YWX-21314-94380

2 vaccinations 8 coded responses 18 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 814 / CO
Registered: 2021-01-13

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-13
Registered in v-safe
2021-01-13
Dose 1 — Moderna
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness

Free text: I am feeling fine. Just very tired today but let's see tomorrow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-23
Survey response — day 7, dose 1
MedDRA: Pruritus — Feeling: Good

Free text: Total body itching from head to toes. Maybe due to something else...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — day 14, dose 1
MedDRA: SARS-CoV-2 test, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Hives all over the body · Healthcare visit (other): took a Covid test and had medication prescribed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-10
Dose 2 — Moderna
2021-02-10
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Body temperature increased, Unevaluable event — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: My usual temp is very low 95.8 to 96.2 so 99 degrees is high for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Body temperature increased, Fatigue, Middle insomnia, Pruritus, Self-medication — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I am extremely tired. My usual temperature is very low 95.7 to 96.3 so 99.6 is felt very much. It is not high all the time, just intermittent. I wake up a lot at night.Had a bit of itchiness today. Took Benadryl.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain, Pain, Toothache — Feeling: Fair · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: dull ear pain/molar pain. Much better than yesterday!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-17
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-24
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-03
Survey response — day 21, dose 2
MedDRA: Fatigue — Feeling: Poor · Be unable to do your normal daily activities

Free text: More tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-04-14
Call 1 — Left Voicemail
2021-05-12
Survey response — 3 months, dose 2
MedDRA: Amnesia, Brain fog, Cognitive disorder — Feeling: Good

Free text: A bit of a brain fog. Some loss of sharpness, harder to remember stuff

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-13	Moderna
2	2021-02-10	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-27	Unsuccessful

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-18

Systemic reaction (other): I am feeling fine. Just very tired today but let's see tomorrow

Release 2 — day 7, dose 1

2021-01-23

Systemic reaction (other): Total body itching from head to toes. Maybe due to something else...

Release 2 — day 14, dose 1

2021-01-27

Symptoms: Hives all over the body

Healthcare visit (other): took a Covid test and had medication prescribed

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): My usual temp is very low 95.8 to 96.2 so 99 degrees is high for me.

2021-02-12

Systemic reaction (other): I am extremely tired. My usual temperature is very low 95.7 to 96.3 so 99.6 is felt very much. It is not high all the time, just intermittent. I wake up a lot at night.Had a bit of itchiness today. Took Benadryl.

2021-02-13

Systemic reaction (other): dull ear pain/molar pain. Much better than yesterday!

Release 5 — day 21, dose 2

2021-03-03

Symptoms: More tired

Release 8 — 3 months, dose 2

2021-05-12

Symptoms: A bit of a brain fog. Some loss of sharpness, harder to remember stuff

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	SARS-CoV-2 test	✓	✓	✓
SD	Amnesia	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Cognitive disorder	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Urticaria	✓	✓	✓
SRO	Body temperature increased	✓	·	✓
SRO	Ear pain	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Middle insomnia	✓	·	✓
SRO	Pain	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Self-medication	✓	·	✓
SRO	Toothache	✓	✓	✓
SRO	Unevaluable event	○	✓	○

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