YUH-26972-08227

2 vaccinations 6 coded responses 22 check-ins 6 free-text entries 4 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 647 / MO
Registered: 2021-04-01

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

2021-03-30
Dose 1 — Moderna
2021-04-01
Registered in v-safe
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 1
MedDRA: Chest pain, Oral discomfort, Toothache — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Teeth pain for several days but may have a sinus infection and also have a sever burn in my mouth. Slight Chest pain off and on for the last several days

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

1 call case(s)
2021-04-04
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Mild Chest pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-04-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-27
Dose 2 — Moderna
2021-04-27
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Palpitations — Feeling: Fair · Site: Pain · Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Free text: Heart racing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-05
Health check-in — day 7, dose 2
Feeling: Fair · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-05-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-14
Call 1 — Left Voicemail
2021-07-30
Survey response — 3 months, dose 2
MedDRA: Headache, Inflammation, Paranasal sinus hypersecretion, Sinusitis, Toothache — 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: Just more inflammation in sinus area. Three sinus infections after Covid vaccination. Sinus drainage, head and teeth pain more severe than normal. I may have had them anyway but inflammation was intense.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-30
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)
2021-10-26
Survey response — 6 months, dose 2
MedDRA: Blood glucose increased, Discomfort, Headache, Kidney infection, Office visit, Sinus disorder, Urinary tract infection — Feeling: Fair · 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: Symptoms: UTI, turned into kidney infection, Kidneys feel bruised often, headaches, sinus issues and elevated blood sugars in am after fasting for 12 plus hours. · Healthcare visit (other): I also saw my primary care doctor and will see a urologist I'm Nov

MedDRA releases: 2024-11 · check-in free text available
2021-10-26
Report sent to call center — 6 months, dose 2
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)
2021-10-26
Call 1 — Left Voicemail
2021-10-27
Call 1 — Left Voicemail
2021-11-10
Call successful
Participant prefers to complete VAERS report online
2022-04-27
Survey response — 12 months, dose 2
MedDRA: Blood glucose increased, COVID-19, Malaise, Medical counselling, Neuralgia, Office visit, Pyrexia, Respiratory disorder — 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

Free text: Symptoms: Nerve pain off and on in teeth after one of the shots and on going. Hard to know why. Also had Covid after the third shot or booster, with sinus, lungs compromised, fever, very sick. Also, have some elevated blood sugar levels. Working to improve. · Healthcare visit (other): Phone visit, doctor visit and dentist

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-04-28
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-30	Moderna
2	2021-04-27	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-03	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-07-30	Successful	Participant prefers to complete VAERS report online
2021-10-26	Successful 2021-11-10	Participant prefers to complete VAERS report online
2022-04-27	Successful 2022-04-28	Participant prefers to complete VAERS report online

Free text

Release 6 — days 1–6 daily, dose 1

2021-04-03

Systemic reaction (other): Teeth pain for several days but may have a sinus infection and also have a sever burn in my mouth. Slight Chest pain off and on for the last several days

2021-04-04

Systemic reaction (other): Mild Chest pain

Release 8 — days 1–6 daily, dose 2

2021-04-29

Systemic reaction (other): Heart racing

Release 9 — 3 months, dose 2

2021-07-30

Symptoms: Just more inflammation in sinus area. Three sinus infections after Covid vaccination. Sinus drainage, head and teeth pain more severe than normal. I may have had them anyway but inflammation was intense.

Release 10 — 6 months, dose 2

2021-10-26

Symptoms: UTI, turned into kidney infection, Kidneys feel bruised often, headaches, sinus issues and elevated blood sugars in am after fasting for 12 plus hours.

Healthcare visit (other): I also saw my primary care doctor and will see a urologist I'm Nov

Release 11 — 12 months, dose 2

2022-04-27

Symptoms: Nerve pain off and on in teeth after one of the shots and on going. Hard to know why. Also had Covid after the third shot or booster, with sinus, lungs compromised, fever, very sick. Also, have some elevated blood sugar levels. Working to improve. cut off by CDC

Healthcare visit (other): Phone visit, doctor visit and dentist

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	Office visit	·	·	✓
SD	Blood glucose increased	·	·	✓
SD	COVID-19	·	·	✓
SD	Discomfort	·	·	✓
SD	Headache	✓	·	✓
SD	Inflammation	✓	·	✓
SD	Kidney infection	·	·	✓
SD	Malaise	·	·	✓
SD	Neuralgia	·	·	✓
SD	Paranasal sinus hypersecretion	✓	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	Sinus disorder	·	·	✓
SD	Sinusitis	✓	·	✓
SD	Toothache	✓	·	✓
SD	Urinary tract infection	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Oral discomfort	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Toothache	✓	✓	✓

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