9PB-96345-07428

3 vaccinations 25 coded responses 37 check-ins 25 free-text entries 6 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 971 / OR
Registered: 2021-02-25

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

Registered dependents

Y2L-85054-79851 Child or adolescent in my care · Male · 2021-11-11

Timeline

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

2021-02-25
Registered in v-safe
2021-02-25
Dose 1 — Moderna
2021-02-25
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Irritability — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Cough, irritability

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Irritability — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cough, irritability

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Irritability, Mood swings — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cough, irritability, mood swings (last 2 days)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Irritability, Mood swings — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cough, irritability, mood swings

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Irritability, Mood swings — Feeling: Fair · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cough, irritability, mood swings

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 7, dose 1
MedDRA: Irritability, Mood swings — Feeling: Good · Site: Pain, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Irritability, mood swings (less prominent)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 14, dose 1
MedDRA: Fatigue, Headache, Impaired quality of life, Irritability, Mood swings, Pain — Feeling: Fair · 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: Continuing and worsening irritability and mood swings. Body aches and headaches have not subsided. Fatigue keeps me from doing daily activities and caring for my family at typical levels.

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

1 call case(s)
2021-03-18
Survey response — day 21, dose 1
MedDRA: Fatigue, Irritability, Medical counselling — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Hospitalization

Free text: Symptoms: My mood has been hard to control because of irritability and fatigue. · Healthcare visit (other): Specialist consultation scheduled in future

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 21, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Dose 2 — Moderna
2021-03-25
Survey response — day 0, dose 2
MedDRA: Cough, Irritability — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Cough, Irritability

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Irritability — Feeling: Good · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Free text: Cough, irritability

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: Cough, Dizziness, Irritability — Feeling: Good · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Free text: Cough, irritability, dizziness

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: Cough, Irritability, Mood swings — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Cough, irritability and mood swings

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Irritability, Mood swings — Feeling: Fair · Site: Pain, Redness, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: Cough, irritability, mood swings

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Irritability, Mood swings — Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Irritability, cough, mood swings

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Irritability, Mood swings — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Severe irritability and mood swings, cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — day 7, dose 2
MedDRA: Cough, Irritability, Mood swings — Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Cough, irritability, mood swings

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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: Pain — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — day 28, dose 2
MedDRA: Mobility decreased, Neuralgia, Pain in extremity, Spinal pain, Unevaluable event — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Symptoms: Limited use of my right arm. Severe nerve pain in the cervical spine and down into right arm. · Healthcare visit (other): MRI scheduled for Sunday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Report sent to call center — day 28, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-06
Survey response — day 42, dose 2
MedDRA: Asthenia, Contusion, Muscle spasms, Neuralgia — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Debilitating nerve pain, unusual bruising, muscle spasms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Ageusia, Anosmia, COVID-19, Chills, Cognitive disorder, Cough, Dyspnoea, Fatigue, Headache, Myalgia, Nausea, Respiratory tract congestion — 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, Outpatient clinic or urgent care clinic visit

Free text: COVID-19 infection: shortness of breath, cognitive impairment, severe fatigue, cough, congestion, muscle aches and pains, headache, chills, loss of taste and smell, nausea, etc.

MedDRA releases: 2024-11 · check-in free text available
2021-09-23
Report sent to call center — 6 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-09-27
Call 1 — Left Voicemail
2021-09-27
Call 1 — Left Voicemail
2021-09-27
Call 1 — Left Voicemail
2021-09-27
Call 1 — Left Voicemail
2021-09-27
Call 1 — Left Voicemail
2021-10-28
Dose 3 — Moderna
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Irritability, Mood swings — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Irritability and mood swings

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Anxiety, Cognitive disorder, Disturbance in attention, Emotional disorder, Irritability — Feeling: Fair · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Cognitive and emotional impairment (e.g., difficulty focusing, irritable, anxious)

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-11-04
Survey response — day 7, dose 3
MedDRA: Ageusia, Decreased appetite, Hot flush — Feeling: Good · Headache, Joint pains, Muscle or body aches, Diarrhea

