YP3-98662-67680

2 vaccinations 12 coded responses 26 check-ins 12 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 981 / WA
Registered: 2021-01-24

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

2021-01-24
Registered in v-safe
2021-01-24
Dose 1 — Moderna
2021-01-24
Survey response — day 0, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Joint pains, Muscle or body aches

Free text: Arthritis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Surgery — Feeling: Fair · Site: Pain, Swelling · Joint pains, Fatigue or tiredness

Free text: I had surgery todayo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Arthritis, Surgery — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Arthritis and surgery yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Arthritis, Spinal pain — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Free text: Pain is from spinal structural and arthritic issued

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Choking — Feeling: Good · Vomiting

Free text: Choked on food

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Joint pains, Muscle or body aches

Free text: Pain is chronic; not related to vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — day 7, dose 1
MedDRA: Adverse reaction — Feeling: Good · Joint pains, Muscle or body aches

Free text: Pain not related to immunization

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-21
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-27
Dose 2 — Moderna
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Survey response — day 14, dose 2
MedDRA: Injection site erythema, Injection site pruritus, Office visit, Vaccination site reaction — Feeling: Fair · Be unable to do your normal daily activities

Free text: At day 8, my upper arm, starting at injection site got progressively red and itchy all the way to my elbow. On call doctor said likely a delayed autoimmune reaction exacerbated by certain meds, particularly Methoyrexate. Much improved.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-27
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-03
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-11
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Ear infection, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Ear infection and side effects from urological procedures and increased GERD issues.

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

1 call case(s)
2021-05-29
Survey response — 3 months, dose 2
MedDRA: Diverticulitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Diverticulitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-29
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-28
Survey response — 6 months, dose 2
MedDRA: Diverticulitis — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: 2 bouts of diverticulitis.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-28
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-02
Call 1 — Left Voicemail
2022-03-01
Survey response — 12 months, dose 2
MedDRA: Dysphonia, Sinusitis, Viral infection — 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, Outpatient clinic or urgent care clinic visit

Free text: Virus, sinus infection, long-term hoarse voice

MedDRA releases: 2024-11 · check-in free text available
2022-03-01
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-10
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-24	Moderna
2	2021-02-27	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-11	Unsuccessful
2021-05-29	Unsuccessful
2021-08-28	Unsuccessful
2022-03-01	Unsuccessful

Free text

Release 2 — day 0, dose 1

2021-01-24

Systemic reaction (other): Arthritis

Release 2 — days 1–6 daily, dose 1

2021-01-26

Systemic reaction (other): I had surgery todayo

2021-01-27

Systemic reaction (other): Arthritis and surgery yesterday

2021-01-28

Systemic reaction (other): Pain is from spinal structural and arthritic issued

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): Choked on food

2021-01-30

Systemic reaction (other): Pain is chronic; not related to vaccination

Release 3 — day 7, dose 1

2021-01-31

Systemic reaction (other): Pain not related to immunization

Release 5 — day 14, dose 2

2021-03-13

Symptoms: At day 8, my upper arm, starting at injection site got progressively red and itchy all the way to my elbow. On call doctor said likely a delayed autoimmune reaction exacerbated by certain meds, particularly Methoyrexate. Much improved.

Release 7 — day 42, dose 2

2021-04-11

Symptoms: Ear infection and side effects from urological procedures and increased GERD issues.

Release 8 — 3 months, dose 2

2021-05-29

Symptoms: Diverticulitis

Release 9 — 6 months, dose 2

2021-08-28

Symptoms: 2 bouts of diverticulitis.

Release 11 — 12 months, dose 2

2022-03-01

Symptoms: Virus, sinus infection, long-term hoarse voice

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
SD	Condition aggravated	✓	✓	✓
SD	Diverticulitis	✓	✓	✓
SD	Dysphonia	·	·	✓
SD	Ear infection	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Vaccination site reaction	✓	✓	✓
SD	Viral infection	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Choking	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Spinal pain	✓	✓	✓
SRO	Surgery	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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