3YX-24969-11021

4 vaccinations 7 coded responses 14 check-ins 6 free-text entries 6 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 973 / OR
Registered: 2021-06-22

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

2021-05-28
Dose 1 — Moderna
2021-06-18
Dose 2 — Moderna
2021-06-22
Registered in v-safe
2021-06-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-06-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-06-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-06-25
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-07-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-07-09
Survey response — day 21, dose 2
MedDRA: Dehydration, Headache, Muscle spasms, Nausea, Stress — Feeling: Fair · Be unable to do your normal daily activities

Free text: Only this week: I have had headaches, nausea, muscle spasms. I strongly doubt the vaccine had anything to do w/these symptoms. I think it was stress, extreme heat, altitude (went to mountains for 4th) and dehydration.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-19
Survey response — day 28, dose 2
MedDRA: Abdominal pain lower, Constipation, Dysuria, Groin pain, Unevaluable event, Urine output decreased — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Sharp pain/cramping left lower abdomen down to groin. Feels a little like UTI, but its not. Some constipation, burning and decreased urination. Not due to vax & will see my GP again today. · Healthcare visit (other): UTI test results negative. Going for follow up care today.

MedDRA releases: 2024-11 · check-in free text available
2021-07-19
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-23
Survey response — day 35, dose 2
MedDRA: Appendicectomy, Emergency care, Gastrointestinal disorder — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Last week I reported G.I. issues that I did not think were connected to the vaccine. Just a few days ago I had an emergency appendectomy. I am in recovery, so I am doing well even though I feel good. · Healthcare visit (other): Again, not related to vaccine. I had an emergency appendectomy.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-23
Report sent to call center — day 35, 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)
2021-07-26
Call 2 — Left Voicemail
2021-07-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-07-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-08-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-17
Survey response — 3 months, dose 2
MedDRA: Cough, Influenza, Nasopharyngitis, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test negative, Sinus disorder — 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: Sore throat, sinus issues, coughing, fever. It is not Covid-19. I was tested. Its just a cold or flu bug.

MedDRA releases: 2024-11 · check-in free text available
2021-09-17
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)
2021-09-21
Call 2 — Left Voicemail
2021-09-21
Call successful
Does not wish to fill out VAERS report
2021-12-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-13
Dose 3 — Moderna
2022-06-20
Survey response — 12 months, dose 2
MedDRA: Cough, Influenza like illness, SARS-CoV-2 test negative, Unevaluable event, Wheezing — 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

Free text: Symptoms: Had flu-like symptoms in March & through April, then again in May. Have had a cough wheezy feeling in chest that is still here. Going to see a physician about it. I did test once for Covid (home test) but it was negative. · Healthcare visit (other): I haven't seen them yet but it will be an office visit.

MedDRA releases: 2024-11 · check-in free text available
2022-06-20
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)
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-06-21
Call 1 — Left Voicemail
2022-08-18
Dose 4 — Moderna
2022-11-17
Survey response — 3 months, dose 4
MedDRA: Office visit, Oxygen saturation abnormal, Wheezing — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: It's not horrible, but I often feel wheezy, like I can't get liquid out of my lungs. I think I had Covid, but didn't test. My doc measured my breathing on a good day and O2 was at 96% (it's usually 99%) so I'm unsure why that is.

MedDRA releases: 2024-11 · check-in free text available
2022-11-17
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)
2022-11-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-02-16
Survey response — 6 months, dose 4
MedDRA: Bronchitis, COVID-19, Malaise, Pneumonia — 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

MedDRA releases: 2024-11
2023-02-16
Report sent to call center — 6 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-02-17
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-28	Moderna	No
2	2021-06-18	Moderna	No
3	2022-01-13	Moderna	No
4	2022-08-18	Moderna	No

Call center

6 call center cases

5 successful · 1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 9 — day 21, dose 2

2021-07-09

Symptoms: Only this week: I have had headaches, nausea, muscle spasms. I strongly doubt the vaccine had anything to do w/these symptoms. I think it was stress, extreme heat, altitude (went to mountains for 4th) and dehydration.

Release 9 — day 28, dose 2

2021-07-19

Symptoms: Sharp pain/cramping left lower abdomen down to groin. Feels a little like UTI, but its not. Some constipation, burning and decreased urination. Not due to vax & will see my GP again today.

Healthcare visit (other): UTI test results negative. Going for follow up care today.

Release 9 — day 35, dose 2

2021-07-23

Symptoms: Last week I reported G.I. issues that I did not think were connected to the vaccine. Just a few days ago I had an emergency appendectomy. I am in recovery, so I am doing well even though I feel good.

Healthcare visit (other): Again, not related to vaccine. I had an emergency appendectomy.

Release 9 — 3 months, dose 2

2021-09-17

Symptoms: Sore throat, sinus issues, coughing, fever. It is not Covid-19. I was tested. Its just a cold or flu bug.

Release 12 — 12 months, dose 2

2022-06-20

Symptoms: Had flu-like symptoms in March & through April, then again in May. Have had a cough wheezy feeling in chest that is still here. Going to see a physician about it. I did test once for Covid (home test) but it was negative.

Healthcare visit (other): I haven't seen them yet but it will be an office visit.

Release 12 — 3 months, dose 4

2022-11-17

Symptoms: It's not horrible, but I often feel wheezy, like I can't get liquid out of my lungs. I think I had Covid, but didn't test. My doc measured my breathing on a good day and O2 was at 96% (it's usually 99%) so I'm unsure why that is.

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	Appendicectomy	✓	·	✓
HCVO	Emergency care	✓	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abdominal pain lower	·	·	✓
SD	Appendicectomy	✓	·	✓
SD	Bronchitis	·	·	✓
SD	Constipation	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dehydration	✓	✓	✓
SD	Dysuria	·	·	✓
SD	Emergency care	✓	·	✓
SD	Gastrointestinal disorder	✓	·	✓
SD	Groin pain	·	·	✓
SD	Headache	✓	✓	✓
SD	Influenza	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Malaise	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	✓	✓
SD	Office visit	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Oxygen saturation abnormal	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pyrexia	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sinus disorder	·	·	✓
SD	Stress	✓	✓	✓
SD	Urine output decreased	·	·	✓
SD	Wheezing	·	·	✓

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