YPX-52759-37334

3 vaccinations 12 coded responses 40 check-ins 12 free-text entries 13 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 800 / CO
Registered: 2021-02-15

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-15
Registered in v-safe
2021-02-15
Dose 1 — Moderna
2021-02-15
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Secretion discharge, Unevaluable event — Feeling: Poor · Fever · Fatigue or tiredness, Nausea · Be unable to work, 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): Coughing up mucus. · Healthcare visit (other): Awaiting return call from physician considering ER visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-19
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Secretion discharge — Feeling: Fair · Fever · Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, 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: Shortness of breath coughing up mucus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-20
Survey response — days 1–6 daily, dose 1
MedDRA: Productive cough — Feeling: Poor · Fever · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, 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: Productive coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Productive cough — Feeling: Poor · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to work, 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: Chest discomfort and productive cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-23
Survey response — day 7, dose 1
MedDRA: Dyspepsia, Respiratory tract infection — Feeling: Poor · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to work, 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: Respiratory imfection heartburn

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Report sent to call center — day 7, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-16
Dose 2 — Moderna
2021-03-16
Survey response — day 0, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Itching · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Lymph node swollen in armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Palpitations — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work, 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: Heartrate to 130, heart palptations. Happened with first vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-03-18
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-03-19
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-23
Health check-in — day 7, dose 2
Feeling: Good · Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-30
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-27
Survey response — day 42, dose 2
MedDRA: Bronchitis, Dizziness — Feeling: Fair · Be unable to work, 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: Lightheaded. Reoeat bronchitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-06
Call 1 — Left Voicemail
2021-09-16
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-10-29
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Swelling, Itching · Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling, Itching · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-10-31
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Chills, Joint pains, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Chills, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-02
Call successful
Participant prefers to complete VAERS report online
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-11-12
Survey response — day 14, dose 3
MedDRA: Cough, Nasal congestion, Rash — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cough, nasal congestion and body rash has still not resolved

MedDRA releases: 2024-11 · check-in free text available
2021-11-28
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-03
Survey response — day 35, dose 3
MedDRA: Fatigue, Pain, Respiratory tract congestion, Upper respiratory tract infection — Feeling: Poor · 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

Free text: Congestion, uri, aches, fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Report sent to call center — day 35, 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 · 1 call case(s)
2021-12-07
Call 1 — Left Voicemail
2021-12-10
Survey response — day 42, dose 3
MedDRA: Abdominal discomfort, Pre-existing disease, Rash — Feeling: Fair · Be unable to work or attend school, 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: Rash is back , stomach upset

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Report sent to call center — day 42, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-13
Call 1 — Requested Callback
2021-12-16
Call 2 — Left Voicemail
2021-12-27
Callback requested for
11:00AM ET
2022-01-28
Survey response — 3 months, dose 3
MedDRA: Clostridium difficile infection, Fatigue — Feeling: Fair · 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

Free text: Fatigue. C diff infection.

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Report sent to call center — 3 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 · 1 call case(s)
2022-02-02
Call 1 — Left Voicemail
2022-04-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-15	Moderna
2	2021-03-16	Moderna
3	2021-10-29	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-18	Unsuccessful
2021-02-19	Unsuccessful
2021-02-20	Unsuccessful
2021-02-21	Unsuccessful
2021-02-23	Unsuccessful
2021-03-17	Unsuccessful
2021-03-18	Unsuccessful
2021-03-19	Unsuccessful
2021-04-27	Unsuccessful
2021-10-31	Successful 2021-11-02	Participant prefers to complete VAERS report online
2021-12-03	Unsuccessful
2021-12-10	Unsuccessful
2022-01-28	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-18

Systemic reaction (other): Coughing up mucus.

Healthcare visit (other): Awaiting return call from physician considering ER visit

2021-02-19

Systemic reaction (other): Shortness of breath coughing up mucus

2021-02-20

Systemic reaction (other): Productive coughing

2021-02-21

Systemic reaction (other): Chest discomfort and productive cough

Release 4 — day 7, dose 1

2021-02-23

Systemic reaction (other): Respiratory imfection heartburn

Release 5 — day 0, dose 2

2021-03-16

Systemic reaction (other): Lymph node swollen in armpit

Release 5 — days 1–6 daily, dose 2

2021-03-17

Systemic reaction (other): Heartrate to 130, heart palptations. Happened with first vaccine

Release 8 — day 42, dose 2

2021-04-27

Symptoms: Lightheaded. Reoeat bronchitis

Release 10 — day 14, dose 3

2021-11-12

Symptoms: Cough, nasal congestion and body rash has still not resolved

Release 10 — day 35, dose 3

2021-12-03

Symptoms: Congestion, uri, aches, fatigue

Release 10 — day 42, dose 3

2021-12-10

Symptoms: Rash is back , stomach upset

Release 11 — 3 months, dose 3

2022-01-28

Symptoms: Fatigue. C diff infection.

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	Unevaluable event	✓	✓	✓
SD	Abdominal discomfort	·	·	✓
SD	Bronchitis	✓	✓	✓
SD	Clostridium difficile infection	·	·	✓
SD	Cough	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Productive cough	✓	✓	✓
SRO	Respiratory tract infection	✓	✓	✓
SRO	Secretion discharge	✓	✓	✓

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