XRB-12794-79115

4 vaccinations 17 coded responses 22 check-ins 17 free-text entries 9 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 640 / MO
Registered: 2021-03-19

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

2021-03-18
Dose 1 — Moderna
2021-03-19
Registered in v-safe
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Dyspnoea, Respiratory tract congestion — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Free text: Severe congested coughing. Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain, Cough, Dyspnoea — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

Free text: Severe coughing. Chest pains. Trouble breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain, Cough, Haematochezia, Hypopnoea, Unevaluable event — Feeling: Poor · Site: Pain, Itching · Fever · 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, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Severe coughing. Chest pains. Bloody stool. Shallow breathing. · Healthcare visit (other): I requested an appointment from my Dr.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Report sent to call center — days 1–6 daily, 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)
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Dyspnoea — 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, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Severe cough. Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — days 1–6 daily, 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)
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · 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, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-03-24
Report sent to call center — days 1–6 daily, 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
Survey response — day 7, dose 1
MedDRA: Cough, Dyspnoea — Feeling: Poor · Site: Pain · 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: Shortness of breath and coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-08
Survey response — day 21, dose 1
MedDRA: Cough, Musculoskeletal stiffness — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: My spine and neck are stiff. My Dr prescribed Meloxicam to help. I am still using am inhaler because my cough will not go away since the vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Dose 2 — Moderna
2021-04-17
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Sneezing — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Coughing and sneezing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Ear pain, Lacrimation increased, Respiratory tract congestion — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Coughing and congestion. Eyes watering. Ear pains

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Survey response — day 21, dose 2
MedDRA: Arthralgia, Cough, Fatigue, Migraine — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Coughing migraines exhaustion joint pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — day 28, dose 2
MedDRA: Ageusia, Balance disorder, Fatigue, Headache, Nausea — 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

Free text: Headaches, loss of taste, nausea, loss of balance, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
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)
2021-05-29
Survey response — day 42, dose 2
MedDRA: Fatigue, Feeding disorder, Nausea — 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, Outpatient clinic or urgent care clinic visit

Free text: Nausea, can't eat, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
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)
2021-10-16
Survey response — 6 months, dose 2
MedDRA: Fatigue — 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

Free text: Constant exhaustion that has been persistent since my vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-20
Call 3 — Left Voicemail
2021-12-10
Dose 3 — Moderna
2022-04-18
Survey response — 12 months, dose 2
MedDRA: Dyspnoea, Exposure to SARS-CoV-2, Pulmonary 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: Massive lung congestion. Difficulty breathing. Exposed to Covid in January.

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-21
Call 1 — Left Voicemail
2022-08-11
Dose 4 — Moderna
2022-08-27
Survey response — day 14, dose 4
MedDRA: Body temperature decreased, Chest pain, Chills, Dyspnoea, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Shortness of breath. Chest pain. Chills. Body aches. Lowered body temp

MedDRA releases: 2024-11 · check-in free text available
2022-09-01
Survey response — day 21, dose 4
MedDRA: SARS-CoV-2 test positive — 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 · Outpatient clinic or urgent care clinic visit

Free text: I tested positive for covid.

MedDRA releases: 2024-11 · check-in free text available
2022-09-01
Report sent to call center — day 21, 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)
2022-09-02
Call 1 — Left Voicemail
2022-09-02
Call 1 — Left Voicemail
2022-09-02
Call 1 — Left Voicemail
2022-09-02
Call 1 — Left Voicemail
2022-09-02
Call 1 — Left Voicemail
2022-09-02
Call 1 — Left Voicemail
2022-09-02
Call 2 — Left Voicemail
2022-09-02
Call 1 — Left Voicemail
2022-09-08
Survey response — day 28, dose 4
MedDRA: Fatigue — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Massive fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Survey response — day 35, dose 4
MedDRA: Cough, Fatigue, Rhinorrhoea — Feeling: Fair · 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: Extreme fatigue. Still coughing and runny nose.

MedDRA releases: 2024-11 · check-in free text available
2022-09-17
Report sent to call center — day 35, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 3 — Left Voicemail
2022-09-19
Call 2 — Left Voicemail
2022-09-19
Call 1 — Left Voicemail
2022-09-23
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-11-10
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-17	Moderna
3	2021-12-10	Moderna	No
4	2022-08-11	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-21	Unsuccessful
2021-03-23	Unsuccessful
2021-03-24	Unsuccessful
2021-05-15	Unsuccessful
2021-05-29	Unsuccessful
2021-10-16	Unsuccessful
2022-04-18	Unsuccessful
2022-09-01	Unsuccessful
2022-09-17	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-19

Systemic reaction (other): Severe congested coughing. Shortness of breath

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Severe coughing. Chest pains. Trouble breathing

2021-03-21

Systemic reaction (other): Severe coughing. Chest pains. Bloody stool. Shallow breathing.

Healthcare visit (other): I requested an appointment from my Dr.

2021-03-23

Systemic reaction (other): Severe cough. Shortness of breath

Release 6 — day 7, dose 1

2021-03-25

Systemic reaction (other): Shortness of breath and coughing

Release 7 — day 21, dose 1

2021-04-08

Symptoms: My spine and neck are stiff. My Dr prescribed Meloxicam to help. I am still using am inhaler because my cough will not go away since the vaccination.

Release 7 — days 1–6 daily, dose 2

2021-04-19

Systemic reaction (other): Coughing and sneezing

2021-04-20

Systemic reaction (other): Coughing and congestion. Eyes watering. Ear pains

Release 8 — day 21, dose 2

2021-05-10

Symptoms: Coughing migraines exhaustion joint pain

Release 8 — day 28, dose 2

2021-05-15

Symptoms: Headaches, loss of taste, nausea, loss of balance, fatigue

Release 8 — day 42, dose 2

2021-05-29

Symptoms: Nausea, can't eat, fatigue

Release 10 — 6 months, dose 2

2021-10-16

Symptoms: Constant exhaustion that has been persistent since my vaccine

Release 11 — 12 months, dose 2

2022-04-18

Symptoms: Massive lung congestion. Difficulty breathing. Exposed to Covid in January.

Release 12 — day 14, dose 4

2022-08-27

Symptoms: Shortness of breath. Chest pain. Chills. Body aches. Lowered body temp

Release 12 — day 21, dose 4

2022-09-01

Symptoms: I tested positive for covid.

Release 12 — day 28, dose 4

2022-09-08

Symptoms: Massive fatigue

Release 12 — day 35, dose 4

2022-09-17

Symptoms: Extreme fatigue. Still coughing and runny nose.

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	Unevaluable event	✓	✓	✓
SD	Ageusia	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Balance disorder	✓	✓	✓
SD	Body temperature decreased	·	·	✓
SD	Chest pain	·	·	✓
SD	Chills	·	·	✓
SD	Cough	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeding disorder	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Musculoskeletal stiffness	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pain	·	·	✓
SD	Pulmonary congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Chest pain	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Haematochezia	✓	✓	✓
SRO	Hypopnoea	✓	✓	✓
SRO	Lacrimation increased	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Sneezing	✓	✓	✓

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