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6D2-10240-05917

4 vaccinations 24 coded responses 43 check-ins 24 free-text entries 2 call cases
Sex
Female
Age at first dose
66+
ZIP prefix
974 / OR
Registered
2021-03-02
Relationship
Self
Race
White
Ethnicity
Hispanic or Latino

Timeline

  1. 2021-02-27
    Dose 1 — Moderna
  2. 2021-03-02
    Registered in v-safe
  3. 2021-03-02
    Survey response — days 1–6 daily, dose 1
    MedDRA: Chills, Nausea, Pain in extremity — Feeling: Fair · Site: Pain
    Free text: Day of vaccination I had very slight chills. Arm got painful about 4-5 hours afterwards. Also very slight nausea. All these the day of.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-03
    Survey response — days 1–6 daily, dose 1
    MedDRA: Fatigue — Feeling: Good
    Free text: I am a bit fatigued, but it is likely from chemotherapy medication.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-03-04
    Survey response — days 1–6 daily, dose 1
    MedDRA: Fatigue, Pre-existing disease — Feeling: Fair · Fatigue or tiredness
    Free text: Fatigue most likely from Chemotherapy medication.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  6. 2021-03-05
    Survey response — days 1–6 daily, dose 1
    MedDRA: Fatigue — Feeling: Good · Fatigue or tiredness
    Free text: As usual. Tiredness may be from chemotherapy.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  7. 2021-03-06
    Survey response — day 7, dose 1
    MedDRA: Unevaluable event — Feeling: Good · Muscle or body aches, Fatigue or tiredness
    Free text: On Chemotherapy this week.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  8. 2021-03-13
    Health check-in — day 14, dose 1
    Feeling: Good
    Adult check-in
  9. 2021-03-20
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  10. 2021-03-27
    Dose 2 — Moderna
  11. 2021-03-27
    Survey response — day 0, dose 2
    MedDRA: Headache — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness
    Free text: Very slight headache
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-03-28
    Survey response — days 1–6 daily, dose 2
    MedDRA: Decreased appetite — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Lack of appetite
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  13. 2021-03-29
    Survey response — days 1–6 daily, dose 2
    MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Overall I feel better today.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  14. 2021-03-30
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness
    Adult check-in
  15. 2021-03-31
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness
    Free text: No headache. But woozy, dizzy a bit.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  16. 2021-04-01
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dizziness — Feeling: Fair · Muscle or body aches, Fatigue or tiredness
    Free text: Dizzy with some movements
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  17. 2021-04-02
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  18. 2021-04-03
    Health check-in — day 7, dose 2
    Feeling: Fair · Fatigue or tiredness
    Adult check-in
  19. 2021-04-10
    Survey response — day 14, dose 2
    MedDRA: Back pain, Fatigue, Myalgia, Pain, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Muscular aches, pain in mid back. ((although the cause could be from chemo or bone strengthener treatment. Both usually cause fatigue and aches)
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  20. 2021-04-17
    Survey response — day 21, dose 2
    MedDRA: Back pain, Pain in extremity — Feeling: Fair · Be unable to do your normal daily activities
    Free text: The last week or so Ive had hand and arm pain I dont usually have. Different on each side. Today I have lower back pain which is unusual.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  21. 2021-04-24
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  22. 2021-05-01
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-05-08
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  24. 2021-06-26
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-09-25
    Survey response — 6 months, dose 2
    MedDRA: Adverse reaction, Medical counselling, Self-medication — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit
    Free text: Slight sinus allergy symptoms. doctors said use spray and allergy pills.
    MedDRA releases: 2024-11 · check-in free text available
  26. 2021-09-25
    Report sent to call center — 6 months, dose 2
    Get care from a doctor or other healthcare professional
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  27. 2021-09-27
    Dose 3 — Moderna
  28. 2021-09-29
    Survey response — days 1–6 daily, dose 3
    MedDRA: Infection, Office visit, Sinus congestion — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities
