Y7F-64129-34432

4 vaccinations 17 coded responses 40 check-ins 16 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 975 / OR
Registered: 2021-05-18

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

2021-05-15
Dose 1 — Moderna
2021-05-18
Registered in v-safe
2021-05-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-05-19
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Headache, Muscle strain, Sensitivity to weather change — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Could be I strained my left lower backside just above the hip. Found old elastic stretch Velcro back brace made for my deceased husband, can get around carefully. Woke up with mild headache that went away shortly after getting up. Joint pain was in knees, however I can feel that before it rains from moisture in the air.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Pain, Weight bearing difficulty — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: pain is sane as yesterday in same lower back area, back hurts to put weight on that left leg or bending

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: same back, less intense so far, heating pad helps

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-22
Survey response — day 7, dose 1
MedDRA: Back disorder — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: same lower left back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-06-05
Survey response — day 21, dose 1
MedDRA: Dizziness — Feeling: Fair

Free text: Lightheadedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-12
Dose 2 — Moderna
2021-06-12
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-06-13
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Pain in extremity, Sluggishness, Somnolence, Swelling — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Slept until 2 P. M., very tired, sluggish, very sore arm, minor swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain lower, Chills, Fatigue, Hypersomnia — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Abdominal pain

Free text: low area abdominal pain not stomach since day 1, last Eve kept wanting to sleep with so tired feeling and chills no temp, slept till p.m. todayling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain, Urinary incontinence — Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness, Abdominal pain

Free text: low belly pain is mild today, today is first day I made it to bathroom without urinating uncontrollably all over me upon arising

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Survey response — days 1–6 daily, dose 2
MedDRA: Taste disorder — Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness, Abdominal pain

Free text: Taste buds dull, abdominal is low area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-06-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-06-19
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-06-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-07-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-07-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-07-17
Survey response — day 35, dose 2
MedDRA: Asthenia, Dizziness, Lip swelling, Presyncope, Tremor, Visual impairment — Feeling: Good

Free text: Bump inside lower lip that hasn't gone away. A episode of near fainting, lightheaded, weak, shaky, left eye seeing a light wave moving. I drank a lot of water and it stopped.

MedDRA releases: 2024-11 · check-in free text available
2021-07-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-06-29
Dose 3 — Moderna
2022-06-30
Survey response — days 1–6 daily, dose 3
MedDRA: Dry mouth, Dry throat, Nasal congestion, Sinus congestion — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: stuffy nose, sinus, dry mouth and throat

MedDRA releases: 2024-11 · check-in free text available
2022-07-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-07-02
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Joint stiffness, Musculoskeletal pain, Musculoskeletal stiffness, Neck pain — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Left backside of hip and neck into shoulder blade underneath has stiffness and aching, just wanted to stay home

MedDRA releases: 2024-11 · check-in free text available
2022-07-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-06
Survey response — day 7, dose 3
MedDRA: Brain fog — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-07-13
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-07-20
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-07-27
Survey response — day 28, dose 3
MedDRA: Dizziness, Fatigue, Nausea — Feeling: Fair

Free text: Some nausea and light headed off and on especially in morning upon waking up, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-08-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-08-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-09-30
Survey response — 3 months, dose 3
MedDRA: Asthenia, Blood pressure increased, Body temperature decreased, Brain fog, Chills, Dizziness, Fatigue, Feeling cold, Feeling hot, Joint swelling, Nail disorder, Nausea, Office visit, Onychoclasis, Weight increased — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I've had 3 Covid vacc only, 4th is due Oct 29th on. Fatigue, nausea, weak, lightheaded, higher BP, ankles swell, cold chills, or feel hot but temp normal or lower, brain fog, thin weak brittle splitting toenails and fingernails, weight gain · Healthcare visit (other): Saw primary in person by appt. Sept 27th to get checked

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-03
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-30
Survey response — 6 months, dose 3
MedDRA: COVID-19, Medical counselling, SARS-CoV-2 test positive — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Symptoms: Got Covid again, horrible case of it hit me Sat, Nov 19, 2022, tested positive at home Sun Nov 21 to Nov 30, 2022. · Healthcare visit (other): Daily messages with doctors via MyChart system

MedDRA releases: 2024-11 · check-in free text available
2022-12-30
Report sent to call center — 6 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 · Emergency room or emergency department visit · 1 call case(s)
2023-01-30
Call successful
Participant prefers to complete VAERS report online
2023-03-12
Dose 4 — Pfizer-BioNTech
2023-03-19
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2023-03-26
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2023-04-02
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2023-04-09
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2023-04-18
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-04-23
Survey response — day 42, dose 4
MedDRA: Blood pressure increased, Dizziness, Dyspnoea, Fatigue — Feeling: Good

