QTL-27620-28871

3 vaccinations 18 coded responses 27 check-ins 18 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 980 / WA
Registered: 2021-02-27

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

Registered dependents

5PL-26539-41772 Adult relative or friend · Male · 2021-06-26

Timeline

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

2021-02-27
Registered in v-safe
2021-02-27
Dose 1 — Moderna
2021-02-27
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: no

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Good · Fatigue or tiredness

Free text: slight shortness of breath. might just be seasonal allergies

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

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Fatigue or tiredness

Free text: had brain fog for a few hours today. not horrible, just annoying. went back to bed for three hours & felt a bit better

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: occasional brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — day 7, dose 1
MedDRA: Dyspnoea — Feeling: Good · Headache, Fatigue or tiredness

Free text: mild short of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — day 14, dose 1
MedDRA: Gastric disorder, Nausea, Self-medication — Feeling: Fair

Free text: slightly sick to stomach, for last 2 days worse today than yesterday, but so far, mostly controlled by over the counter meds

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 21, dose 1
MedDRA: Dizziness, Headache, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: nausea, dizzyness, headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Dose 2 — Moderna
2021-03-27
Survey response — day 0, dose 2
MedDRA: Euphoric mood — Feeling: Good

Free text: so far, all good. really euphoric that husband & i gotten this far, closer to normallife again. the two shots

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, Feeling abnormal, Injection site discomfort — Feeling: Good · Fatigue or tiredness

Free text: some soreness at injection site but not what id call painful. farigue, as with first shot. just tired, bleh, some brain fog. no other symptoms or discomfort.

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: Abdominal discomfort, Abdominal pain upper — Feeling: Good · Abdominal pain

Free text: last noght, had tummy cramps, medium discomfort thru the night, gone by about noon today

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: Adverse reaction — Feeling: Good · Muscle or body aches

Free text: noticable, but very mild...might be from sitting around too much.

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: Adverse reaction — Feeling: Good · Fatigue or tiredness

Free text: nope, feel more myself, so does my husband(he wouldnt do survey, but had shot same day & has had same symptoms as i did

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Hospitalisation, Hypertension, Medical counselling — Feeling: Poor · Fever · Headache, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): fairly severe lower abdomn pain left side. blood pressure very high. triage nurse sending me to hospital now for tests. 5pm west coast time · Healthcare visit (other): on my way to hospital for tests. rightnow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Report sent to call center — days 1–6 daily, 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)
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Emergency care, Pain, Pre-existing disease — Feeling: Fair · Fever · Chills, Headache, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): pain diagnosed last night at hospital emergency docs severe diverticulosis , unknown cause. i did have once before 30 years ago.room · Healthcare visit (other): emergency room gor 3-4 hors, CT scan, bloodwork, sent homw with antibiotics& pain meds. will follow up with my gp doc on tiesday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Report sent to call center — days 1–6 daily, 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)
2021-04-03
Survey response — day 7, dose 2
MedDRA: Abdominal pain, Body temperature increased, Office visit — Feeling: Fair · Fever · Muscle or body aches, Abdominal pain · Be unable to work, 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: Systemic reaction (other): my temp normal is 97.3, so 99 is high for me. still suffering from very uncomfortable abdomin pain, still on antibioticc & still need pain meds. · Healthcare visit (other): i will see my doctor on tuesday for possible further treatment.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Report sent to call center — day 7, 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)
2021-04-10
Survey response — day 14, dose 2
MedDRA: Diverticulum — Feeling: Poor · Be unable to work, 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

Free text: diverticulosis been bad early started week after shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Report sent to call center — day 14, 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)
2021-04-19
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-10
Survey response — day 42, dose 2
MedDRA: Brain fog, Fatigue, Loss of personal independence in daily activities — Feeling: Fair · Be unable to do your normal daily activities

