — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Severe sore throat, with headache and body ache, elevated temperature

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Dose 4 — Moderna
2022-04-20
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-04-21
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-04-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2022-04-23
Survey response — days 1–6 daily, dose 4
MedDRA: Fatigue, Rhinorrhoea — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: tire quickly; runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Muscle or body aches

Adult check-in
2022-04-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-04-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-29
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-04
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-11
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-18
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-25
Survey response — day 35, dose 4
MedDRA: Diarrhoea, Headache, Pyrexia, Vomiting — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Vomiting fever diarrhea - in that order. From Thursday night to Sunday night; bad headache all day Monday.

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-19
Survey response — 6 months, dose 4
MedDRA: Breast swelling, Fatigue — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Swollen breast; fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-10-19
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-20
Call 1 — Left Voicemail
2023-04-22
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-15	Moderna
2	2021-03-15	Moderna
3	2021-10-25	Moderna	No
4	2022-04-20	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-10-19	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-16

Systemic reaction (other): Sharp ear pain

2021-03-18

Systemic reaction (other): A few moments of feeling a bit feverish and still a little achy and tired, but much better

Release 6 — day 14, dose 2

2021-03-29

Symptoms: Just feeling rocky and not able to focus. cant imagine its vaccine related (its been two weeks today)

Release 9 — 6 months, dose 2

2021-09-13

Symptoms: diarrhea, headache, felt slightly feverish, very tired - in Portland last weekend of July; took test, was negative

Release 10 — days 1–6 daily, dose 3

2021-10-26

Systemic reaction (other): Moments (2-3) chest tightbess

Release 11 — 3 months, dose 3

2022-01-24

Symptoms: Severe sore throat, with headache and body ache, elevated temperature

Release 11 — days 1–6 daily, dose 4

2022-04-23

Systemic reaction (other): tire quickly; runny nose

Release 11 — day 35, dose 4

2022-05-25

Symptoms: Vomiting fever diarrhea - in that order. From Thursday night to Sunday night; bad headache all day Monday.

Release 12 — 6 months, dose 4

2022-10-19

Symptoms: Swollen breast; fatigue

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	Breast swelling	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Disturbance in attention	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Vomiting	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Ear pain	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rhinorrhoea	·	·	✓

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