YX3-24755-11468

2 vaccinations 5 coded responses 18 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 836 / ID
Registered: 2021-03-04

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

2021-03-04
Registered in v-safe
2021-03-04
Dose 1 — Moderna
2021-03-04
Survey response — day 0, dose 1
MedDRA: Heart rate irregular, Malaise — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: My heart beat was weird for a few seconds before I started not feeling real good.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Loss of consciousness, Unevaluable event — Feeling: Poor · Chills · Be unable to work, 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: Systemic reaction (other): Blacked out for a second today and then experienced light headedness all day today, blood pressure was still in normal range, but elevated. · Healthcare visit (other): Calls primary doctor to get in and get checked out

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Survey response — day 14, dose 1
MedDRA: Hypertension — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: High blood pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Survey response — day 21, dose 1
MedDRA: Hypertension — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Blood pressure is high and not responding to medication that I was put on a week after the vaccine. I have never had high blood pressure and they have upped my medication to 50 mg.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-01
Dose 2 — Moderna
2021-04-01
Health check-in — day 0, dose 2
Feeling: Fair · Fever · Joint pains, Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-25
Survey response — day 21, dose 2
MedDRA: Fatigue, Muscular weakness — Feeling: Fair · Be unable to work, 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: Very tired, joints and muscles really weak.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Report sent to call center — day 21, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-21
Call 1 — Could Not Reach Participant
2022-04-01
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-10	Unsuccessful
2021-03-18	Unsuccessful
2021-03-25	Unsuccessful
2021-04-25	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-04

Systemic reaction (other): My heart beat was weird for a few seconds before I started not feeling real good.

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Blacked out for a second today and then experienced light headedness all day today, blood pressure was still in normal range, but elevated.

Healthcare visit (other): Calls primary doctor to get in and get checked out

Release 5 — day 14, dose 1

2021-03-18

Symptoms: High blood pressure

Release 6 — day 21, dose 1

2021-03-25

Symptoms: Blood pressure is high and not responding to medication that I was put on a week after the vaccine. I have never had high blood pressure and they have upped my medication to 50 mg.

Release 7 — day 21, dose 2

2021-04-25

Symptoms: Very tired, joints and muscles really weak.

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	Unevaluable event	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Heart rate irregular	✓	✓	✓
SRO	Loss of consciousness	✓	✓	✓
SRO	Malaise	✓	✓	✓

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