XYW-19582-12724

4 vaccinations 15 coded responses 41 check-ins 15 free-text entries 8 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 975 / OR
Registered: 2021-02-21

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

2021-02-20
Dose 1 — Moderna
2021-02-21
Registered in v-safe
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea, Abdominal pain

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — 7 day, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — 14 day, dose 1
Feeling: Good

Adult check-in
2021-03-13
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-03-20
Dose 2 — Moderna
2021-03-20
Health check-in — 0 day, dose 2
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-27
Health check-in — 7 day, dose 2
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — 21 day, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — 28 day, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-06-21
Health check-in — 3 month, dose 2
Feeling: Good

Adult check-in
2021-09-18
Health check-in — 6 month, dose 2
Feeling: Good

Adult check-in
2021-10-13
Dose 3 — Moderna
Co-administered: Flu
2021-10-26
Survey response — 7 day, dose 3
MedDRA: Hypertonic bladder, Respiratory tract congestion — Feeling: Poor · Fatigue or tiredness · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2021-10-26
Report sent to call center — 7 day, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-27
Survey response — 14 day, dose 3
MedDRA: Condition aggravated, Pre-existing disease — 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

MedDRA releases: 2024-11 · check-in answers available
2021-10-27
Report sent to call center — 14 day, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-27
Call X — Could Not Reach Participant
2021-10-28
Call X — Could Not Reach Participant
2021-11-03
Health check-in — 21 day, dose 3
Feeling: Good

Adult check-in
2021-11-11
Survey response — 28 day, dose 3
MedDRA: Sputum retention — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-11-18
Health check-in — 35 day, dose 3
Feeling: Good

Adult check-in
2021-11-24
Survey response — 42 day, dose 3
MedDRA: Bronchitis — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-01-12
Survey response — 3 month, dose 3
MedDRA: Hospitalisation — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-04-13
Survey response — 6 month, dose 3
MedDRA: Bronchitis, Office visit, Productive cough, Secretion discharge — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-04-13
Report sent to call center — 6 month, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-20
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-24
Dose 4 — Moderna
2022-06-24
Survey response — 0 day, dose 4
MedDRA: Pulmonary congestion — Feeling: Poor · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-06-25
Survey response — days 1–6 daily, dose 4
MedDRA: Pulmonary congestion — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-06-27
Survey response — days 1–6 daily, dose 4
MedDRA: Respiratory tract congestion, Unevaluable event — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-06-27
Report sent to call center — days 1–6 daily, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-28
Call 1 — Could Not Reach Participant
2022-06-28
Call 1 — Could Not Reach Participant
2022-06-28
Call 1 — Could Not Reach Participant
2022-06-28
Call 1 — Could Not Reach Participant
2022-06-29
Survey response — days 1–6 daily, dose 4
MedDRA: Fatigue, Muscle spasms — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2022-06-30
Survey response — days 1–6 daily, dose 4
MedDRA: Arthralgia, Office visit — Feeling: Fair · Site: Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-06-30
Report sent to call center — days 1–6 daily, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-01
Call 2 — Could Not Reach Participant
2022-07-01
Call 2 — Could Not Reach Participant
2022-07-01
Call 2 — Could Not Reach Participant
2022-07-01
Call 2 — Could Not Reach Participant
2022-07-01
Call 1 — Could Not Reach Participant
2022-07-03
Survey response — 7 day, dose 4
MedDRA: Fatigue, Unevaluable event — Feeling: Poor · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-07-03
Report sent to call center — 7 day, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-05
Call 1 — Could Not Reach Participant
2022-07-08
Health check-in — 14 day, dose 4
Feeling: Fair

Adult check-in
2022-07-08
Call 3 — Could Not Reach Participant
2022-07-08
Call 3 — Could Not Reach Participant
2022-07-08
Call 3 — Could Not Reach Participant
2022-07-08
Call 3 — Could Not Reach Participant
2022-07-08
Call 2 — Could Not Reach Participant
2022-07-08
Call 2 — Could Not Reach Participant
2022-07-15
Survey response — 21 day, dose 4
MedDRA: Office visit, Respiratory tract congestion — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-07-15
Report sent to call center — 21 day, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-18
Call 3 — Could Not Reach Participant
2022-07-18
Call 3 — Could Not Reach Participant
2022-07-18
Callback requested for
05:00PM ET
2022-07-18
Call 1 — Could Not Reach Participant
2022-07-23
Health check-in — 28 day, dose 4
Feeling: Fair

Adult check-in
2022-07-29
Survey response — 35 day, dose 4
MedDRA: Tremor — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available
2022-08-05
Survey response — 42 day, dose 4
MedDRA: Office visit, Unevaluable event — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11 · check-in answers available
2022-08-05
Report sent to call center — 42 day, 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

1 call case(s)
2022-08-08
Call 2 — Left Voicemail
2022-08-08
Call 1 — Could Not Reach Participant
2022-08-12
Call X — Could Not Reach Participant
2022-08-12
Call X — Could Not Reach Participant
2022-08-12
Call X — Could Not Reach Participant
2022-08-12
Call 3 — Could Not Reach Participant
2022-08-12
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-20	Moderna
2	2021-03-20	Moderna
3	2021-10-13	Moderna	Flu
4	2022-06-24	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-26	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-10-27	Successful	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-13	Successful 2022-04-20	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-27	Unsuccessful
2022-06-30	Unsuccessful
2022-07-03	Unsuccessful
2022-07-15	Unsuccessful
2022-08-05	Unsuccessful

Free text

Release 10

Systemic reaction (other): Chest congestion

Healthcare visit (other): Over active bladder

Symptoms: Harder to get rid of built up mucous that accumulates from my years of having broncietic

Symptoms: More trouble cleaning my lungs of sputum

Symptoms: Bronchitis

Symptoms: Was in hospital 11/30 to 12/03

Release 11

Symptoms: Broneketes flailed up lots of mucus but easy to cough out

Healthcare visit (other): Doctor in office

Release 12

Systemic reaction (other): Lungs congested

Systemic reaction (other): Lungs still over congested

Systemic reaction (other): Still congested

Healthcare visit (other): None yet

Systemic reaction (other): Still more fatigued and tired than usual muscle spasms

Systemic reaction (other): Joint pain left hand

Healthcare visit (other): Dentist

Systemic reaction (other): More fatigue than usual

Healthcare visit (other): Didn't get any appointments wouldn't have been able to go

Symptoms: More congested

Healthcare visit (other): Dr (b)(6) and mammogram

redacted (b)(6)

Symptoms: Shaking

Symptoms: Might have Cystic Fibrosis

Healthcare visit (other): Dr visit s

Free-text releases are not linked to a specific 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	Hypertonic bladder	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Bronchitis	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Productive cough	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Secretion discharge	·	·	✓
SD	Sputum retention	·	·	✓
SD	Tremor	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Muscle spasms	·	·	✓
SRO	Pulmonary congestion	·	·	✓
SRO	Respiratory tract congestion	·	·	✓

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