ZC7-32237-12650

5 vaccinations 12 coded responses 46 check-ins 11 free-text entries 9 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 191 / PA
Registered: 2021-01-25

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

2021-01-22
Dose 1 — Moderna
2021-01-25
Registered in v-safe
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Survey response — day 14, dose 1
MedDRA: Injection site pruritus, Injection site swelling, Injection site warmth — Feeling: Good

Free text: Itchy and local swelling and heat at the injection site on upper arm. Been this way for about 5 days now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-18
Dose 2 — Moderna
2021-02-18
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

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

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Abdominal pain

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-25
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 28, dose 2
MedDRA: Abdominal pain upper, Diarrhoea, Dizziness, Hypotension, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Frequent bouts of Nausea (and Im someone who never gets nauseous) and frequent diarrhea over last few days along with stomach cramping. And dizzyness with blood pressure running lower than normal. · Healthcare visit (other): Visit to cardiologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-27
Survey response — day 35, dose 2
MedDRA: Pre-existing disease, Sinus pain, Urticaria — Feeling: Good

Free text: Hives and sinus pain and NO it is not allergies. They feel different.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-22
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-20
Dose 3 — Moderna
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-11-03
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-11
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-24
Survey response — day 35, dose 3
MedDRA: Dyspnoea, Fatigue — Feeling: Fair

Free text: Fatigue, slight shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-23
Call 3 — Left Voicemail
2022-01-19
Survey response — 3 months, dose 3
MedDRA: Arthralgia, Myalgia — 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

Free text: Symmetric Muscle and joint pain

MedDRA releases: 2024-11 · check-in free text available
2022-01-19
Report sent to call center — 3 months, dose 3
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)
2022-01-20
Call successful
Does not wish to fill out VAERS report
2022-01-20
Call successful
Does not wish to fill out VAERS report
2022-04-10
Dose 4 — Moderna
2022-04-20
Health check-in — day 7, dose 4
Feeling: Good · Abdominal pain

Adult check-in
2022-04-20
Survey response — 6 months, dose 3
MedDRA: Atrial fibrillation, Cardiac arrest, Cardiac pacemaker insertion — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: AFIB and stopped heart. Got a pacemaker implanted on March 17.

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-21
Call 2 — Left Voicemail
2022-04-28
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-15
Survey response — day 35, dose 4
MedDRA: Abdominal pain upper, COVID-19, Dizziness, Ear pain, Fatigue, Headache, Oropharyngeal pain, Pyrexia, Rhinorrhoea — Feeling: Poor · 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: Positive for covid. Fever, sore throat, runny nose, ear aches, headache, fatigue, dizzy, stomach aches

MedDRA releases: 2024-11 · check-in free text available
2022-05-15
Report sent to call center — day 35, 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 · 1 call case(s)
2022-05-17
Call 2 — Left Voicemail
2022-07-10
Survey response — 3 months, dose 4
MedDRA: COVID-19 — Feeling: Good · 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 in mid May

MedDRA releases: 2024-11 · check-in free text available
2022-07-10
Report sent to call center — 3 months, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-12
Call 1 — Left Voicemail
2022-07-12
Call 1 — Left Voicemail
2022-07-12
Call 3 — Left Voicemail
2022-07-12
Call 3 — Left Voicemail
2022-07-12
Call 2 — Left Voicemail
2022-09-14
Dose 5 — Moderna
2022-09-16
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-09-18
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Abdominal pain

Adult check-in
2022-09-19
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-21
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-09-28
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-10-05
Survey response — day 21, dose 5
MedDRA: Fungal skin infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Yeast Infection on abdominal skin area.

