YZK-13499-03496

5 vaccinations 17 coded responses 60 check-ins 15 free-text entries 9 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 498 / MI
Registered: 2021-03-10

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

2021-03-10
Registered in v-safe
2021-03-10
Dose 1 — Moderna
2021-03-10
Health check-in — day 0, dose 1
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 1
MedDRA: Constipation — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Constipation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Constipation — Feeling: Good · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness

Free text: Constipation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — day 7, dose 1
Feeling: Good · Site: Swelling · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-03-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Survey response — day 21, dose 1
MedDRA: Asthma, Office visit, Oropharyngeal pain, Sinusitis — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Sinus infection sore throat increased asthma · Healthcare visit (other): Primary care physician

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-07
Dose 2 — Moderna
2021-04-07
Survey response — day 0, dose 2
MedDRA: Sinusitis — Feeling: Good

Free text: Sinus infection on doxycycline

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Hypogeusia — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Diminish taste

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site warmth — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Injection area is warm to touch

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

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-04-14
Health check-in — day 7, dose 2
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-06
Survey response — 6 months, dose 2
MedDRA: Atrial fibrillation — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Atrial Fibrillation 7/22/2021 Episodes lasting seconds to hours continue

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-11-11
Dose 3 — Moderna
2021-11-11
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-11-12
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-13
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness, Sleep disorder — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Dizziness- broken up sleep

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-11-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-18
Health check-in — day 7, dose 3
Feeling: Good · Site: Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-25
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-16
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-23
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-10
Survey response — 3 months, dose 3
MedDRA: COVID-19, Influenza — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Covid for 35 days Influenza

MedDRA releases: 2024-11 · check-in free text available
2022-02-10
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-02-14
Call 2 — Left Voicemail
2022-04-12
Dose 4 — Moderna
2022-04-19
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-26
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-03
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-10
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-17
Survey response — day 35, dose 4
MedDRA: Anaemia, Atrial fibrillation, Haemoglobin decreased, Pre-existing disease, Rheumatoid arthritis, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Hospitalization

Free text: Symptoms: Worsening anemia hgb 8.7 Increased Episodes of AFib RA flare up · Healthcare visit (other): Out patient iron infusion

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
Report sent to call center — day 35, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Hospitalization · 1 call case(s)
2022-05-18
Call 3 — Could Not Reach Participant
2022-05-23
Call 3 — Left Voicemail
2022-05-23
Call 3 — Could Not Reach Participant
2022-05-24
Survey response — day 42, dose 4
MedDRA: Atrial fibrillation, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Atrial fibrillation episodes increased after vaccines

MedDRA releases: 2024-11 · check-in free text available
2022-05-24
Report sent to call center — day 42, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-05-25
Call 3 — Could Not Reach Participant
2022-07-12
Survey response — 3 months, dose 4
MedDRA: Atrial fibrillation — 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: Increased episodes of AFib

MedDRA releases: 2024-11 · check-in free text available
2022-07-12
Report sent to call center — 3 months, dose 4
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 · 1 call case(s)
2022-07-13
Call 3 — Could Not Reach Participant
2022-10-11
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-10-25
Dose 5 — Moderna
Co-administered: Flu
2022-10-27
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-10-28
Survey response — days 1–6 daily, dose 5
MedDRA: Injection site rash, Rash — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Rash about 8inches long 5 inches wide on arm injections given

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-30
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Redness, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-10-31
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Swelling, Itching · Headache, Joint pains

Adult check-in
2022-11-01
Health check-in — day 7, dose 5
Feeling: Good · Site: Swelling, Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-11-08
Survey response — day 14, dose 5
MedDRA: Asthma, Ear infection, Migraine, Pyrexia, Sinusitis — Feeling: Fair · Be unable to work or attend school, 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: Fever, sinus infection, ear infection, worsening asthma. Migraine headache lasting a week!

