YZV-24997-72739

5 vaccinations 19 coded responses 69 check-ins 18 free-text entries 6 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 900 / CA
Registered: 2021-03-24

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-24
Registered in v-safe
2021-03-24
Dose 1 — Moderna
2021-03-24
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-14
Survey response — day 21, dose 1
MedDRA: Dyspnoea, Fatigue — Feeling: Fair · Be unable to work, 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: very tired, some shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Report sent to call center — day 21, dose 1
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-21
Dose 2 — Moderna
2021-04-21
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-04-28
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

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

Adult check-in
2021-05-12
Survey response — day 21, dose 2
MedDRA: Headache — Feeling: Fair

Free text: mild headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Survey response — day 28, dose 2
MedDRA: Chills, Headache, Oropharyngeal pain — Feeling: Fair

Free text: mild sore throat, continued mild headache, some chills, no fever. Think it's seasonal allergies and recent wildfires near us in L.A. though.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-21
Survey response — 3 months, dose 2
MedDRA: Dizziness, Dyspnoea, Fatigue, Head discomfort, Headache, Musculoskeletal stiffness, Nausea, Productive cough — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: shortness of breath, extreme fatigue, headache/pressure, chest phlegm, neck stiffness, occasional lightheaded, nausea

MedDRA releases: 2024-11 · check-in free text available
2021-07-21
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-22
Survey response — 6 months, dose 2
MedDRA: Fatigue, Headache, Injection site pain, Oropharyngeal pain — Feeling: Fair

Free text: sore upper arm near injection site (last week) mild fatigue sore throat headache (today)

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Dose 3 — Moderna
2021-10-29
Health check-in — day 0, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Fair · Chills, Headache, Fatigue or tiredness, Nausea · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: lightheaded, dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Call 1 — Left Voicemail
2021-11-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-11-14
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Survey response — day 21, dose 3
MedDRA: Injection site pain — Feeling: Good

Free text: slight soreness around injection site

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-03
Survey response — day 35, dose 3
MedDRA: Chills, Oropharyngeal pain — Feeling: Fair

Free text: sore throat and mild chills

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-28
Survey response — 3 months, dose 3
MedDRA: Cough — Feeling: Fair

Free text: cough

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Survey response — 6 months, dose 3
MedDRA: COVID-19 — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: got covid

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Report sent to call center — 6 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-02
Call 1 — Left Voicemail
2022-05-02
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-07-05
Dose 4 — Moderna
2022-07-05
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2022-07-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-07-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches

Adult check-in
2022-07-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-11
Survey response — days 1–6 daily, dose 4
MedDRA: Brain fog — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-07-12
Survey response — day 7, dose 4
MedDRA: Dyspnoea — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: short of breath

MedDRA releases: 2024-11 · check-in free text available
2022-07-19
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-26
Survey response — day 21, dose 4
MedDRA: Brain fog, Speech disorder — Feeling: Fair · Be unable to work or attend school

Free text: more brain fog, new symptom dififculty with speech

MedDRA releases: 2024-11 · check-in free text available
2022-08-02
Survey response — day 28, dose 4
MedDRA: Brain fog, Speech disorder — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: trouble speaking, more brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-08-09
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-08-16
Survey response — day 42, dose 4
MedDRA: Brain fog, Dysgraphia, Office visit, Pre-existing disease, Speech disorder — 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

Free text: Symptoms: more cognitive difficulty esp with speech, writing, typing, brain fog, but this all probably long covid and not from booster · Healthcare visit (other): in person dr appt

MedDRA releases: 2024-11 · check-in free text available
2022-08-16
Report sent to call center — day 42, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-08-19
Call 1 — Left Voicemail
2022-08-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-04
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-14
Dose 5 — Pfizer-BioNTech
2022-10-14
Health check-in — day 0, dose 5
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-10-15
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-10-16
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-10-17
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Redness, Swelling, Itching · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-18
Survey response — days 1–6 daily, dose 5
MedDRA: Pre-existing disease — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: from long covid not

