3PX-15084-30086

5 vaccinations 15 coded responses 39 check-ins 14 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 982 / WA
Registered: 2021-02-20

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-16
Dose 1 — Moderna
2021-02-15
Dose 2 — Moderna
2021-02-20
Registered in v-safe
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Fever · Headache, Fatigue or tiredness, Diarrhea · 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 · Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-22
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-08
Survey response — day 21, dose 2
MedDRA: Oral surgery, Tooth abscess — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Abscesses tooth · Healthcare visit (other): Oral surgery

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-15
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-29
Survey response — day 42, dose 2
MedDRA: Diarrhoea — Feeling: Good · Be unable to do your normal daily activities

Free text: Frequent Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-17
Survey response — 3 months, dose 2
MedDRA: Muscle spasms — Feeling: Good · Be unable to do your normal daily activities

Free text: Severe leg and foot cramps, both legs.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-16
Survey response — 6 months, dose 2
MedDRA: Neck mass, Pre-existing disease, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Found a lump in my neck. Already had cancer twice. Not likely related to covid or vax. · Healthcare visit (other): Still waiting for an appointment

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-16
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-23
Call 1 — Left Voicemail
2021-08-24
Call successful
Not applicable - Accidental Reporting
2021-09-03
Dose 3 — Moderna
2021-09-04
Survey response — days 1–6 daily, dose 3
MedDRA: Hypoaesthesia, Immediate post-injection reaction, Injection site pain, Muscular weakness, Neuralgia, Pain in extremity, Paraesthesia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: When I first got the injection a pain shot from the site down my arm to the back of my hand. Felt like nerve pain. My arm and hand were hard to use for an hour or so. Had numbness and tingling for several hours.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-09-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-09-07
Survey response — days 1–6 daily, dose 3
MedDRA: Headache, Middle insomnia — Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains, Fatigue or tiredness

Free text: Woke up in night with headache; gone now.

MedDRA releases: 2024-11 · check-in free text available
2021-09-08
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site erythema — Feeling: Good · Site: Pain, Redness, Swelling, Itching

Free text: The redness at the site has spread to two spots 4 and 5 inches below the original site.

MedDRA releases: 2024-11 · check-in free text available
2021-09-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-09-10
Health check-in — day 7, dose 3
Feeling: Good · Site: Redness · None

Adult check-in
2021-09-17
Survey response — day 14, dose 3
MedDRA: Dizziness, Lymphadenopathy, Oropharyngeal pain, SARS-CoV-2 test, 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 · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Swollen neck lymph nodes, vomiting, sore throat, dizziness, lightheaded. · Healthcare visit (other): Covid test

MedDRA releases: 2024-11 · check-in free text available
2021-09-17
Report sent to call center — day 14, 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

1 call case(s)
2021-09-21
Call successful
Participant prefers to complete VAERS report online
2021-09-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-10-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-08
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-02-08
Dose 4 — Moderna
2022-02-09
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Fatigue or tiredness

Adult check-in
2022-02-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-02-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2022-02-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-02-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · None

Adult check-in
2022-02-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-02-15
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-02-22
Survey response — day 14, dose 4
MedDRA: Asthenia, Body temperature increased, Diarrhoea, Fatigue, Influenza, Nausea, Pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Flu symptoms Feb 15-19 Fatigue, body aches, fever 99.7F, nausea, diarrhea. Antigen test was negative so I thought I must have had a flu. But I am still quite weak, no stamina.

MedDRA releases: 2024-11 · check-in free text available
2022-03-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-03-08
Survey response — day 28, dose 4
MedDRA: Dyspnoea — Feeling: Fair

Free text: Little short of breath

MedDRA releases: 2024-11 · check-in free text available
2022-03-15
Survey response — day 35, dose 4
MedDRA: Aphasia, Dyspnoea, Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Awful fatigue, can't find words, some shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2022-03-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-05-10
Survey response — 3 months, dose 4
MedDRA: Adverse reaction — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Rosalia - mild

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-11
Call 1 — Left Voicemail
2022-08-09
Survey response — 6 months, dose 4
MedDRA: Asthma, Dyspnoea exertional, Pre-existing disease, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I seem to have developed a more pronounced asthma problem. Which is resulting in higher medication use, shortness of breath on exertion. Doc wants to see me and I'm purchasing a heart monitor watch, counting breaths while resting and exercising. · Healthcare visit (other): Just made the appointment.

