YKR-73116-22840

4 vaccinations 26 coded responses 53 check-ins 25 free-text entries 7 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 800 / CO
Registered: 2021-03-22

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

2021-03-22
Registered in v-safe
2021-03-22
Dose 1 — Moderna
2021-03-22
Survey response — day 0, dose 1
MedDRA: Back pain — Feeling: Good

Free text: Tweaked my back before going to get the vaccine so my back aches, but not becauseof the vaccine. .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Just minor ache at injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Survey response — day 7, dose 1
MedDRA: Fatigue, Headache, Neuralgia, Pain in extremity, Poor quality sleep — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Headache and fatigue was minor today from not sleeping well last night. Had very minor nerve pain in right arm overnight, but that resolved before waking this morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — day 14, dose 1
MedDRA: Back pain, Diarrhoea, Muscle strain — Feeling: Good

Free text: Diarrhea one episode one day. Back pain for about 3 days...not related to vaccine. I just twisted and it tweaked my back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-19
Dose 2 — Moderna
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-22
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Fair · Headache

Free text: Stress headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-23
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Neck pain — Feeling: Good · Site: Pain · Headache, Muscle or body aches

Free text: Awoke with a mild headache and neck ache. Better now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 2
MedDRA: Myalgia, Neck pain — Feeling: Good · Muscle or body aches

Free text: Base of neck/upper trap pain specifically, the rest of my muscles are fine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Neck pain — Feeling: Good · Muscle or body aches

Free text: Still have neck pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 7, dose 2
Feeling: Good · None

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

Adult check-in
2021-05-10
Survey response — day 21, dose 2
MedDRA: Eye irritation, Medical counselling, Ocular hyperaemia, Pruritus, Rash, Self-medication — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Rash on forearms and back of left hand resurfaced mildly. Itchy , small bumps. (Body mildly itches). Used cortizone cream on arms, lotions, and took half dose of benadryl Saturday night. Better today. Right eye red and irritated yesterday/toda · Healthcare visit (other): Called for eye drop suggestions

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-31
Survey response — day 42, dose 2
MedDRA: Crying, Eye pain, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I've been having eye pain. Our dog passed away at the end of April and for a few weeks I cried frequently. As a result the eye doctor thinks I wore away some protective minerals. I'm on prescription drops and an antibiotic .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-18
Survey response — 6 months, dose 2
MedDRA: Abdominal distension, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Bloating · Healthcare visit (other): Blood test and ultrasounds to search for why i am bloating.

MedDRA releases: 2024-11 · check-in free text available
2021-10-18
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-10-19
Call successful
Participant prefers to complete VAERS report online
2021-11-17
Dose 3 — Moderna
2021-11-18
Survey response — days 1–6 daily, dose 3
MedDRA: Insomnia — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Insomnia last night

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Survey response — days 1–6 daily, dose 3
MedDRA: Pyrexia, Throat irritation — Feeling: Good · Fever · Chills, Headache, Fatigue or tiredness

Free text: No fever today, just last night. Mild scratchy throat.

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-21
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal distension, Cough — Feeling: Good · Headache

Free text: Continued bloating and slight cough

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal distension — Feeling: Good

Free text: Just bloating

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-24
Survey response — day 7, dose 3
MedDRA: Abdominal distension — Feeling: Good

Free text: Just bloating

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-22
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-29
Survey response — day 42, dose 3
MedDRA: Nausea, Throat irritation — Feeling: Good

Free text: Slight scratchy throat, and nausea, for two evenings, but better today.

