Z7Q-19221-71984

4 vaccinations 10 coded responses 28 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 575 / SD
Registered: 2020-12-24

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

2020-12-24
Registered in v-safe
2020-12-24
Dose 1 — Moderna
2020-12-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Diarrhea

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2020-12-31
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-07
Survey response — day 14, dose 1
MedDRA: Fatigue, Nausea — Feeling: Fair · Be unable to work

Free text: Severe nausea, extreme fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Report sent to call center — day 14, dose 1
Be unable to work

1 call case(s)
2021-01-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-21
Dose 2 — Moderna
2021-01-21
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Nausea, Abdominal pain

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-11
Survey response — day 21, dose 2
MedDRA: Arthralgia, Pain — Feeling: Fair

Free text: Body/joint aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-25
Survey response — day 35, dose 2
MedDRA: Arthralgia, Headache — Feeling: Fair

Free text: Headache, joint pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 42, dose 2
MedDRA: Nausea — Feeling: Good · Be unable to do your normal daily activities

Free text: Bout of extreme nausea, only lasted about 3 hours then was gone (did not vomit)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-22
Survey response — 6 months, dose 2
MedDRA: Cough — Feeling: Fair

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Dose 3 — Moderna
Co-administered: Flu
2022-01-21
Survey response — 12 months, dose 2
MedDRA: Cough, Decreased appetite, Headache, Respiratory tract congestion — 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: Cough, congestion, headache, loss of appetite

MedDRA releases: 2024-11 · check-in free text available
2022-01-21
Report sent to call center — 12 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-24
Call 1 — Left Voicemail
2022-09-30
Dose 4 — Moderna
Co-administered: Flu
2022-10-23
Survey response — day 21, dose 4
MedDRA: Arthralgia, Headache, Injection site erythema, Injection site warmth, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities

Free text: Severe joint pain after latest booster; arm was sore, felt hot to the touch at injection site, redness from injection site spreading down arm to above elbow; persistent headache

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-05
Survey response — day 35, dose 4
MedDRA: Arthralgia, Headache, Myalgia — Feeling: Fair

Free text: Achy leg muscles and joints, headache

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Survey response — day 42, dose 4
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2023-01-01
Survey response — 3 months, dose 4
MedDRA: Headache, Rhinorrhoea — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-03-31
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-24	Moderna
2	2021-01-21	Moderna
3	2021-10-28	Moderna	Flu
4	2022-09-30	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-01-07	priority 2/3
2022-01-21	Unsuccessful

Free text

Release 1 — day 14, dose 1

2021-01-07

Symptoms: Severe nausea, extreme fatigue

Release 4 — day 21, dose 2

2021-02-11

Symptoms: Body/joint aches

Release 4 — day 35, dose 2

2021-02-25

Symptoms: Headache, joint pain

Release 5 — day 42, dose 2

2021-03-04

Symptoms: Bout of extreme nausea, only lasted about 3 hours then was gone (did not vomit)

Release 9 — 6 months, dose 2

2021-07-22

Symptoms: Cough

Release 11 — 12 months, dose 2

2022-01-21

Symptoms: Cough, congestion, headache, loss of appetite

Release 12 — day 21, dose 4

2022-10-23

Symptoms: Severe joint pain after latest booster; arm was sore, felt hot to the touch at injection site, redness from injection site spreading down arm to above elbow; persistent headache

Release 12 — day 35, dose 4

2022-11-05

Symptoms: Achy leg muscles and joints, headache

Release 12 — day 42, dose 4

2022-11-11

Symptoms: Fatigue

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
SD	Arthralgia	✓	✓	✓
SD	Cough	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site erythema	·	·	✓
SD	Injection site warmth	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	·	·	✓
SD	Pre-existing disease	·	·	○
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓

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