ZK9-16466-85359

3 vaccinations 8 coded responses 20 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 688 / NE
Registered: 2020-12-30

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

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site bruising — Feeling: Good · Site: Pain

Free text: Bruise at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-04
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Pain

Free text: Mild Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Good

Free text: Mild fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Dose 2 — Moderna
2021-01-25
Survey response — day 21, dose 1
MedDRA: Chills, Fatigue, Pain, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: 2nd vac on 1-22-2021. Woke up next morning with fever, chills, severe fatigue and body aches. Symptoms mentioned occurred about 24-36 hours. Still have some fatigue. Luckily I was off for the weekend after having 2nd vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — day 7, dose 2
MedDRA: Feeling hot — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dampness on forehead/face feeling of being hot but no fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-14
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-02-28
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-07
Survey response — day 42, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-23
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-24
Survey response — 12 months, dose 2
MedDRA: Fatigue, Oropharyngeal pain, Pyrexia, Unevaluable event — 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

Free text: Symptoms: Low grade fever, extreme fatigue, severe sore throat · Healthcare visit (other): Scheduled online to have COVID test completed tomorrow at health department

MedDRA releases: 2024-11 · check-in free text available
2022-01-24
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

1 call case(s)
2022-01-27
Call 2 — Left Voicemail
2022-07-22
Dose 3 — Moderna
2022-10-23
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2023-01-22
Survey response — 6 months, dose 3
MedDRA: Fatigue, Gastroenteritis — 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

MedDRA releases: 2024-11
2023-01-22
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 · 1 call case(s)
2023-01-23
Call 1 — Left Voicemail
2023-01-23
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-22	Moderna
3	2022-07-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-24	Unsuccessful
2023-01-22	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-01

Systemic reaction (other): Bruise at injection site

2021-01-04

Systemic reaction (other): Mild Sore throat

Release 1 — day 14, dose 1

2021-01-13

Symptoms: Mild fatigue

Release 2 — day 21, dose 1

2021-01-25

Symptoms: 2nd vac on 1-22-2021. Woke up next morning with fever, chills, severe fatigue and body aches. Symptoms mentioned occurred about 24-36 hours. Still have some fatigue. Luckily I was off for the weekend after having 2nd vaccination

Release 3 — day 7, dose 2

2021-01-31

Systemic reaction (other): Dampness on forehead/face feeling of being hot but no fever

Release 5 — day 42, dose 2

2021-03-07

Symptoms: Tired

Release 11 — 12 months, dose 2

2022-01-24

Symptoms: Low grade fever, extreme fatigue, severe sore throat

Healthcare visit (other): Scheduled online to have COVID test completed tomorrow at health department

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	Unevaluable event	·	·	✓
SD	Chills	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gastroenteritis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓

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