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YZZ-77674-45335

4 vaccinations 10 coded responses 43 check-ins 9 free-text entries 3 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
479 / IN
Registered
2021-01-26
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-01-26
    Registered in v-safe
  2. 2021-01-26
    Dose 1 — Moderna
  3. 2021-01-26
    Health check-in — day 0, dose 1
    Feeling: Good · None
    Adult check-in
  4. 2021-01-27
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  5. 2021-01-28
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-01-29
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Diarrhea
    Adult check-in
  7. 2021-01-30
    Survey response — days 1–6 daily, dose 1
    MedDRA: Hypersomnia — Feeling: Good · Fatigue or tiredness
    Free text: Slept 11 hours second night after shot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-01-31
    Survey response — days 1–6 daily, dose 1
    MedDRA: Erythema — Feeling: Good · Rash, not including the immediate area around the injection site
    Free text: My cheeks are bright pink
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  9. 2021-02-01
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Diarrhea
    Adult check-in
  10. 2021-02-02
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-02-11
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  12. 2021-02-16
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-02-23
    Dose 2 — Moderna
  14. 2021-02-25
    Survey response — days 1–6 daily, dose 2
    MedDRA: Fatigue, Pain — Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness
    Free text: These were symptoms that I had yesterday. I have only some achiness and tiredness today.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  15. 2021-02-27
    Survey response — days 1–6 daily, dose 2
    MedDRA: Arthralgia, Pain in extremity, Self-medication — Feeling: Good · Site: Pain · Joint pains · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Systemic reaction (other): The pain is in my right hand and wrist so I dont know whether or not its related to the shot. · Healthcare visit (other): I thought that my hand or wrist might have a broken bone because the pain woke me up at night. Tylenol helps it a lot.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-02-27
    Report sent to call center — days 1–6 daily, dose 2
    Get care from a doctor or other healthcare professional
    1 call case(s)
  17. 2021-03-01
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  18. 2021-03-02
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-03-09
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  20. 2021-03-16
    Health check-in — day 21, dose 2
    Feeling: Fair
    Adult check-in
  21. 2021-03-23
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-03-30
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-04-06
    Survey response — day 42, dose 2
    MedDRA: Headache — Feeling: Fair
    Free text: Headache
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-05-25
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-08-26
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-09-09
  27. 2021-10-28
    Dose 3 — Moderna
  28. 2021-10-28
    Health check-in — day 0, dose 3
    Feeling: Good · Site: Pain · None
    Adult check-in
  29. 2021-10-29
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Abdominal pain
    Adult check-in
  30. 2021-10-30
    Survey response — days 1–6 daily, dose 3
    MedDRA: Body temperature decreased, Pain of skin, Self-medication — Feeling: Fair · Site: Pain · Fever · Muscle or body aches
    Free text: My skin hurt until I took Tylenol at 9 am and I feel fine now. Last night my skin hurt and my temperature was 95.3. I took Tylenol and went to sleep.
    MedDRA releases: 2024-11 · check-in free text available
  31. 2021-10-31
    Survey response — days 1–6 daily, dose 3
    MedDRA: Pain of skin, Self-medication — Feeling: Good · Site: Pain, Swelling · Fever · Muscle or body aches, Diarrhea
    Free text: Skin hurt until I took Tylenol
    MedDRA releases: 2024-11 · check-in free text available
  32. 2021-11-01
    Health check-in — days 1–6 daily, dose 3
    Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Adult check-in
  33. 2021-11-02
    Survey response — days 1–6 daily, dose 3
    MedDRA: Back pain — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Back pain
    MedDRA releases: 2024-11 · check-in free text available
  34. 2021-11-03
    Health check-in — days 1–6 daily, dose 3
    Feeling: Good · None
    Adult check-in
  35. 2021-11-04
    Health check-in — day 7, dose 3
    Feeling: Good · None
    Adult check-in
  36. 2021-11-11
    Health check-in — day 14, dose 3
    Feeling: Good
    Adult check-in
  37. 2021-11-18
    Health check-in — day 21, dose 3
    Feeling: Good
    Adult check-in
  38. 2021-11-26
    Health check-in — day 28, dose 3
    Feeling: Good
    Adult check-in
  39. 2021-12-02
    Health check-in — day 35, dose 3
    Feeling: Good
    Adult check-in
  40. 2021-12-09
    Health check-in — day 42, dose 3
    Feeling: Good
    Adult check-in
  41. 2022-01-29
    Health check-in — 3 months, dose 3
    Feeling: Good
    Adult check-in
  42. 2022-04-28
    Dose 4 — Moderna
  43. 2022-04-28
    Health check-in — 6 months, dose 3
    Feeling: Good
    Adult check-in
  44. 2022-05-19
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  45. 2022-05-27
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  46. 2022-06-02
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  47. 2022-06-09
    Health check-in — day 42, dose 4
    Feeling: Good
    Adult check-in
  48. 2022-07-28
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  49. 2022-10-27
    Survey response — 6 months, dose 4
    MedDRA: COVID-19, SARS-CoV-2 test negative — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Had Covid August 25 And tested negative September 5.
    MedDRA releases: 2024-11 · check-in free text available
  50. 2022-10-27
    Report sent to call center — 6 months, dose 4
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  51. 2022-10-28
  52. 2023-04-28
    Survey response — 12 months, dose 4
    MedDRA: Pain in extremity — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    MedDRA releases: 2024-11
  53. 2023-04-28
    Report sent to call center — 12 months, dose 4
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  54. 2023-05-01
  55. 2023-05-01
  56. 2023-05-01

Vaccinations

DoseDateManufacturerCo-administered
12021-01-26Moderna
22021-02-23Moderna
32021-10-28Moderna No
42022-04-28Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-02-27 Unsuccessful
2022-10-27 Unsuccessful
2023-04-28 Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-30

Systemic reaction (other): Slept 11 hours second night after shot.

2021-01-31

Systemic reaction (other): My cheeks are bright pink

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): These were symptoms that I had yesterday. I have only some achiness and tiredness today.

2021-02-27

Systemic reaction (other): The pain is in my right hand and wrist so I dont know whether or not its related to the shot.
Healthcare visit (other): I thought that my hand or wrist might have a broken bone because the pain woke me up at night. Tylenol helps it a lot.

Release 7 — day 42, dose 2

2021-04-06

Symptoms: Headache

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): My skin hurt until I took Tylenol at 9 am and I feel fine now. Last night my skin hurt and my temperature was 95.3. I took Tylenol and went to sleep.

2021-10-31

Systemic reaction (other): Skin hurt until I took Tylenol

2021-11-02

Systemic reaction (other): Back pain

Release 12 — 6 months, dose 4

2022-10-27

Symptoms: Had Covid August 25 And tested negative September 5.

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

FieldPreferred term2021-092023-042024-11
HCVOArthralgia ✓ ✓ ✓
HCVOPain in extremity ✓ ✓ ✓
HCVOSelf-medication ✓ ✓ ✓
SDCOVID-19 · · ✓
SDHeadache ✓ ✓ ✓
SDPain in extremity · · ✓
SDSARS-CoV-2 test negative · · ✓
SROArthralgia ✓ ✓ ✓
SROBack pain · · ✓
SROBody temperature decreased · · ✓
SROErythema ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROHypersomnia ✓ ✓ ✓
SROPain ✓ ✓ ✓
SROPain in extremity ✓ ✓ ✓
SROPain of skin · · ✓
SROSelf-medication · · ✓

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

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