YY8-62794-28980

5 vaccinations 5 coded responses 35 check-ins 4 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 287 / NC
Registered: 2021-01-21

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

2021-01-20
Dose 1 — Moderna
2021-01-21
Registered in v-safe
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Good

Free text: In retrospect, I realize that I had a vague headache on the day after given the vaccine. It was not severe enough to take anything for it.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling — Feeling: Good

Free text: Starting 1/28 there was slight swelling @ vaccination site and a red blotch approximately 2x4 inches below vaccination site. It became itchy on 1/29, faded to pink on 1/31 and is no longer itchy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-17
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-20
Dose 3 — Moderna
2022-02-17
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-11
Dose 4 — Moderna
2022-04-28
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-02
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-09
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-16
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-05-23
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-11
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-12
Dose 5 — Pfizer-BioNTech
2022-10-10
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-10-21
Survey response — day 35, dose 5
MedDRA: Pain in extremity — Feeling: Good

Free text: Right foot pain, possibly plantar fasciitis

MedDRA releases: 2024-11 · check-in free text available
2022-10-24
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-12
Survey response — 3 months, dose 5
MedDRA: Atrial fibrillation, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: A. Fib · Healthcare visit (other): Cardiology referral

MedDRA releases: 2024-11 · check-in free text available
2022-12-12
Report sent to call center — 3 months, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-13
Call 1 — Left Voicemail
2023-03-13
Survey response — 6 months, dose 5
MedDRA: Atrial fibrillation, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-13
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-15
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-15
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna
3	2021-11-20	Moderna	No
4	2022-04-11	Moderna	No
5	2022-09-12	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-12-12	Successful 2023-03-15	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-13	Successful 2023-03-15	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-25

Systemic reaction (other): In retrospect, I realize that I had a vague headache on the day after given the vaccine. It was not severe enough to take anything for it.

Release 3 — day 14, dose 1

2021-02-03

Symptoms: Starting 1/28 there was slight swelling @ vaccination site and a red blotch approximately 2x4 inches below vaccination site. It became itchy on 1/29, faded to pink on 1/31 and is no longer itchy.

Release 12 — day 35, dose 5

2022-10-21

Symptoms: Right foot pain, possibly plantar fasciitis

Release 12 — 3 months, dose 5

2022-12-12

Symptoms: A. Fib

Healthcare visit (other): Cardiology referral

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	Atrial fibrillation	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pain in extremity	·	·	✓
SRO	Headache	✓	✓	✓

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