MedDRA releases: 2024-11 · check-in free text available
2022-08-09
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

1 call case(s)
2022-08-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-05
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-12-09
Survey response — 3 months, dose 5
MedDRA: COVID-19, Influenza — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: COVID Nov 2022 Flu now - Dec2022

MedDRA releases: 2024-11 · check-in free text available
2023-03-06
Survey response — 6 months, dose 5
MedDRA: Influenza — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-16	Moderna
2	2021-02-15	Moderna
3	2021-09-03	Moderna	No
4	2022-02-08	Moderna	No
5	2022-09-05	Pfizer-BioNTech	Flu

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 5 — day 21, dose 2

2021-03-08

Symptoms: Abscesses tooth

Healthcare visit (other): Oral surgery

Release 6 — day 42, dose 2

2021-03-29

Symptoms: Frequent Diarrhea

Release 8 — 3 months, dose 2

2021-05-17

Symptoms: Severe leg and foot cramps, both legs.

Release 9 — 6 months, dose 2

2021-08-16

Symptoms: Found a lump in my neck. Already had cancer twice. Not likely related to covid or vax.

Healthcare visit (other): Still waiting for an appointment

Release 9 — days 1–6 daily, dose 3

2021-09-04

Systemic reaction (other): When I first got the injection a pain shot from the site down my arm to the back of my hand. Felt like nerve pain. My arm and hand were hard to use for an hour or so. Had numbness and tingling for several hours.

2021-09-07

Systemic reaction (other): Woke up in night with headache; gone now.

2021-09-08

Systemic reaction (other): The redness at the site has spread to two spots 4 and 5 inches below the original site.

Release 9 — day 14, dose 3

2021-09-17

Symptoms: Swollen neck lymph nodes, vomiting, sore throat, dizziness, lightheaded.

Healthcare visit (other): Covid test

Release 11 — day 14, dose 4

2022-02-22

Symptoms: Flu symptoms Feb 15-19 Fatigue, body aches, fever 99.7F, nausea, diarrhea. Antigen test was negative so I thought I must have had a flu. But I am still quite weak, no stamina.

Release 11 — day 28, dose 4

2022-03-08

Symptoms: Little short of breath

Release 11 — day 35, dose 4

2022-03-15

Symptoms: Awful fatigue, can't find words, some shortness of breath

Release 11 — 3 months, dose 4

2022-05-10

Symptoms: Rosalia - mild

Release 12 — 6 months, dose 4

2022-08-09

Symptoms: I seem to have developed a more pronounced asthma problem. Which is resulting in higher medication use, shortness of breath on exertion. Doc wants to see me and I'm purchasing a heart monitor watch, counting breaths while resting and exercising.

Healthcare visit (other): Just made the appointment.

Release 12 — 3 months, dose 5

2022-12-09

Symptoms: COVID Nov 2022 Flu now - Dec2022

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	Oral surgery	✓	✓	✓
HCVO	SARS-CoV-2 test	·	·	✓
HCVO	Unevaluable event	✓	·	✓
SD	Adverse reaction	·	·	✓
SD	Aphasia	·	·	✓
SD	Asthenia	·	·	✓
SD	Asthma	·	·	✓
SD	Body temperature increased	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Dyspnoea exertional	·	·	✓
SD	Fatigue	·	·	✓
SD	Influenza	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Nausea	·	·	✓
SD	Neck mass	✓	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Tooth abscess	✓	✓	✓
SD	Vomiting	·	·	✓
SRO	Headache	·	·	✓
SRO	Hypoaesthesia	✓	·	✓
SRO	Immediate post-injection reaction	✓	·	✓
SRO	Injection site erythema	·	·	✓
SRO	Injection site pain	✓	·	✓
SRO	Middle insomnia	·	·	✓
SRO	Muscular weakness	✓	·	✓
SRO	Neuralgia	✓	·	✓
SRO	Pain in extremity	✓	·	✓
SRO	Paraesthesia	✓	·	✓

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