YKS-28180-32862

1 vaccination 6 coded responses 8 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 511 / IA
Registered: 2021-03-17

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

2021-03-17
Registered in v-safe
2021-03-17
Dose 1 — Moderna
2021-03-17
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain, Upper-airway cough syndrome — Feeling: Poor · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Red sore throat one side only, post nasal drip, was 96.6 this morning, now 2 degrees higher.

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: Lung disorder, Oxygen consumption increased — Feeling: Poor · Fever · Headache, 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 · Telehealth, virtual health, or email health consultation

Free text: Had to use Albuterol to increase oxygen intake. Feels like the two times I had walking pneumonia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Headache, Lymph node pain, Neck pain — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Pain in joints/head are almost completely on right side. Lymph, lower neck, right side, still very sore to touch. Family refuses to think it's vaccine related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Medical counselling, Pyrexia — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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: Systemic reaction (other): When temp went up to 101, my breathing became labored like when I first developed acute symptoms. Will get results for covid test on Wed 24th, tested negative for flu and strep. Temp went down and breathing eased over a few hours. · Healthcare visit (other): Drive thru covid testing to rule out

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Report sent to call center — days 1–6 daily, dose 1
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: Back pain, Diarrhoea, Influenza virus test negative, Nausea, SARS-CoV-2 test, Self-medication, Streptococcus test — Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Temple temp now 98.3 without acetaminophen. Forgot to mention the pain in back that was present for three days, believe it was kidneys. Tested neg for flu and rapid Strep. Covid test results will be tomorrow. Nausea and diarrhea are reoccurring after day of absence. New general practitioner is collecting all medical records possible, will be testing for autoimmune markers.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 7, dose 1
MedDRA: Asthenia, Fatigue, Pain, Painful respiration, Pyrexia, Renal pain, Respiratory disorder, SARS-CoV-2 test negative, Unevaluable event — Feeling: Fair · Fever · 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 · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Kidney pain, dull and consistent. Fever, fatigue, weakness, breathing and kidney pain increases after simple physical exertion i. e. Going up a flight of stairs to get food. · Healthcare visit (other): Will be getting labs done to check kidney function tomorrow. Negative Covid test.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-05
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2022-03-14
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-20	Unsuccessful
2021-03-22	Unsuccessful
2021-03-24	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-19

Systemic reaction (other): Red sore throat one side only, post nasal drip, was 96.6 this morning, now 2 degrees higher.

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Had to use Albuterol to increase oxygen intake. Feels like the two times I had walking pneumonia

2021-03-21

Systemic reaction (other): Pain in joints/head are almost completely on right side. Lymph, lower neck, right side, still very sore to touch. Family refuses to think it's vaccine related.

2021-03-22

Systemic reaction (other): When temp went up to 101, my breathing became labored like when I first developed acute symptoms. Will get results for covid test on Wed 24th, tested negative for flu and strep. Temp went down and breathing eased over a few hours.

Healthcare visit (other): Drive thru covid testing to rule out

2021-03-23

Systemic reaction (other): Temple temp now 98.3 without acetaminophen. Forgot to mention the pain in back that was present for three days, believe it was kidneys. Tested neg for flu and rapid Strep. Covid test results will be tomorrow. Nausea and diarrhea are reoccurring after day of absence. New general practitioner is collecting all medical records possible, will be testing for autoimmune markers.

Release 6 — day 7, dose 1

2021-03-24

Systemic reaction (other): Kidney pain, dull and consistent. Fever, fatigue, weakness, breathing and kidney pain increases after simple physical exertion i. e. Going up a flight of stairs to get food.

Healthcare visit (other): Will be getting labs done to check kidney function tomorrow. Negative Covid test.

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	SARS-CoV-2 test negative	✓	✓	✓
HCVO	Unevaluable event	○	✓	○
SRO	Arthralgia	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Influenza virus test negative	✓	✓	✓
SRO	Lung disorder	✓	·	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Neck pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Oxygen consumption increased	○	✓	○
SRO	Pain	✓	·	✓
SRO	Painful respiration	✓	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Renal pain	✓	✓	✓
SRO	Respiratory disorder	○	✓	○
SRO	SARS-CoV-2 test	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Streptococcus test	✓	✓	✓
SRO	Upper-airway cough syndrome	✓	✓	✓

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