599-11769-40925

3 vaccinations 16 coded responses 36 check-ins 16 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 980 / WA
Registered: 2021-02-24

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

Timeline

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

2021-02-24
Registered in v-safe
2021-02-24
Dose 1 — Moderna
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal discomfort, Pain, Pyrexia — Feeling: Good · Fatigue or tiredness

Free text: On the second day had stomach issues. Every day by evening felt feverish with body pains

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Survey response — day 14, dose 1
MedDRA: Blood pressure increased, Gastrointestinal disorder — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Elevated Blood pressure and stomach issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-25
Dose 2 — Moderna
2021-03-25
Health check-in — day 0, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 2
MedDRA: Flatulence — Feeling: Poor · Site: Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Gas in stomach

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Restlessness, Sleep disorder — Feeling: Fair · Site: Swelling, Itching · Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Restless disturbed sleep at night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Poor quality sleep — Feeling: Fair · Site: Swelling, Itching · Joint pains, Fatigue or tiredness · Be unable to work

Free text: Slightly tired restless sleep at night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Itching · Fever · Chills, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Poor quality sleep — Feeling: Good

Free text: Only restless sleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-15
Survey response — day 21, dose 2
MedDRA: Peripheral swelling, Somnolence — Feeling: Good · Be unable to do your normal daily activities

Free text: Sleepyhead n swollen feet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 28, dose 2
MedDRA: Asthenia, Blood pressure increased, Dizziness, Hypertension, Hypotension, Peripheral swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Low blood pressure, lightheaded, swelling of feet, energy level low.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — day 35, dose 2
MedDRA: Asthenia, Hypotension — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Low blood pressure n low energy n swelling of feet from the time of 2nd dose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-12-09
Call successful
Participant prefers to complete VAERS report online
2021-12-13
Dose 3 — Moderna
2021-12-13
Survey response — day 0, dose 3
MedDRA: Pyrexia — Feeling: Fair · Site: Pain · Fever · Joint pains

Free text: Feverish

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — days 1–6 daily, dose 3
MedDRA: Insomnia — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Unable to sleep

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Survey response — days 1–6 daily, dose 3
MedDRA: Adverse reaction, Self-medication — Feeling: Fair · Site: Pain, Itching · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Yesterday when reactions were severe Tylenol 2 Tablets worked just for 4 hrs barely.

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-17
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site pain, Injection site pruritus — Feeling: Good · Site: Pain, Itching

Free text: Mild pain and itching on the injection site

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Survey response — days 1–6 daily, dose 3
MedDRA: Poor quality sleep — Feeling: Good · Muscle or body aches

Free text: Not getting good sleep

MedDRA releases: 2024-11 · check-in free text available
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-20
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-27
Survey response — day 14, dose 3
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint pains

MedDRA releases: 2024-11 · check-in free text available
2022-01-03
Survey response — day 21, dose 3
MedDRA: Arthralgia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Knee pains

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-17
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-24	Moderna
2	2021-03-25	Moderna
3	2021-12-13	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-28

Systemic reaction (other): On the second day had stomach issues. Every day by evening felt feverish with body pains

Release 5 — day 14, dose 1

2021-03-10

Symptoms: Elevated Blood pressure and stomach issues

Release 6 — days 1–6 daily, dose 2

2021-03-26

Systemic reaction (other): Gas in stomach

2021-03-27

Systemic reaction (other): Restless disturbed sleep at night

2021-03-28

Systemic reaction (other): Slightly tired restless sleep at night

2021-03-30

Systemic reaction (other): Only restless sleep

Release 7 — day 21, dose 2

2021-04-15

Symptoms: Sleepyhead n swollen feet

Release 7 — day 28, dose 2

2021-04-22

Symptoms: Low blood pressure, lightheaded, swelling of feet, energy level low.

Release 8 — day 35, dose 2

2021-04-30

Symptoms: Low blood pressure n low energy n swelling of feet from the time of 2nd dose

Release 10 — day 0, dose 3

2021-12-13

Systemic reaction (other): Feverish

Release 10 — days 1–6 daily, dose 3

2021-12-14

Systemic reaction (other): Unable to sleep

2021-12-15

Systemic reaction (other): Yesterday when reactions were severe Tylenol 2 Tablets worked just for 4 hrs barely.

2021-12-17

Systemic reaction (other): Mild pain and itching on the injection site

2021-12-18

Systemic reaction (other): Not getting good sleep

Release 10 — day 14, dose 3

2021-12-27

Symptoms: Joint pains

Release 10 — day 21, dose 3

2022-01-03

Symptoms: Knee pains

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
SD	Arthralgia	·	·	✓
SD	Asthenia	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Hypertension	✓	✓	○
SD	Hypotension	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Somnolence	✓	✓	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Adverse reaction	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Injection site pruritus	·	·	✓
SRO	Insomnia	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Poor quality sleep	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Restlessness	✓	✓	✓
SRO	Self-medication	·	·	✓
SRO	Sleep disorder	✓	✓	✓

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