MedDRA releases: 2024-11
2023-06-13
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-05-15	Moderna
2	2021-06-12	Moderna
3	2022-06-29	Moderna	No
4	2023-03-12	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-09-30	Successful 2022-10-03	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-30	Successful 2023-01-30	Participant prefers to complete VAERS report online

Free text

Release 8 — days 1–6 daily, dose 1

2021-05-19

Systemic reaction (other): Could be I strained my left lower backside just above the hip. Found old elastic stretch Velcro back brace made for my deceased husband, can get around carefully. Woke up with mild headache that went away shortly after getting up. Joint pain was in knees, however I can feel that before it rains from moisture in the air.

2021-05-20

Systemic reaction (other): pain is sane as yesterday in same lower back area, back hurts to put weight on that left leg or bending

2021-05-21

Systemic reaction (other): same back, less intense so far, heating pad helps

Release 8 — day 7, dose 1

2021-05-22

Systemic reaction (other): same lower left back

Release 8 — day 21, dose 1

2021-06-05

Symptoms: Lightheadedness

Release 9 — days 1–6 daily, dose 2

2021-06-13

Systemic reaction (other): Slept until 2 P. M., very tired, sluggish, very sore arm, minor swelling

2021-06-14

Systemic reaction (other): low area abdominal pain not stomach since day 1, last Eve kept wanting to sleep with so tired feeling and chills no temp, slept till p.m. todayling

2021-06-15

Systemic reaction (other): low belly pain is mild today, today is first day I made it to bathroom without urinating uncontrollably all over me upon arising

2021-06-16

Systemic reaction (other): Taste buds dull, abdominal is low area

Release 9 — day 35, dose 2

2021-07-17

Symptoms: Bump inside lower lip that hasn't gone away. A episode of near fainting, lightheaded, weak, shaky, left eye seeing a light wave moving. I drank a lot of water and it stopped.

Release 12 — days 1–6 daily, dose 3

2022-06-30

Systemic reaction (other): stuffy nose, sinus, dry mouth and throat

2022-07-02

Systemic reaction (other): Left backside of hip and neck into shoulder blade underneath has stiffness and aching, just wanted to stay home

Release 12 — day 7, dose 3

2022-07-06

Systemic reaction (other): brain fog

Release 12 — day 28, dose 3

2022-07-27

Symptoms: Some nausea and light headed off and on especially in morning upon waking up, fatigue

Release 12 — 3 months, dose 3

2022-09-30

Symptoms: I've had 3 Covid vacc only, 4th is due Oct 29th on. Fatigue, nausea, weak, lightheaded, higher BP, ankles swell, cold chills, or feel hot but temp normal or lower, brain fog, thin weak brittle splitting toenails and fingernails, weight gain

Healthcare visit (other): Saw primary in person by appt. Sept 27th to get checked

Release 12 — 6 months, dose 3

2022-12-30

Symptoms: Got Covid again, horrible case of it hit me Sat, Nov 19, 2022, tested positive at home Sun Nov 21 to Nov 30, 2022.

Healthcare visit (other): Daily messages with doctors via MyChart system

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	Office visit	·	·	✓
SD	Asthenia	·	·	✓
SD	Blood pressure increased	·	·	✓
SD	Body temperature decreased	·	·	✓
SD	Brain fog	·	·	✓
SD	Chills	·	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Feeling cold	·	·	✓
SD	Feeling hot	·	·	✓
SD	Joint swelling	·	·	✓
SD	Lip swelling	·	·	✓
SD	Nail disorder	·	·	✓
SD	Nausea	·	·	✓
SD	Onychoclasis	·	·	✓
SD	Presyncope	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Tremor	·	·	✓
SD	Visual impairment	·	·	✓
SD	Weight increased	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Abdominal pain lower	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Back disorder	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Brain fog	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Dry mouth	·	·	✓
SRO	Dry throat	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Joint stiffness	·	·	✓
SRO	Muscle strain	✓	✓	✓
SRO	Musculoskeletal pain	·	·	✓
SRO	Musculoskeletal stiffness	·	·	✓
SRO	Nasal congestion	·	·	✓
SRO	Neck pain	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Sensitivity to weather change	✓	✓	✓
SRO	Sinus congestion	·	·	✓
SRO	Sluggishness	✓	✓	✓
SRO	Somnolence	✓	✓	✓
SRO	Swelling	✓	✓	✓
SRO	Taste disorder	✓	✓	✓
SRO	Urinary incontinence	✓	✓	✓
SRO	Weight bearing difficulty	✓	✓	✓

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