YX9-15393-16432

4 vaccinations 5 coded responses 25 check-ins 5 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 050 / VT
Registered: 2021-02-14

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

2021-02-12
Dose 1 — Moderna
2021-02-14
Registered in v-safe
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-02-19
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-26
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth — Feeling: Good

Free text: I had thought that the red, slightly swollen and warm to the touch injection sight had disappeared but after my last check in, later that evening it had returned to bright red again and slightly raised. The next morning the red appearance was still t

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-12
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Extreme fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event, Office visit — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): No · Healthcare visit (other): Dentist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Survey response — day 7, dose 2
MedDRA: Mouth ulceration, Stress — Feeling: Good

Free text: Oral ulcers that my Dentist is saying is perhaps due to stream. I didnt realize I was stressed but I suppose everyone is this past year.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-11
Survey response — 3 months, dose 2
MedDRA: Office visit, Specialist consultation, Toothache — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I had a toothache a couple of weeks ago. I went to my family dentist. She recommended that I see an endodontist. She in turn sent me to an oral surgeon and I will hopefully have an appointment soon for an extraction. · Healthcare visit (other): Outpatient dental

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-17
Call 1 — Left Voicemail
2021-06-18
Call 2 — Left Voicemail
2021-09-10
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-09
Dose 3 — Moderna
2022-03-12
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-05
Dose 4 — Moderna
2022-08-04
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-05
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-05
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2021-12-09	Moderna	No
4	2022-05-05	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-18	Unsuccessful
2021-06-11	Unsuccessful

Free text

Release 4 — day 14, dose 1

2021-02-26

Symptoms: I had thought that the red, slightly swollen and warm to the touch injection sight had disappeared but after my last check in, later that evening it had returned to bright red again and slightly raised. The next morning the red appearance was still t cut off by CDC

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): Extreme fatigue

2021-03-18

Systemic reaction (other): No

Healthcare visit (other): Dentist

Release 6 — day 7, dose 2

2021-03-19

Systemic reaction (other): Oral ulcers that my Dentist is saying is perhaps due to stream. I didnt realize I was stressed but I suppose everyone is this past year.

Release 9 — 3 months, dose 2

2021-06-11

Symptoms: I had a toothache a couple of weeks ago. I went to my family dentist. She recommended that I see an endodontist. She in turn sent me to an oral surgeon and I will hopefully have an appointment soon for an extraction.

Healthcare visit (other): Outpatient dental

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	✓	✓	✓
HCVO	Specialist consultation	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Toothache	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Mouth ulceration	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Stress	✓	✓	✓

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