Free text: Loss of appetite and taste, hot flashes

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-20
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-10-30
Survey response — 12 months, dose 3
MedDRA: Brain fog, Dyspnoea, Lethargy, Memory impairment, Pain — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Lethargy, brain fog/weakened memory, random pain, shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2022-10-30
Report sent to call center — 12 months, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Moderna
2	2021-03-25	Moderna
3	2021-10-28	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-11	Unsuccessful
2021-03-18	Unsuccessful
2021-04-23	Unsuccessful
2021-05-06	Unsuccessful
2021-09-23	Unsuccessful
2022-10-30	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-26

Systemic reaction (other): Cough

2021-02-27

Systemic reaction (other): Cough, irritability

2021-02-28

Systemic reaction (other): Cough, irritability

2021-03-01

Systemic reaction (other): Cough, irritability, mood swings (last 2 days)

2021-03-02

Systemic reaction (other): Cough, irritability, mood swings

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): Cough, irritability, mood swings

Release 5 — day 7, dose 1

2021-03-04

Systemic reaction (other): Irritability, mood swings (less prominent)

Release 5 — day 14, dose 1

2021-03-11

Symptoms: Continuing and worsening irritability and mood swings. Body aches and headaches have not subsided. Fatigue keeps me from doing daily activities and caring for my family at typical levels.

Release 5 — day 21, dose 1

2021-03-18

Symptoms: My mood has been hard to control because of irritability and fatigue.

Healthcare visit (other): Specialist consultation scheduled in future

Release 6 — day 0, dose 2

2021-03-25

Systemic reaction (other): Cough, Irritability

Release 6 — days 1–6 daily, dose 2

2021-03-26

Systemic reaction (other): Cough, irritability

2021-03-27

Systemic reaction (other): Cough, irritability, dizziness

2021-03-28

Systemic reaction (other): Cough, irritability and mood swings

2021-03-29

Systemic reaction (other): Cough, irritability, mood swings

2021-03-30

Systemic reaction (other): Irritability, cough, mood swings

2021-03-31

Systemic reaction (other): Severe irritability and mood swings, cough

Release 6 — day 7, dose 2

2021-04-01

Systemic reaction (other): Cough, irritability, mood swings

Release 7 — day 21, dose 2

2021-04-15

Symptoms: Body aches

Release 7 — day 28, dose 2

2021-04-23

Symptoms: Limited use of my right arm. Severe nerve pain in the cervical spine and down into right arm.

Healthcare visit (other): MRI scheduled for Sunday

Release 8 — day 42, dose 2

2021-05-06

Symptoms: Debilitating nerve pain, unusual bruising, muscle spasms

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: COVID-19 infection: shortness of breath, cognitive impairment, severe fatigue, cough, congestion, muscle aches and pains, headache, chills, loss of taste and smell, nausea, etc.

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): Irritability and mood swings

2021-11-01

Systemic reaction (other): Cognitive and emotional impairment (e.g., difficulty focusing, irritable, anxious)

Release 10 — day 7, dose 3

2021-11-04

Systemic reaction (other): Loss of appetite and taste, hot flashes

Release 12 — 12 months, dose 3

2022-10-30

Symptoms: Lethargy, brain fog/weakened memory, random pain, shortness of breath

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	Medical counselling	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Asthenia	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Chills	·	·	✓
SD	Cognitive disorder	·	·	✓
SD	Contusion	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Impaired quality of life	✓	✓	✓
SD	Irritability	✓	✓	✓
SD	Lethargy	·	·	✓
SD	Memory impairment	·	·	✓
SD	Mobility decreased	✓	✓	✓
SD	Mood swings	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Nausea	·	·	✓
SD	Neuralgia	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Spinal pain	✓	✓	✓
SRO	Ageusia	·	·	✓
SRO	Anxiety	·	·	✓
SRO	Cognitive disorder	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Decreased appetite	·	·	✓
SRO	Disturbance in attention	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Emotional disorder	·	·	✓
SRO	Hot flush	·	·	✓
SRO	Irritability	✓	✓	✓
SRO	Mood swings	✓	✓	✓

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