    Free text: Slight sinus congestion, infection saw doctor for in July and August.
    MedDRA releases: 2024-11 · check-in free text available
  29. 2021-09-29
  30. 2021-09-30
    Survey response — days 1–6 daily, dose 3
    MedDRA: Pyrexia — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work or attend school
    Free text: No measurable fever. 99-100.4 degrees on 9/27 and 9/28.
    MedDRA releases: 2024-11 · check-in free text available
  31. 2021-10-01
    Survey response — days 1–6 daily, dose 3
    MedDRA: Erythema — Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Arm does was red yesterday. I noticed after checking in.
    MedDRA releases: 2024-11 · check-in free text available
  32. 2021-10-02
    Survey response — days 1–6 daily, dose 3
    MedDRA: Vertigo — Feeling: Fair · Site: Redness, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school
    Free text: Ive had Vertigo for over a month. Of course not related to the vaccine.
    MedDRA releases: 2024-11 · check-in free text available
  33. 2021-10-03
    Survey response — days 1–6 daily, dose 3
    MedDRA: Dizziness postural — Feeling: Fair · Site: Redness · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: No headache but slight dizziness when moving. May be partially vertigo.
    MedDRA releases: 2024-11 · check-in free text available
  34. 2021-10-04
    Health check-in — day 7, dose 3
    Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to work or attend school
    Adult check-in
  35. 2021-10-11
    Survey response — day 14, dose 3
    MedDRA: Office visit, Pre-existing disease, Vertigo — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional
    Free text: Symptoms: Not necessarily related to vaccination. Zometa treatment, new steroid medication, Xyloda chemo pills. Continued vertigo possible brain tumor caused. · Healthcare visit (other): Monthly oncology visit.
    MedDRA releases: 2024-11 · check-in free text available
  36. 2021-10-11
    Report sent to call center — day 14, dose 3
    Be unable to work or attend school · Get care from a doctor or other healthcare professional
    1 call case(s)
  37. 2021-10-12
  38. 2021-10-20
    Survey response — day 21, dose 3
    MedDRA: Pre-existing disease, Vertigo — Feeling: Good · Be unable to do your normal daily activities
    Free text: Related to cancer tumors in brain. Vertigo, etc. Also reaction to new steroid medication.
    MedDRA releases: 2024-11 · check-in free text available
  39. 2021-10-25
    Health check-in — day 28, dose 3
    Feeling: Fair
    Adult check-in
  40. 2021-11-01
    Health check-in — day 35, dose 3
    Feeling: Fair
    Adult check-in
  41. 2021-11-08
    Health check-in — day 42, dose 3
    Feeling: Fair
    Adult check-in
  42. 2021-12-27
    Health check-in — 3 months, dose 3
    Feeling: Fair
    Adult check-in
  43. 2022-03-28
    Survey response — 6 months, dose 3
    MedDRA: COVID-19, Cough, Fatigue, Nasopharyngitis, Throat irritation — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: Contracted Covid January 22. Tickle in throat, very slight cold symptoms, very slight cough ( maybe 2-4 times a day). Very fatigued.
    MedDRA releases: 2024-11 · check-in free text available
  44. 2022-04-05
    Dose 4 — Moderna
  45. 2022-04-14
    Survey response — day 7, dose 4
    MedDRA: Adverse drug reaction, Unevaluable event — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities
    Free text: Fatigue mainly from chemo.
    MedDRA releases: 2024-11 · check-in free text available
  46. 2022-04-19
    Health check-in — day 14, dose 4
    Feeling: Fair
    Adult check-in
  47. 2022-04-26
    Health check-in — day 21, dose 4
    Feeling: Fair
    Adult check-in
  48. 2022-05-03
    Health check-in — day 28, dose 4
    Feeling: Fair
    Adult check-in
  49. 2022-05-10
    Survey response — day 35, dose 4
    MedDRA: Alopecia, Nail growth abnormal — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Actually. 3-4 weeks ago I noticed my fingernails had a different growth pattern. Plus my hair is thinning like crazy. Today I combed out at least 40-50 hairs.. these are similar to chemo side effects. But I never had this type or severity.
    MedDRA releases: 2024-11 · check-in free text available
  50. 2022-05-17
    Survey response — day 42, dose 4
    MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities
    Free text: Just slight backache. Areas that have been an issue before. ( possibly from inactivity)
    MedDRA releases: 2024-11 · check-in free text available
  51. 2022-07-05
    Health check-in — 3 months, dose 4
    Feeling: Fair
    Adult check-in
  52. 2022-10-04
    Health check-in — 6 months, dose 4
    Feeling: Fair
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-02-27Moderna
22021-03-27Moderna
32021-09-27Moderna No
42022-04-05Moderna No

