YW3-15751-23239

4 vaccinations 21 coded responses 47 check-ins 20 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 352 / AL
Registered: 2021-03-03

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Moderna
2021-03-03
Survey response — day 0, dose 1
MedDRA: Pruritus, Swelling face — Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: initial facial swelling that disappeared, all over itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus, Swelling face — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: all over itching, sensation of facial fullness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: all over itching, yet not as bad as prior 2 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good

Free text: arm still sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Good · Fever · Chills, Nausea

Free text: i forgot to report yesterday that i had a slight cough which ive had today. not painful, not productive - just out of the norm for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — day 7, dose 1
MedDRA: Dyspnoea — Feeling: Good

Free text: feeling winded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 14, dose 1
MedDRA: Chills, Diarrhoea, Fatigue, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: chills, nausea, diarrhea, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 21, dose 1
MedDRA: Chills, Diarrhoea, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: horrible diarrhea, fatigue, chills

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-02
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Lymphadenopathy, Oropharyngeal pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: sore throat, swollen glands, shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Lymphadenopathy, Oropharyngeal pain, Pyrexia — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: fever spiked last night but has diminished today. still have sore throat, swollen glands, shortness of breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Oropharyngeal pain — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: sore throat, shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-09
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-07
Survey response — day 35, dose 2
MedDRA: Asthma, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: worsening asthma

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Survey response — day 42, dose 2
MedDRA: Dyspnoea — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: difficulty breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-01
Survey response — 6 months, dose 2
MedDRA: Dizziness, Dyspnoea — 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: shortness of breath, difficulty catching breath, increased dizziness

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
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)
2021-10-06
Call 1 — Left Voicemail
2021-11-01
Dose 3 — Moderna
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · Fever · Chills

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · Chills, Fatigue or tiredness

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Itching · Fever · Chills

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-08
Health check-in — day 7, dose 3
Feeling: Fair · Site: Redness, Itching · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-15
Survey response — day 14, dose 3
MedDRA: Chills, Malaise, Oropharyngeal pain — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: malaise, chills, sore throat over the weekend

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — day 21, dose 3
MedDRA: Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: achy muscles

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-06
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-13
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-31
Survey response — 3 months, dose 3
MedDRA: Brain fog, COVID-19, Cough, Dyspnoea, Fatigue, Feeling of body temperature change, Headache, Myalgia, Nausea, Pain, Pyrexia — 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: Covid19. severe HA, all over body aches and muscle pain. freezing cold & brurbing hot cycle. fever. cough. short of breath. fatigue. brain fog. moderate nausea. Symptoms of HA, brain fog, shortness of breath/fatigue still lingering.

MedDRA releases: 2024-11 · check-in free text available
2022-01-31
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-04
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-07-23
Dose 4 — Moderna
2022-08-05
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-08-06
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-08-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-08-20
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-08-27
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-09-03
Survey response — day 42, dose 4
MedDRA: Asthma, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: worsening asthma

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Survey response — 3 months, dose 4
MedDRA: Sinusitis — 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: have had terrible sinus infection or something x 2 weeks.

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Report sent to call center — 3 months, dose 4
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)
2022-10-25
Call 1 — Left Voicemail
2023-01-21
Survey response — 6 months, dose 4
MedDRA: Influenza like illness, Lethargy — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-04-02	Moderna
3	2021-11-01	Moderna	No
4	2022-07-23	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-01	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-31	Successful 2022-02-01	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-10-22	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-03

Systemic reaction (other): initial facial swelling that disappeared, all over itching

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): all over itching, sensation of facial fullness

2021-03-05

Systemic reaction (other): all over itching, yet not as bad as prior 2 days

2021-03-06

Systemic reaction (other): arm still sore

2021-03-09

Systemic reaction (other): i forgot to report yesterday that i had a slight cough which ive had today. not painful, not productive - just out of the norm for me.

Release 5 — day 7, dose 1

2021-03-10

Systemic reaction (other): feeling winded

Release 5 — day 14, dose 1

2021-03-17

Symptoms: chills, nausea, diarrhea, fatigue

Release 6 — day 21, dose 1

2021-03-24

Symptoms: horrible diarrhea, fatigue, chills

Release 6 — days 1–6 daily, dose 2

2021-04-03

Systemic reaction (other): sore throat, swollen glands, shortness of breath

2021-04-04

Systemic reaction (other): fever spiked last night but has diminished today. still have sore throat, swollen glands, shortness of breath.

2021-04-05

Systemic reaction (other): sore throat, shortness of breath

Release 8 — day 35, dose 2

2021-05-07

Symptoms: worsening asthma

Release 8 — day 42, dose 2

2021-05-14

Symptoms: difficulty breathing

Release 9 — 6 months, dose 2

2021-10-01

Symptoms: shortness of breath, difficulty catching breath, increased dizziness

Release 10 — days 1–6 daily, dose 3

2021-11-03

Systemic reaction (other): sore throat

Release 10 — day 14, dose 3

2021-11-15

Symptoms: malaise, chills, sore throat over the weekend

Release 10 — day 21, dose 3

2021-11-22

Symptoms: achy muscles

Release 11 — 3 months, dose 3

2022-01-31

Symptoms: Covid19. severe HA, all over body aches and muscle pain. freezing cold & brurbing hot cycle. fever. cough. short of breath. fatigue. brain fog. moderate nausea. Symptoms of HA, brain fog, shortness of breath/fatigue still lingering.

Release 12 — day 42, dose 4

2022-09-03

Symptoms: worsening asthma

Release 12 — 3 months, dose 4

2022-10-22

Symptoms: have had terrible sinus infection or something x 2 weeks.

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	Asthma	✓	✓	✓
SD	Brain fog	·	·	✓
SD	Chills	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling of body temperature change	·	·	✓
SD	Headache	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Lethargy	·	·	✓
SD	Malaise	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Sinusitis	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Swelling face	✓	✓	✓

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