285-10892-91205

4 vaccinations 13 coded responses 39 check-ins 12 free-text entries 8 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 982 / WA
Registered: 2021-02-24

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

2021-02-16
Dose 1 — Moderna
2021-02-24
Registered in v-safe
2021-02-24
Health check-in — day 7, dose 1
Feeling: Poor · Fever · Headache, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-02
Survey response — day 14, dose 1
MedDRA: Fatigue, Nausea, Pain, Pyrexia, Vomiting — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Low fever, aches, nausea and vomiting, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-16
Dose 2 — Moderna
2021-03-16
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-23
Survey response — day 7, dose 2
MedDRA: Enteritis, Eructation, Parosmia — Feeling: Fair · Fever · Chills, Nausea

Free text: Probable enteritis, burping sulfur

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-15
Survey response — 3 months, dose 2
MedDRA: Office visit, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Escalation of my type 2 diabetes · Healthcare visit (other): Office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-23
Call 1 — Left Voicemail
2021-06-23
Call successful
Not applicable - Accidental Reporting
2021-09-16
Survey response — 6 months, dose 2
MedDRA: Transient ischaemic attack — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: TIA

MedDRA releases: 2024-11 · check-in free text available
2021-09-16
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-20
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-11-02
Dose 3 — Moderna
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Musculoskeletal chest pain, Unevaluable event — Feeling: Poor · Site: Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: lungs, ribs sore moderate

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Immunisation reaction — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I have covid arm with onset overnight

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-11-11
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-11-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-24
Survey response — day 21, dose 3
MedDRA: Dyspnoea exertional — Feeling: Good

Free text: Shortness of breath with walking

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-15
Survey response — day 42, dose 3
MedDRA: Chest pain, Dyspnoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Shortness of breath, chest pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-16
Call successful
Not applicable - Accidental Reporting
2022-02-01
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-16
Dose 4 — Moderna
2022-04-16
Health check-in — day 0, dose 4
Feeling: Good · Site: Swelling · None

Adult check-in
2022-04-17
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2022-04-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-04-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-25
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-30
Survey response — day 14, dose 4
MedDRA: Gastrointestinal disorder, Haemorrhoidal haemorrhage, 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 · Emergency room or emergency department visit

Free text: GI problems, hemorrhoidal bleeding, temp

MedDRA releases: 2024-11 · check-in free text available
2022-04-30
Report sent to call center — day 14, 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

Emergency room or emergency department visit · 1 call case(s)
2022-05-02
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-05-07
Survey response — day 21, dose 4
MedDRA: Constipation, Diarrhoea, Fatigue, Haemorrhoidal haemorrhage, Pyrexia, Vomiting — 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 · Emergency room or emergency department visit

Free text: One week low grade fever, vomiting, diarrhea, fatigue, constipation, bleeding hemorroids

MedDRA releases: 2024-11 · check-in free text available
2022-05-07
Report sent to call center — day 21, 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

Emergency room or emergency department visit · 1 call case(s)
2022-05-10
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2022-05-14
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-21
Survey response — day 35, dose 4
MedDRA: Transient ischaemic attack — 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 · Emergency room or emergency department visit, Hospitalization

Free text: TIA

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Report sent to call center — day 35, 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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-05-24
Call 2 — Could Not Reach Participant
2022-05-27
Call 3 — Could Not Reach Participant
2022-05-28
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-17
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-15
Survey response — 6 months, dose 4
MedDRA: Cardiac failure — 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: Heart failure, possible aphasia

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Report sent to call center — 6 months, dose 4
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)
2022-10-17
Call 2 — Left Voicemail
2023-04-19
Survey response — 12 months, dose 4
MedDRA: Corneal abrasion, Dry eye, Unevaluable event, Urinary tract disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-04-19
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 · Emergency room or emergency department visit · 1 call case(s)
2023-04-20
Call 1 — Left Voicemail
2023-04-20
Call 1 — Left Voicemail
2023-04-20
Call 1 — Left Voicemail
2023-04-20
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2023-04-20
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2023-04-20
Call successful
Reported to VAERS voluntarily prior to GDIT contact

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-16	Moderna
2	2021-03-16	Moderna
3	2021-11-02	Moderna	No
4	2022-04-16	Moderna	No

Call center

8 call center cases

8 successful

VAERS report filed, before or during a call: 5

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-03-02

Symptoms: Low fever, aches, nausea and vomiting, fatigue

Release 6 — day 7, dose 2

2021-03-23

Systemic reaction (other): Probable enteritis, burping sulfur

Release 9 — 3 months, dose 2

2021-06-15

Symptoms: Escalation of my type 2 diabetes

Healthcare visit (other): Office visit

Release 9 — 6 months, dose 2

2021-09-16

Symptoms: TIA

Release 10 — days 1–6 daily, dose 3

2021-11-03

Systemic reaction (other): lungs, ribs sore moderate

2021-11-05

Systemic reaction (other): I have covid arm with onset overnight

Release 10 — day 21, dose 3

2021-11-24

Symptoms: Shortness of breath with walking

Release 10 — day 42, dose 3

2021-12-15

Symptoms: Shortness of breath, chest pain

Release 11 — day 14, dose 4

2022-04-30

Symptoms: GI problems, hemorrhoidal bleeding, temp

Release 11 — day 21, dose 4

2022-05-07

Symptoms: One week low grade fever, vomiting, diarrhea, fatigue, constipation, bleeding hemorroids

Release 11 — day 35, dose 4

2022-05-21

Symptoms: TIA

Release 12 — 6 months, dose 4

2022-10-15

Symptoms: Heart failure, possible aphasia

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	Cardiac failure	·	·	✓
SD	Chest pain	·	·	✓
SD	Constipation	·	·	✓
SD	Corneal abrasion	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dry eye	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Dyspnoea exertional	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Haemorrhoidal haemorrhage	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Transient ischaemic attack	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Urinary tract disorder	·	·	✓
SD	Vomiting	✓	✓	✓
SRO	Enteritis	✓	✓	✓
SRO	Eructation	✓	✓	✓
SRO	Immunisation reaction	·	·	✓
SRO	Musculoskeletal chest pain	·	·	✓
SRO	Parosmia	○	✓	○
SRO	Unevaluable event	·	·	✓

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