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Report sent to call center — day 21, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-06
Call 2 — Could Not Reach Participant
2022-10-06
Call 3 — Could Not Reach Participant
2022-10-06
Call 2 — Could Not Reach Participant
2022-10-11
Call 3 — Could Not Reach Participant
2022-10-12
Survey response — day 28, dose 5
MedDRA: Fatigue, Fungal skin infection, Respiratory tract congestion — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Congestion, extreme fatigue, fungus skin infection

MedDRA releases: 2024-11 · check-in free text available
2022-10-12
Report sent to call center — day 28, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-13
Call 2 — Could Not Reach Participant
2022-10-18
Call 3 — Could Not Reach Participant
2022-10-19
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-10-26
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2022-12-14
Survey response — 3 months, dose 5
MedDRA: COVID-19 — 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

Free text: I got covid in November

MedDRA releases: 2024-11 · check-in free text available
2022-12-14
Report sent to call center — 3 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)
2022-12-15
Call 2 — Could Not Reach Participant
2022-12-20
Call X — Left Voicemail
2022-12-20
Call X — Left Voicemail
2022-12-20
Call X — Left Voicemail
2022-12-20
Call X — Left Voicemail
2022-12-20
Call X — Left Voicemail
2022-12-20
Call 3 — Left Voicemail
2023-03-15
Survey response — 6 months, dose 5
MedDRA: Tachycardia — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-15
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)
2023-03-16
Call 1 — Left Voicemail
2023-03-16
Call 1 — Left Voicemail
2023-03-16
Call 1 — Left Voicemail
2023-03-16
Call 1 — Left Voicemail
2023-03-16
Call 1 — Left Voicemail
2023-03-16
Call 1 — Left Voicemail
2023-03-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-18	Moderna
3	2021-10-20	Moderna	No
4	2022-04-10	Moderna	No
5	2022-09-14	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-18	Successful 2022-01-20	Does not wish to fill out VAERS report
2022-01-19	Successful 2022-01-20	Does not wish to fill out VAERS report
2022-04-20	Unsuccessful
2022-05-15	Unsuccessful
2022-07-10	Unsuccessful
2022-10-05	Unsuccessful
2022-10-12	Unsuccessful
2022-12-14	Unsuccessful
2023-03-15	Unsuccessful

Free text

Release 3 — day 14, dose 1

2021-02-05

Symptoms: Itchy and local swelling and heat at the injection site on upper arm. Been this way for about 5 days now.

Release 5 — day 28, dose 2

2021-03-18

Symptoms: Frequent bouts of Nausea (and Im someone who never gets nauseous) and frequent diarrhea over last few days along with stomach cramping. And dizzyness with blood pressure running lower than normal.

Healthcare visit (other): Visit to cardiologist

Release 6 — day 35, dose 2

2021-03-27

Symptoms: Hives and sinus pain and NO it is not allergies. They feel different.

Release 10 — day 35, dose 3

2021-11-24

Symptoms: Fatigue, slight shortness of breath

Release 10 — 3 months, dose 3

2022-01-19

Symptoms: Symmetric Muscle and joint pain

Release 11 — 6 months, dose 3

2022-04-20

Symptoms: AFIB and stopped heart. Got a pacemaker implanted on March 17.

Release 11 — day 35, dose 4

2022-05-15

Symptoms: Positive for covid. Fever, sore throat, runny nose, ear aches, headache, fatigue, dizzy, stomach aches

Release 12 — 3 months, dose 4

2022-07-10

Symptoms: Covid in mid May

Release 12 — day 21, dose 5

2022-10-05

Symptoms: Yeast Infection on abdominal skin area.

Release 12 — day 28, dose 5

2022-10-12

Symptoms: Congestion, extreme fatigue, fungus skin infection

Release 12 — 3 months, dose 5

2022-12-14

Symptoms: I got covid in November

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	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Atrial fibrillation	·	·	✓
SD	Cardiac arrest	·	·	✓
SD	Cardiac pacemaker insertion	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Ear pain	·	·	✓
SD	Fatigue	·	·	✓
SD	Fungal skin infection	·	·	✓
SD	Headache	·	·	✓
SD	Hypotension	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinus pain	✓	✓	✓
SD	Tachycardia	·	·	✓
SD	Urticaria	✓	✓	✓

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