Call center

2 call center cases

2 unsuccessful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-03-02

Systemic reaction (other): Day of vaccination I had very slight chills. Arm got painful about 4-5 hours afterwards. Also very slight nausea. All these the day of.

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): I am a bit fatigued, but it is likely from chemotherapy medication.

2021-03-04

Systemic reaction (other): Fatigue most likely from Chemotherapy medication.

2021-03-05

Systemic reaction (other): As usual. Tiredness may be from chemotherapy.

Release 5 — day 7, dose 1

2021-03-06

Systemic reaction (other): On Chemotherapy this week.

Release 6 — day 0, dose 2

2021-03-27

Systemic reaction (other): Very slight headache

Release 6 — days 1–6 daily, dose 2

2021-03-28

Systemic reaction (other): Lack of appetite

2021-03-29

Systemic reaction (other): Overall I feel better today.

2021-03-31

Systemic reaction (other): No headache. But woozy, dizzy a bit.

2021-04-01

Systemic reaction (other): Dizzy with some movements

Release 7 — day 14, dose 2

2021-04-10

Symptoms: Muscular aches, pain in mid back. ((although the cause could be from chemo or bone strengthener treatment. Both usually cause fatigue and aches)

Release 7 — day 21, dose 2

2021-04-17

Symptoms: The last week or so Ive had hand and arm pain I dont usually have. Different on each side. Today I have lower back pain which is unusual.

Release 9 — 6 months, dose 2

2021-09-25

Symptoms: Slight sinus allergy symptoms. doctors said use spray and allergy pills.

Release 9 — days 1–6 daily, dose 3

2021-09-29

Systemic reaction (other): Slight sinus congestion, infection saw doctor for in July and August.

2021-09-30

Systemic reaction (other): No measurable fever. 99-100.4 degrees on 9/27 and 9/28.

2021-10-01

Systemic reaction (other): Arm does was red yesterday. I noticed after checking in.

2021-10-02

Systemic reaction (other): Ive had Vertigo for over a month. Of course not related to the vaccine.

2021-10-03

Systemic reaction (other): No headache but slight dizziness when moving. May be partially vertigo.

Release 10 — day 14, dose 3

2021-10-11

Symptoms: Not necessarily related to vaccination. Zometa treatment, new steroid medication, Xyloda chemo pills. Continued vertigo possible brain tumor caused.
Healthcare visit (other): Monthly oncology visit.

Release 10 — day 21, dose 3

2021-10-20

Symptoms: Related to cancer tumors in brain. Vertigo, etc. Also reaction to new steroid medication.

Release 11 — 6 months, dose 3

2022-03-28

Symptoms: Contracted Covid January 22. Tickle in throat, very slight cold symptoms, very slight cough ( maybe 2-4 times a day). Very fatigued.

Release 11 — day 7, dose 4

2022-04-14

Systemic reaction (other): Fatigue mainly from chemo.

Release 11 — day 35, dose 4

2022-05-10

Symptoms: Actually. 3-4 weeks ago I noticed my fingernails had a different growth pattern. Plus my hair is thinning like crazy. Today I combed out at least 40-50 hairs.. these are similar to chemo side effects. But I never had this type or severity.

Release 11 — day 42, dose 4

2022-05-17

Symptoms: Just slight backache. Areas that have been an issue before. ( possibly from inactivity)

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

FieldPreferred term2021-092023-042024-11
HCVOOffice visit · · ✓
SDAdverse reaction · · ✓
SDAlopecia · · ✓
SDBack pain ✓ ✓ ✓
SDCondition aggravated · · ✓
SDCough · · ✓
SDCOVID-19 · · ✓
SDFatigue ✓ ✓ ✓
SDMedical counselling · · ✓
SDMyalgia ✓ ✓ ✓
SDNail growth abnormal · · ✓
SDNasopharyngitis · · ✓
SDPain ✓ ✓ ✓
SDPain in extremity ✓ ✓ ✓
SDPre-existing disease ✓ ✓ ✓
SDSelf-medication · · ✓
SDThroat irritation · · ✓
SDVertigo · · ✓
SROAdverse drug reaction · · ✓
SROAdverse reaction ✓ ✓ ✓
SROChills ✓ ✓ ✓
SRODecreased appetite ✓ ✓ ✓
SRODizziness ✓ ✓ ✓
SRODizziness postural · · ✓
SROErythema · · ✓
SROFatigue ✓ ✓ ✓
SROHeadache ✓ ✓ ✓
SROInfection · · ✓
SRONausea ✓ ✓ ✓
SROOffice visit · · ✓
SROPain in extremity ✓ ✓ ✓
SROPre-existing disease ✓ ✓ ✓
SROPyrexia · · ✓
SROSinus congestion · · ✓
SROUnevaluable event ✓ ✓ ✓
SROVertigo · · ✓

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

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