MedDRA releases: 2024-11 · check-in free text available
2022-02-16
Survey response — 3 months, dose 3
MedDRA: Cough, Throat irritation — Feeling: Good

Free text: Slight cough, slight scratchy throat several weeks ago

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Survey response — 6 months, dose 3
MedDRA: Lymphadenopathy, Mammogram abnormal, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Swollen lymph nodes in my breast, etc..., shown on a mammogram. I have to go back for a repeat diagnostic test and ultrasound. I was told, at imagining, this has been a vaccine problem for many women. · Healthcare visit (other): Mammogram

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-20
Call successful
Participant prefers to complete VAERS report online
2022-05-20
Call successful
Participant prefers to complete VAERS report online
2022-05-20
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-10
Dose 4 — Moderna
2022-11-10
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain, Swelling · Headache

Adult check-in
2022-11-11
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2022-11-13
Survey response — days 1–6 daily, dose 4
MedDRA: Nasal congestion, Productive cough, Sleep disorder, Vomiting — Feeling: Poor · Site: Swelling · Fatigue or tiredness, Vomiting, Diarrhea · Be unable to do your normal daily activities

Free text: Bad cough, from phlegm on windpipe kept me up all night, causing me to vomit. I think I picked up another virus. I also have some nasal congestion.

MedDRA releases: 2024-11 · check-in free text available
2022-11-14
Survey response — days 1–6 daily, dose 4
MedDRA: Cough, Diarrhoea, Medical counselling, Productive cough, Secretion discharge, Sputum discoloured, Telemedicine — Feeling: Fair · Headache, Muscle or body aches · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Yellow sinus mucus, but much less coughing. Diarrhea yesterday. · Healthcare visit (other): Spoke to the pharmacy for suggestions to get rid of phlegm and mucus, and also doctor office online patient portal

MedDRA releases: 2024-11 · check-in free text available
2022-11-14
Report sent to call center — days 1–6 daily, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-15
Survey response — days 1–6 daily, dose 4
MedDRA: Cough, Nasal congestion — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Nasal congestion, and cough...might have been exposed to RSV just prior to getting vaccinated...but didn't know that at the time

MedDRA releases: 2024-11 · check-in free text available
2022-11-15
Call 1 — Left Voicemail
2022-11-15
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-16
Survey response — days 1–6 daily, dose 4
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair · Headache

Free text: Cough and congestion remain

MedDRA releases: 2024-11 · check-in free text available
2022-11-17
Survey response — day 7, dose 4
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair

Free text: Cough, congestion

MedDRA releases: 2024-11 · check-in free text available
2022-11-24
Survey response — day 14, dose 4
MedDRA: Office visit, Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Had a sinus infection · Healthcare visit (other): In office

MedDRA releases: 2024-11 · check-in free text available
2022-11-24
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-25
Call 2 — Left Voicemail
2022-12-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-12-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-02-09
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-05-11
Survey response — 6 months, dose 4
MedDRA: Arthralgia, Office visit, Pain in extremity — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-05-11
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2023-05-12
Call 1 — Left Voicemail
2023-05-12
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-19	Moderna
3	2021-11-17	Moderna	No
4	2022-11-10	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-10	Successful 2022-05-20	Participant prefers to complete VAERS report online
2021-05-31	Successful 2022-05-20	Participant prefers to complete VAERS report online
2021-10-18	Successful 2021-10-19	Participant prefers to complete VAERS report online
2022-05-19	Successful 2022-05-20	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-14	Successful 2022-11-15	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-24	Unsuccessful
2023-05-11	Unsuccessful

Free text

Release 6 — day 0, dose 1

2021-03-22

Systemic reaction (other): Tweaked my back before going to get the vaccine so my back aches, but not becauseof the vaccine. .

Release 6 — days 1–6 daily, dose 1

2021-03-23

Systemic reaction (other): Just minor ache at injection site.

Release 6 — day 7, dose 1

2021-03-29

Systemic reaction (other): Headache and fatigue was minor today from not sleeping well last night. Had very minor nerve pain in right arm overnight, but that resolved before waking this morning.

Release 6 — day 14, dose 1

2021-04-05

Symptoms: Diarrhea one episode one day. Back pain for about 3 days...not related to vaccine. I just twisted and it tweaked my back.

Release 7 — days 1–6 daily, dose 2

2021-04-22

Systemic reaction (other): Stress headache

2021-04-23

Systemic reaction (other): Awoke with a mild headache and neck ache. Better now.

