YTH-34014-17730

3 vaccinations 16 coded responses 30 check-ins 16 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 231 / VA
Registered: 2021-02-02

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Registered dependents

XXV-27911-32990 Child or adolescent in my care · Male · 2021-11-28

Timeline

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

2021-02-02
Registered in v-safe
2021-02-03
Dose 1 — Moderna
2021-02-03
Survey response — day 0, dose 1
MedDRA: Dysgeusia — Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: metallic taste in mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia, Rhinorrhoea — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Metallic taste, runny nose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Decreased appetite, Dry mouth — Feeling: Poor · Site: Pain, Redness · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Free text: Coughing, dry mouth, loss of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Decreased appetite, Nausea — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Loss of appetite, slight nausea, coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Rhinorrhoea — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 7, dose 1
MedDRA: Rhinorrhoea — Feeling: Good · Headache, Fatigue or tiredness

Free text: Runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 1
Feeling: Good

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

Adult check-in
2021-03-05
Dose 2 — Moderna
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Hypoaesthesia, Visual impairment — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Numbness in arm, visual effects

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Congestion, sore throat.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Paranasal sinus hypersecretion, Reaction to previous exposure to any vaccine — Feeling: Fair · Fatigue or tiredness

Free text: Been extremely exhausted for the last two days. Also nasal drainage. Had that with the first shot too, but thought it was maybe a cold. Odd to have it again after the 2nd dose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-11-28
Dose 3 — Moderna
2021-11-28
Survey response — day 0, dose 3
MedDRA: Paraesthesia oral — Feeling: Fair · Site: Redness

Free text: Tingling in lips

MedDRA releases: 2024-11 · check-in free text available
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school

Adult check-in
2021-12-04
Survey response — days 1–6 daily, dose 3
MedDRA: Depressed mood — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work or attend school

Free text: Depressed mood.

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-12-12
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-22
Survey response — day 21, dose 3
MedDRA: Headache, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache nausea. May be unrelated to vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-12-29
Survey response — day 28, dose 3
MedDRA: Headache, Nasal congestion, Throat irritation — Feeling: Fair · Be unable to work or attend school

Free text: Nasal congestion, scratchy throat, headache.

MedDRA releases: 2024-11 · check-in free text available
2022-01-02
Survey response — day 35, dose 3
MedDRA: COVID-19, Fatigue, Headache, Pain, Respiratory symptom — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I have COVID, respiratory symptoms, fatigue, headache and body aches

MedDRA releases: 2024-11 · check-in free text available
2022-01-09
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-27
Survey response — 3 months, dose 3
MedDRA: COVID-19, Post-acute COVID-19 syndrome — 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, Outpatient clinic or urgent care clinic visit

Free text: I had covid on dec 28 and recovered. I have since been suffering with symptoms of long covid.

MedDRA releases: 2024-11 · check-in free text available
2022-02-27
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-01
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-05	Moderna
3	2021-11-28	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-27	Successful 2022-03-01	Participant prefers to complete VAERS report online

Free text

Release 3 — day 0, dose 1

2021-02-03

Systemic reaction (other): metallic taste in mouth

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): Metallic taste, runny nose.

2021-02-05

Systemic reaction (other): Coughing, dry mouth, loss of appetite

2021-02-06

Systemic reaction (other): Loss of appetite, slight nausea, coughing

2021-02-07

Systemic reaction (other): Coughing

2021-02-08

Systemic reaction (other): Runny nose

Release 4 — day 7, dose 1

2021-02-10

Systemic reaction (other): Runny nose

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): Numbness in arm, visual effects

2021-03-07

Systemic reaction (other): Congestion, sore throat.

2021-03-11

Systemic reaction (other): Been extremely exhausted for the last two days. Also nasal drainage. Had that with the first shot too, but thought it was maybe a cold. Odd to have it again after the 2nd dose.

Release 10 — day 0, dose 3

2021-11-28

Systemic reaction (other): Tingling in lips

Release 10 — days 1–6 daily, dose 3

2021-12-04

Systemic reaction (other): Depressed mood.

Release 10 — day 21, dose 3

2021-12-22

Symptoms: Headache nausea. May be unrelated to vaccine

Release 10 — day 28, dose 3

2021-12-29

Symptoms: Nasal congestion, scratchy throat, headache.

Release 10 — day 35, dose 3

2022-01-02

Symptoms: I have COVID, respiratory symptoms, fatigue, headache and body aches

Release 11 — 3 months, dose 3

2022-02-27

Symptoms: I had covid on dec 28 and recovered. I have since been suffering with symptoms of long covid.

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	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Post-acute COVID-19 syndrome	·	·	✓
SD	Respiratory symptom	·	·	✓
SD	Throat irritation	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Depressed mood	·	·	✓
SRO	Dry mouth	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Paraesthesia oral	·	·	✓
SRO	Paranasal sinus hypersecretion	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Visual impairment	✓	✓	✓

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