Y3D-27555-20539

2 vaccinations 13 coded responses 23 check-ins 13 free-text entries 6 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 973 / OR
Registered: 2021-07-24

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

2021-07-21
Dose 1 — Moderna
2021-07-24
Registered in v-safe
2021-07-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-07-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-07-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-07-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-07-28
Survey response — day 7, dose 1
MedDRA: Acupuncture, Nodule, Physiotherapy, Pre-existing disease — Feeling: Good · Muscle or body aches · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Knot in mid back and prior inflamed shoulder not healing · Healthcare visit (other): PT and acupuncture

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-28
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-04
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-08-05
Call 1 — Left Voicemail
2021-08-11
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-08-18
Survey response — day 28, dose 1
MedDRA: Fatigue — Feeling: Fair

Free text: Tired

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-20
Dose 2 — Moderna
2021-08-21
Survey response — days 1–6 daily, dose 2
MedDRA: Balance disorder, Dizziness, Muscle twitching — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy, off balance, muscle twitching in face

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-22
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Muscle twitching — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy, strange muscle twitching in face

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-23
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle twitching — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Still having facial twitching

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-24
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle twitching — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to work or attend school

Free text: Facial twitching

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-08-26
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle twitching — Feeling: Good

Free text: Facial twitching finally subsied

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-27
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-09-05
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-09-10
Survey response — day 21, dose 2
MedDRA: Headache, Office visit — Feeling: Fair · Be unable to work or attend school

Free text: Unable to hold a chiropractic adjustment. Chronic headaches.

MedDRA releases: 2024-11 · check-in free text available
2021-09-17
Survey response — day 28, dose 2
MedDRA: Ear swelling, Rash, Rash pruritic — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Odd rash and itchin, ears, scalp, neck and shoulders. Swollen ears.

MedDRA releases: 2024-11 · check-in free text available
2021-09-17
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-21
Call 1 — Left Voicemail
2021-09-26
Survey response — day 35, dose 2
MedDRA: Anxiety, Office visit, Pre-existing disease, Psoriasis — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Exacerbation of auto immune issues with psoriasis for which i saw my dr last week. · Healthcare visit (other): Psoriasis and anxiety consult

MedDRA releases: 2024-11 · check-in free text available
2021-09-26
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-01
Call 1 — Left Voicemail
2021-10-04
Survey response — day 42, dose 2
MedDRA: Alopecia, Anxiety, Fear, Office visit, Pre-existing disease, Psoriasis — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Continued psoriasis flare up and losing hair by the handful. Scared i wil be bald soon. Frequent anxiety attacks. · Healthcare visit (other): Naturopth regarding calming the overactive immune response.

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-07
Call 1 — Left Voicemail
2021-11-20
Survey response — 3 months, dose 2
MedDRA: Alopecia, Autoimmune disorder, Psoriasis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Increased psoriasis/ autoimmune issues. And lost half my hair.

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-29
Call successful
Participant prefers to complete VAERS report online
2022-02-20
Survey response — 6 months, dose 2
MedDRA: Abnormal clotting factor, Alopecia, Autoimmune disorder, Blood test abnormal, Hepatic steatosis, Pre-existing disease, Psoriasis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Continued flare up of psoriasis / autoimmune issues. Hair loss. New fatty liver and clotting factor abnormalities in bloodwor

MedDRA releases: 2024-11 · check-in free text available
2022-02-20
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)
2022-02-21
Call 1 — Left Voicemail
2022-08-20
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-21	Moderna	No
2	2021-08-20	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-28	Successful	Participant prefers to complete VAERS report online
2021-09-17	Successful	Participant prefers to complete VAERS report online
2021-09-26	Successful	Participant prefers to complete VAERS report online
2021-10-04	Successful	Participant prefers to complete VAERS report online
2021-11-20	Successful 2021-11-29	Participant prefers to complete VAERS report online
2022-02-20	Unsuccessful

Free text

Release 9 — day 7, dose 1

2021-07-28

Systemic reaction (other): Knot in mid back and prior inflamed shoulder not healing

Healthcare visit (other): PT and acupuncture

Release 9 — day 28, dose 1

2021-08-18

Symptoms: Tired

Release 9 — days 1–6 daily, dose 2

2021-08-21

Systemic reaction (other): Dizzy, off balance, muscle twitching in face

2021-08-22

Systemic reaction (other): Dizzy, strange muscle twitching in face

2021-08-23

Systemic reaction (other): Still having facial twitching

2021-08-24

Systemic reaction (other): Facial twitching

2021-08-26

Systemic reaction (other): Facial twitching finally subsied

Release 9 — day 21, dose 2

2021-09-10

Symptoms: Unable to hold a chiropractic adjustment. Chronic headaches.

Release 9 — day 28, dose 2

2021-09-17

Symptoms: Odd rash and itchin, ears, scalp, neck and shoulders. Swollen ears.

Release 9 — day 35, dose 2

2021-09-26

Symptoms: Exacerbation of auto immune issues with psoriasis for which i saw my dr last week.

Healthcare visit (other): Psoriasis and anxiety consult

Release 10 — day 42, dose 2

2021-10-04

Symptoms: Continued psoriasis flare up and losing hair by the handful. Scared i wil be bald soon. Frequent anxiety attacks.

Healthcare visit (other): Naturopth regarding calming the overactive immune response.

Release 10 — 3 months, dose 2

2021-11-20

Symptoms: Increased psoriasis/ autoimmune issues. And lost half my hair.

Release 11 — 6 months, dose 2

2022-02-20

Symptoms: Continued flare up of psoriasis / autoimmune issues. Hair loss. New fatty liver and clotting factor abnormalities in bloodwor

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	Acupuncture	✓	·	✓
HCVO	Anxiety	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Physiotherapy	✓	·	✓
HCVO	Psoriasis	·	·	✓
SD	Abnormal clotting factor	·	·	✓
SD	Alopecia	·	·	✓
SD	Anxiety	·	·	✓
SD	Autoimmune disorder	·	·	✓
SD	Blood test abnormal	·	·	✓
SD	Ear swelling	·	·	✓
SD	Fatigue	✓	·	✓
SD	Fear	·	·	✓
SD	Headache	·	·	✓
SD	Hepatic steatosis	·	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Psoriasis	·	·	✓
SD	Rash	·	·	✓
SD	Rash pruritic	·	·	✓
SRO	Balance disorder	✓	·	✓
SRO	Dizziness	✓	·	✓
SRO	Muscle twitching	✓	·	✓
SRO	Nodule	✓	·	✓
SRO	Pre-existing disease	✓	·	✓

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