MedDRA releases: 2024-11 · check-in free text available
2022-11-08
Report sent to call center — day 14, dose 5
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-09
Call X — Left Voicemail
2022-11-09
Call X — Left Voicemail
2022-11-09
Call X — Left Voicemail
2022-11-09
Call X — Requested Callback
2022-11-09
Call X — Left Voicemail
2022-11-09
Call X — Left Voicemail
2022-11-09
Call 3 — Left Voicemail
2022-11-15
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-22
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-29
Survey response — day 35, dose 5
MedDRA: Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Yet another URI (2 since this vaccine)

MedDRA releases: 2024-11 · check-in free text available
2022-12-06
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-25
Survey response — 3 months, dose 5
MedDRA: Influenza — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-01-25
Report sent to call center — 3 months, dose 5
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-25
Call 1 — Left Voicemail
2023-01-25
Call 1 — Left Voicemail
2023-01-25
Call 1 — Left Voicemail
2023-01-25
Call 1 — Left Voicemail
2023-01-25
Call 1 — Left Voicemail
2023-01-25
Call 1 — Left Voicemail
2023-01-25
Call 1 — Left Voicemail
2023-01-25
Call 1 — Left Voicemail
2023-04-25
Survey response — 6 months, dose 5
MedDRA: Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-25
Report sent to call center — 6 months, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-26
Call 2 — Left Voicemail
2023-04-26
Call 2 — Left Voicemail
2023-04-26
Call 3 — Left Voicemail
2023-04-26
Call 2 — Left Voicemail
2023-04-26
Call 2 — Left Voicemail
2023-04-26
Call 2 — Left Voicemail
2023-04-26
Call 2 — Left Voicemail
2023-04-26
Call 2 — Left Voicemail
2023-04-26
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-07	Moderna
3	2021-11-11	Moderna	No
4	2022-04-12	Moderna	No
5	2022-10-25	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-03-31	Unsuccessful
2021-10-06	Unsuccessful
2022-02-10	Unsuccessful
2022-05-17	Unsuccessful
2022-05-24	Unsuccessful
2022-07-12	Unsuccessful
2022-11-08	Unsuccessful
2023-01-25	Unsuccessful
2023-04-25	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-12

Systemic reaction (other): Constipation

2021-03-14

Systemic reaction (other): Constipation

Release 6 — day 21, dose 1

2021-03-31

Symptoms: Sinus infection sore throat increased asthma

Healthcare visit (other): Primary care physician

Release 7 — day 0, dose 2

2021-04-07

Systemic reaction (other): Sinus infection on doxycycline

Release 7 — days 1–6 daily, dose 2

2021-04-09

Systemic reaction (other): Diminish taste

2021-04-10

Systemic reaction (other): Injection area is warm to touch

Release 10 — 6 months, dose 2

2021-10-06

Symptoms: Atrial Fibrillation 7/22/2021 Episodes lasting seconds to hours continue

Release 10 — days 1–6 daily, dose 3

2021-11-13

Systemic reaction (other): Dizziness- broken up sleep

Release 11 — 3 months, dose 3

2022-02-10

Symptoms: Covid for 35 days Influenza

Release 11 — day 35, dose 4

2022-05-17

Symptoms: Worsening anemia hgb 8.7 Increased Episodes of AFib RA flare up

Healthcare visit (other): Out patient iron infusion

Release 11 — day 42, dose 4

2022-05-24

Symptoms: Atrial fibrillation episodes increased after vaccines

Release 12 — 3 months, dose 4

2022-07-12

Symptoms: Increased episodes of AFib

Release 12 — days 1–6 daily, dose 5

2022-10-28

Systemic reaction (other): Rash about 8inches long 5 inches wide on arm injections given

Release 12 — day 14, dose 5

2022-11-08

Symptoms: Fever, sinus infection, ear infection, worsening asthma. Migraine headache lasting a week!

Release 12 — day 35, dose 5

2022-11-29

Symptoms: Yet another URI (2 since this vaccine)

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	Unevaluable event	·	·	✓
SD	Anaemia	·	·	✓
SD	Asthma	✓	✓	✓
SD	Atrial fibrillation	·	·	✓
SD	COVID-19	·	·	✓
SD	Ear infection	·	·	✓
SD	Haemoglobin decreased	·	·	✓
SD	Influenza	·	·	✓
SD	Migraine	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rheumatoid arthritis	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Constipation	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Hypogeusia	✓	✓	✓
SRO	Injection site rash	·	·	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Rash	·	·	✓
SRO	Sinusitis	✓	✓	✓
SRO	Sleep disorder	·	·	✓

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