MedDRA releases: 2024-11 · check-in free text available
2022-10-19
Survey response — days 1–6 daily, dose 5
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: symptoms from long covid got worse after booster

MedDRA releases: 2024-11 · check-in free text available
2022-10-20
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · 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
2022-10-21
Health check-in — day 7, dose 5
Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-10-28
Survey response — day 14, dose 5
MedDRA: Head discomfort, Headache, Post-acute COVID-19 syndrome — Feeling: Fair · Be unable to do your normal daily activities

Free text: headache, head pressure. might be from long covid or new medication though

MedDRA releases: 2024-11 · check-in free text available
2022-11-06
Health check-in — day 21, dose 5
Feeling: Fair

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

Adult check-in
2022-11-18
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-11-25
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-13
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-18
Survey response — 6 months, dose 5
MedDRA: Fatigue, Headache, Mental fatigue — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-18
Report sent to call center — 6 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-20
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna
2	2021-04-21	Moderna
3	2021-10-29	Moderna	No
4	2022-07-05	Moderna	No
5	2022-10-14	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-14	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-07-21	Successful 2021-07-26	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-11-04	Successful 2021-11-08	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-29	Successful 2022-05-02	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-16	Successful 2022-08-19	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-18	Unsuccessful

Free text

Release 7 — day 21, dose 1

2021-04-14

Symptoms: very tired, some shortness of breath

Release 8 — day 21, dose 2

2021-05-12

Symptoms: mild headache

Release 8 — day 28, dose 2

2021-05-19

Symptoms: mild sore throat, continued mild headache, some chills, no fever. Think it's seasonal allergies and recent wildfires near us in L.A. though.

Release 9 — 3 months, dose 2

2021-07-21

Symptoms: shortness of breath, extreme fatigue, headache/pressure, chest phlegm, neck stiffness, occasional lightheaded, nausea

Release 10 — 6 months, dose 2

2021-10-22

Symptoms: sore upper arm near injection site (last week) mild fatigue sore throat headache (today)

Release 10 — days 1–6 daily, dose 3

2021-11-04

Systemic reaction (other): lightheaded, dizzy

Release 10 — day 21, dose 3

2021-11-19

Symptoms: slight soreness around injection site

Release 10 — day 35, dose 3

2021-12-03

Symptoms: sore throat and mild chills

Release 11 — 3 months, dose 3

2022-01-28

Symptoms: cough

Release 11 — 6 months, dose 3

2022-04-29

Symptoms: got covid

Release 12 — days 1–6 daily, dose 4

2022-07-11

Systemic reaction (other): brain fog

Release 12 — day 7, dose 4

2022-07-12

Systemic reaction (other): short of breath

Release 12 — day 21, dose 4

2022-07-26

Symptoms: more brain fog, new symptom dififculty with speech

Release 12 — day 28, dose 4

2022-08-02

Symptoms: trouble speaking, more brain fog

Release 12 — day 42, dose 4

2022-08-16

Symptoms: more cognitive difficulty esp with speech, writing, typing, brain fog, but this all probably long covid and not from booster

Healthcare visit (other): in person dr appt

Release 12 — days 1–6 daily, dose 5

2022-10-18

Systemic reaction (other): from long covid not

2022-10-19

Systemic reaction (other): symptoms from long covid got worse after booster

Release 12 — day 14, dose 5

2022-10-28

Symptoms: headache, head pressure. might be from long covid or new medication though

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	·	·	✓
SD	Brain fog	·	·	✓
SD	Chills	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	·	·	✓
SD	Dysgraphia	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Head discomfort	·	·	✓
SD	Headache	✓	✓	✓
SD	Injection site pain	·	·	✓
SD	Mental fatigue	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Post-acute COVID-19 syndrome	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Productive cough	·	·	✓
SD	Speech disorder	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Condition aggravated	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Pre-existing disease	·	·	✓

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