YWR-30401-77034

4 vaccinations 11 coded responses 49 check-ins 10 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 104 / NY
Registered: 2020-12-29

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

Timeline

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

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Oropharyngeal pain, Respiratory tract congestion — Feeling: Poor · Site: Pain · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Slight Congestion and slight sore throat as of last night. Major fatigue.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I was exhausted in bed until 3 pm this afternoon. Now I finally feel better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Fair · Fatigue or tiredness

Free text: Took vitamin supplements to help with mild fatigue: iron, B6, & B12.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-28
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Impaired work ability, Myalgia, Pyrexia — Feeling: Fair · Site: Pain, Redness, Swelling

Free text: Yesterday, day after 2nd shot: stayed home from work with slight fever, muscle soreness & fatigue. Last night, those symptoms went away.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion — Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness

Free text: Stuffy nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Good · Site: Itching

Free text: Injection site has gone from huge black & blue to brown, so it is fading.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-27
Survey response — 6 months, dose 2
MedDRA: Dyspnoea exertional, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Shortness of breathe when I exercise Lightly. I am having a nuclear stress test next week. This may be unrelated to my vaccination. · Healthcare visit (other): Regular cardiologist office

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-27
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-28
Call 1 — Left Voicemail
2021-12-08
Dose 3 — Moderna
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness · Be unable to work or attend school

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

Adult check-in
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-15
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-22
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-29
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-07
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-14
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-19
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-08
Survey response — 6 months, dose 3
MedDRA: Fatigue, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school

Free text: Extreme tiredness yesterday, slight sore throat. Covid test negative.

MedDRA releases: 2024-11 · check-in free text available
2022-12-10
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2022-12-13
Dose 4 — Moderna
2022-12-15
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-12-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Nausea

Adult check-in
2022-12-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-12-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-12-20
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-12-27
Survey response — day 14, dose 4
MedDRA: Fatigue, Nasopharyngitis, Pyrexia, Sneezing — Feeling: Fair · Be unable to work or attend school

Free text: A cold: One day a fever, sneezing, tired

MedDRA releases: 2024-11 · check-in free text available
2023-01-03
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2023-01-10
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-01-18
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-01-24
Survey response — day 42, dose 4
MedDRA: Atrial fibrillation, Dyspnoea exertional — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-01-24
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-25
Call successful
Not applicable - Accidental Reporting
2023-03-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-06-13
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna
3	2021-12-08	Moderna	No
4	2022-12-13	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-01	priority 2/3
2021-01-02	priority 2/3
2021-07-27	Successful 2022-01-22	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2023-01-24	Successful 2023-01-25	Not applicable - Accidental Reporting

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): No

2021-01-01

Systemic reaction (other): Slight Congestion and slight sore throat as of last night. Major fatigue.

2021-01-02

Systemic reaction (other): I was exhausted in bed until 3 pm this afternoon. Now I finally feel better

2021-01-04

Systemic reaction (other): Took vitamin supplements to help with mild fatigue: iron, B6, & B12.

Release 3 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): Yesterday, day after 2nd shot: stayed home from work with slight fever, muscle soreness & fatigue. Last night, those symptoms went away.

2021-01-30

Systemic reaction (other): Stuffy nose

2021-02-01

Systemic reaction (other): Injection site has gone from huge black & blue to brown, so it is fading.

Release 9 — 6 months, dose 2

2021-07-27

Symptoms: Shortness of breathe when I exercise Lightly. I am having a nuclear stress test next week. This may be unrelated to my vaccination.

Healthcare visit (other): Regular cardiologist office

Release 11 — 6 months, dose 3

2022-06-08

Symptoms: Extreme tiredness yesterday, slight sore throat. Covid test negative.

Release 12 — day 14, dose 4

2022-12-27

Symptoms: A cold: One day a fever, sneezing, tired

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	Atrial fibrillation	·	·	✓
SD	Dyspnoea exertional	✓	·	✓
SD	Fatigue	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sneezing	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Impaired work ability	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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