2021-04-24

Systemic reaction (other): Base of neck/upper trap pain specifically, the rest of my muscles are fine

2021-04-25

Systemic reaction (other): Still have neck pain

Release 8 — day 21, dose 2

2021-05-10

Symptoms: Rash on forearms and back of left hand resurfaced mildly. Itchy , small bumps. (Body mildly itches). Used cortizone cream on arms, lotions, and took half dose of benadryl Saturday night. Better today. Right eye red and irritated yesterday/toda cut off by CDC

Healthcare visit (other): Called for eye drop suggestions

Release 8 — day 42, dose 2

2021-05-31

Symptoms: I've been having eye pain. Our dog passed away at the end of April and for a few weeks I cried frequently. As a result the eye doctor thinks I wore away some protective minerals. I'm on prescription drops and an antibiotic .

Release 10 — 6 months, dose 2

2021-10-18

Symptoms: Bloating

Healthcare visit (other): Blood test and ultrasounds to search for why i am bloating.

Release 10 — days 1–6 daily, dose 3

2021-11-18

Systemic reaction (other): Insomnia last night

2021-11-19

Systemic reaction (other): No fever today, just last night. Mild scratchy throat.

2021-11-21

Systemic reaction (other): Continued bloating and slight cough

2021-11-22

Systemic reaction (other): Just bloating

Release 10 — day 7, dose 3

2021-11-24

Systemic reaction (other): Just bloating

Release 10 — day 42, dose 3

2021-12-29

Symptoms: Slight scratchy throat, and nausea, for two evenings, but better today.

Release 11 — 3 months, dose 3

2022-02-16

Symptoms: Slight cough, slight scratchy throat several weeks ago

Release 11 — 6 months, dose 3

2022-05-19

Symptoms: Swollen lymph nodes in my breast, etc..., shown on a mammogram. I have to go back for a repeat diagnostic test and ultrasound. I was told, at imagining, this has been a vaccine problem for many women.

Healthcare visit (other): Mammogram

Release 12 — days 1–6 daily, dose 4

2022-11-13

Systemic reaction (other): Bad cough, from phlegm on windpipe kept me up all night, causing me to vomit. I think I picked up another virus. I also have some nasal congestion.

2022-11-14

Systemic reaction (other): Yellow sinus mucus, but much less coughing. Diarrhea yesterday.

Healthcare visit (other): Spoke to the pharmacy for suggestions to get rid of phlegm and mucus, and also doctor office online patient portal

2022-11-15

Systemic reaction (other): Nasal congestion, and cough...might have been exposed to RSV just prior to getting vaccinated...but didn't know that at the time

2022-11-16

Systemic reaction (other): Cough and congestion remain

Release 12 — day 7, dose 4

2022-11-17

Systemic reaction (other): Cough, congestion

Release 12 — day 14, dose 4

2022-11-24

Symptoms: Had a sinus infection

Healthcare visit (other): In office

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	Abdominal distension	·	·	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
HCVO	Productive cough	·	·	✓
HCVO	Secretion discharge	·	·	✓
HCVO	Telemedicine	·	·	✓
HCVO	Unevaluable event	·	·	✓
SD	Abdominal distension	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	✓	✓	✓
SD	Cough	·	·	✓
SD	Crying	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Eye irritation	✓	✓	✓
SD	Eye pain	✓	✓	✓
SD	Lymphadenopathy	·	·	✓
SD	Mammogram abnormal	·	·	✓
SD	Muscle strain	✓	✓	✓
SD	Nausea	·	·	✓
SD	Ocular hyperaemia	✓	✓	✓
SD	Office visit	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Throat irritation	·	·	✓
SRO	Abdominal distension	·	·	✓
SRO	Back pain	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Diarrhoea	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Insomnia	·	·	✓
SRO	Myalgia	✓	✓	✓
SRO	Nasal congestion	·	·	✓
SRO	Neck pain	✓	✓	✓
SRO	Neuralgia	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Poor quality sleep	✓	✓	✓
SRO	Productive cough	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Secretion discharge	·	·	✓
SRO	Sleep disorder	·	·	✓
SRO	Sputum discoloured	·	·	✓
SRO	Throat irritation	·	·	✓
SRO	Vomiting	·	·	✓

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