YXF-25785-20440

6 vaccinations 6 coded responses 53 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 853 / AZ
Registered: 2021-02-13

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

2021-02-13
Registered in v-safe
2021-02-13
Dose 1 — Moderna
2021-02-13
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-13
Dose 2 — Moderna
2021-03-13
Survey response — day 0, dose 2
MedDRA: Immediate post-injection reaction, Pain — Feeling: Good

Free text: Slight stinging immediate after injection which dissipated in 5 minutes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · None

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

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising, Injection site erythema — Feeling: Good · Site: Redness

Free text: Redness at injection site looks more like a bruise now

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 — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-12
Survey response — 3 months, dose 2
MedDRA: Nasopharyngitis, Sinus disorder — Feeling: Fair

Free text: Sinus cold with no fever or chest congestion.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-11
Survey response — 6 months, dose 2
MedDRA: Hospitalisation, Knee arthroplasty, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Total knee replacement surgery on 8/31/21. Got Covid test (negative) as required before approval for surgery. · Healthcare visit (other): Overnight hospitalization

MedDRA releases: 2024-11 · check-in free text available
2021-09-11
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-16
Call 1 — Requested Callback
2021-09-16
Callback requested for
05:45PM ET
2021-09-16
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-11
Dose 3 — Moderna
2022-03-15
Survey response — 12 months, dose 2
MedDRA: Hypertension, Medical counselling, Office visit, Rash, Self-medication — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Diagnosed with high blood pressure and proscribed medication. Sought medical care for rash on back, cause undetermined and advised to use 1% hydrocortisone cream. · Healthcare visit (other): Nurse practitioner at my doctors office.

MedDRA releases: 2024-11 · check-in free text available
2022-03-15
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-16
Call successful
Does not wish to fill out VAERS report
2022-04-06
Dose 4 — Moderna
2022-04-26
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-27
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-04
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-11
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-18
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-06
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-02
Dose 5 — Moderna
Co-administered: Flu
2022-10-03
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2022-10-04
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · None

Adult check-in
2022-10-05
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2022-10-06
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2022-10-07
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Redness · None

Adult check-in
2022-10-08
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-09
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-16
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-23
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-30
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-06
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-13
Survey response — day 42, dose 5
MedDRA: Paranasal sinus discomfort, Upper-airway cough syndrome — Feeling: Fair

Free text: Post nasal drip and sinus pressure

MedDRA releases: 2024-11 · check-in free text available
2023-01-01
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-02
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in
2023-05-02
Dose 6 — Moderna
2023-05-08
Health check-in — days 1–6 daily, dose 6
Feeling: Good · None

Adult check-in
2023-05-09
Health check-in — day 7, dose 6
Feeling: Good · None

Adult check-in
2023-05-16
Health check-in — day 14, dose 6
Feeling: Good

Adult check-in
2023-05-23
Health check-in — day 21, dose 6
Feeling: Good

Adult check-in
2023-05-30
Health check-in — day 28, dose 6
Feeling: Good

Adult check-in
2023-06-06
Health check-in — day 35, dose 6
Feeling: Good

Adult check-in
2023-06-13
Health check-in — day 42, dose 6
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Moderna
2	2021-03-13	Moderna
3	2021-11-11	Moderna	No
4	2022-04-06	Moderna	No
5	2022-10-02	Moderna	Flu
6	2023-05-02	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-11	Successful 2021-09-16	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-15	Successful 2022-03-16	Does not wish to fill out VAERS report

Free text

Release 5 — day 0, dose 2

2021-03-13

Systemic reaction (other): Slight stinging immediate after injection which dissipated in 5 minutes

Release 5 — days 1–6 daily, dose 2

2021-03-18

Systemic reaction (other): Redness at injection site looks more like a bruise now

Release 9 — 3 months, dose 2

2021-06-12

Symptoms: Sinus cold with no fever or chest congestion.

Release 9 — 6 months, dose 2

2021-09-11

Symptoms: Total knee replacement surgery on 8/31/21. Got Covid test (negative) as required before approval for surgery.

Healthcare visit (other): Overnight hospitalization

Release 11 — 12 months, dose 2

2022-03-15

Symptoms: Diagnosed with high blood pressure and proscribed medication. Sought medical care for rash on back, cause undetermined and advised to use 1% hydrocortisone cream.

Healthcare visit (other): Nurse practitioner at my doctors office.

Release 12 — day 42, dose 5

2022-11-13

Symptoms: Post nasal drip and sinus pressure

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	Hospitalisation	·	·	✓
HCVO	Medical counselling	·	·	✓
SD	Hypertension	·	·	✓
SD	Knee arthroplasty	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Office visit	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Rash	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Self-medication	·	·	✓
SD	Sinus disorder	✓	✓	✓
SD	Upper-airway cough syndrome	·	·	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Pain	✓	✓	✓

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