Free text: brain fog & fatigue stll attacking both my husband & myself. not all the time, but every few days/ weeks, but in fainess, we understand that it could just be stress from pandemic life challenges. we just don't know.sometimes cant care for my horses

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-09
Call successful
Does not wish to fill out VAERS report
2021-06-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-27
Dose 3 — Moderna
2022-03-27
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-03-27
Survey response — day 0, dose 3
MedDRA: Irritable bowel syndrome — Feeling: Fair · Fatigue or tiredness

Free text: IBS

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-27	Moderna
2	2021-03-27	Moderna
3	2022-03-27	Moderna	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-02-27

Systemic reaction (other): no

Release 4 — days 1–6 daily, dose 1

2021-03-02

Systemic reaction (other): slight shortness of breath. might just be seasonal allergies

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): had brain fog for a few hours today. not horrible, just annoying. went back to bed for three hours & felt a bit better

2021-03-05

Systemic reaction (other): occasional brain fog

Release 5 — day 7, dose 1

2021-03-06

Systemic reaction (other): mild short of breath

Release 5 — day 14, dose 1

2021-03-13

Symptoms: slightly sick to stomach, for last 2 days worse today than yesterday, but so far, mostly controlled by over the counter meds

Release 6 — day 21, dose 1

2021-03-20

Symptoms: nausea, dizzyness, headache

Release 6 — day 0, dose 2

2021-03-27

Systemic reaction (other): so far, all good. really euphoric that husband & i gotten this far, closer to normallife again. the two shots

Release 6 — days 1–6 daily, dose 2

2021-03-28

Systemic reaction (other): some soreness at injection site but not what id call painful. farigue, as with first shot. just tired, bleh, some brain fog. no other symptoms or discomfort.

2021-03-29

Systemic reaction (other): last noght, had tummy cramps, medium discomfort thru the night, gone by about noon today

2021-03-30

Systemic reaction (other): noticable, but very mild...might be from sitting around too much.

2021-03-31

Systemic reaction (other): nope, feel more myself, so does my husband(he wouldnt do survey, but had shot same day & has had same symptoms as i did

2021-04-01

Systemic reaction (other): fairly severe lower abdomn pain left side. blood pressure very high. triage nurse sending me to hospital now for tests. 5pm west coast time

Healthcare visit (other): on my way to hospital for tests. rightnow

2021-04-02

Systemic reaction (other): pain diagnosed last night at hospital emergency docs severe diverticulosis , unknown cause. i did have once before 30 years ago.room

Healthcare visit (other): emergency room gor 3-4 hors, CT scan, bloodwork, sent homw with antibiotics& pain meds. will follow up with my gp doc on tiesday

Release 6 — day 7, dose 2

2021-04-03

Systemic reaction (other): my temp normal is 97.3, so 99 is high for me. still suffering from very uncomfortable abdomin pain, still on antibioticc & still need pain meds.

Healthcare visit (other): i will see my doctor on tuesday for possible further treatment.

Release 7 — day 14, dose 2

2021-04-10

Symptoms: diverticulosis been bad early started week after shot

Release 8 — day 42, dose 2

2021-05-10

Symptoms: brain fog & fatigue stll attacking both my husband & myself. not all the time, but every few days/ weeks, but in fainess, we understand that it could just be stress from pandemic life challenges. we just don't know.sometimes cant care for my horses cut off by CDC

Release 11 — day 0, dose 3

2022-03-27

Systemic reaction (other): IBS

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	Emergency care	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Brain fog	✓	✓	✓
SD	Diverticulum	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gastric disorder	✓	✓	○
SD	Headache	✓	✓	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Self-medication	·	·	✓
SRO	Abdominal discomfort	✓	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Abdominal pain upper	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Body temperature increased	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Euphoric mood	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Hospitalisation	✓	✓	✓
SRO	Hypertension	✓	✓	✓
SRO	Injection site discomfort	✓	✓	✓
SRO	Irritable bowel syndrome	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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