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YQ9-36366-13877

3 vaccinations 6 coded responses 9 check-ins 6 free-text entries 1 call case
Sex
Female
Age at first dose
31-35
ZIP prefix
980 / WA
Registered
2021-04-21
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-19
    Dose 1 — Moderna
  2. 2021-04-19
    Dose 2 — Moderna
  3. 2021-04-21
    Registered in v-safe
  4. 2021-04-21
    Survey response — days 1–6 daily, dose 2
    MedDRA: Dysstasia, Fatigue, Feeling abnormal, Gait disturbance, Hot flush, Insomnia, Tremor — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities
    Free text: Brain fog, difficulty standing or moving around without getting shaky, hot flashes when standing up, extreme difficulty sleeping despite being incredibly tired
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  5. 2021-04-22
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fatigue or tiredness
    Adult check-in
  6. 2021-04-23
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  7. 2021-10-18
    Survey response — 6 months, dose 2
    MedDRA: Diverticulitis, Diverticulum intestinal — 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: I developed diverticuli in my colon and experienced a mild case of diverticulitis about three months ago.
    MedDRA releases: 2024-11 · check-in free text available
  8. 2021-10-18
    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
    Outpatient clinic or urgent care clinic visit · 1 call case(s)
  9. 2021-10-20
  10. 2021-10-25
  11. 2022-02-11
    Dose 3 — Moderna
  12. 2022-02-13
    Survey response — days 1–6 daily, dose 3
    MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities
    Free text: The lymph node on the side where I got the shot is swollen to the size of an orange and it's extremely tender!
    MedDRA releases: 2024-11 · check-in free text available
  13. 2022-02-14
    Survey response — days 1–6 daily, dose 3
    MedDRA: Lymph node pain, Lymphadenopathy, Pain — Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities
    Free text: My lymph node on the side I got the shot is still very, very swollen and tender to the point of pain whenever I shift that arm!!
    MedDRA releases: 2024-11 · check-in free text available
  14. 2022-02-15
    Survey response — days 1–6 daily, dose 3
    MedDRA: Angina pectoris, Heart rate increased — Feeling: Good · Site: Pain, Swelling
    Free text: I am experiencing a very tiny twinge in my heart accompanied by what seems like a slightly increased heart rate. This started after I performed a minimally strenuous physical task. But I've never experienced anything like it before.
    MedDRA releases: 2024-11 · check-in free text available
  15. 2022-02-20
    Health check-in — day 7, dose 3
    Feeling: Fair · Site: Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  16. 2022-02-25
    Survey response — day 14, dose 3
    MedDRA: Fatigue, Lymphadenopathy — Feeling: Fair · Be unable to do your normal daily activities
    Free text: My lymph node in the arm I got my booster is still swollen and I still feel generally fatigued everyday in comparison to before the booster.
    MedDRA releases: 2024-11 · check-in free text available

Vaccinations

DoseDateManufacturerCo-administered
12021-03-19Moderna
22021-04-19Moderna
32022-02-11Moderna No

Call center

ReportedOutcomeVAERS-related outcome
2021-10-18 Unsuccessful

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-21

Systemic reaction (other): Brain fog, difficulty standing or moving around without getting shaky, hot flashes when standing up, extreme difficulty sleeping despite being incredibly tired

Release 10 — 6 months, dose 2

2021-10-18

Symptoms: I developed diverticuli in my colon and experienced a mild case of diverticulitis about three months ago.

Release 11 — days 1–6 daily, dose 3

2022-02-13

Systemic reaction (other): The lymph node on the side where I got the shot is swollen to the size of an orange and it's extremely tender!

2022-02-14

Systemic reaction (other): My lymph node on the side I got the shot is still very, very swollen and tender to the point of pain whenever I shift that arm!!

2022-02-15

Systemic reaction (other): I am experiencing a very tiny twinge in my heart accompanied by what seems like a slightly increased heart rate. This started after I performed a minimally strenuous physical task. But I've never experienced anything like it before.

Release 11 — day 14, dose 3

2022-02-25

Symptoms: My lymph node in the arm I got my booster is still swollen and I still feel generally fatigued everyday in comparison to before the booster.

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

FieldPreferred term2021-092023-042024-11
SDDiverticulitis · · ✓
SDDiverticulum intestinal · · ✓
SDFatigue · · ✓
SDLymphadenopathy · · ✓
SROAngina pectoris · · ✓
SRODysstasia ✓ ✓ ✓
SROFatigue ✓ ✓ ✓
SROFeeling abnormal ✓ ✓ ✓
SROGait disturbance ✓ ✓ ✓
SROHeart rate increased · · ✓
SROHot flush ✓ ✓ ✓
SROInsomnia ✓ ✓ ✓
SROLymph node pain · · ✓
SROLymphadenopathy · · ✓
SROPain · · ✓
SROTremor ✓ ✓ ✓

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