YWW-30035-77566

4 vaccinations 23 coded responses 44 check-ins 22 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 462 / IN
Registered: 2021-02-11

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

2021-02-11
Registered in v-safe
2021-02-11
Dose 1 — Moderna
2021-02-11
Health check-in — day 0, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Nausea, Vomiting, Diarrhea, Abdominal pain

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2021-02-15
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Neck pain — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Severe dizziness, neck pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Fever · Headache

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 7, dose 1
Feeling: Fair · None

Adult check-in
2021-02-25
Survey response — day 14, dose 1
MedDRA: Injection site pruritus, Pyrexia — Feeling: Fair

Free text: The injection site itched like crazy for three days. I also have an intermittent low-grade fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-11
Dose 2 — Moderna
2021-03-11
Survey response — day 0, dose 2
MedDRA: Hypoaesthesia — Feeling: Fair · Fever · Chills, Fatigue or tiredness

Free text: Injection site does not hurt but my whole arm feels numb

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Neck pain — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: My neck is really sore on the injection side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Fatigue or tiredness, Nausea

Free text: Sore thtoat

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: Dizziness — Feeling: Fair · Fatigue or tiredness

Free text: Really dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 7, dose 2
MedDRA: Dizziness — Feeling: Good

Free text: Still dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-01
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-08
Survey response — day 28, dose 2
MedDRA: Dizziness, Unevaluable event, Vertigo — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Uncontrollable dizziness / vertigo. Loud noise in left ear that prohibits sleep · Healthcare visit (other): Waiting for neurologist appointment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — day 28, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-15
Survey response — day 35, dose 2
MedDRA: Balance disorder, Dizziness, Loss of personal independence in daily activities, Sleep disorder, Vertigo — Feeling: Poor · Be unable to do your normal daily activities

Free text: Dizziness / vertigo will not go away. It is constant and unrelenting. It's difficult to sleep and eat and walk without bouncing off of things or having to catch my balance.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 42, dose 2
MedDRA: Dizziness, Insomnia, Unevaluable event — Feeling: Poor · 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: Symptoms: Still incredibly dizzy. Sometimes a lot dizzier than others. No time when I'm not dizzy. Difficult to sleep · Healthcare visit (other): MRI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-10
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-11
Survey response — 6 months, dose 2
MedDRA: Dizziness, Office visit, Vertigo — Feeling: Fair · 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: My vertigo has gotten much stronger and more constant. I'm dizzy 95% of the time. I've had MRIs and been to a neurologist and they say it's idiopathic.

MedDRA releases: 2024-11 · check-in free text available
2021-09-11
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

1 call case(s)
2021-09-14
Call 1 — Left Voicemail
2021-10-07
Call successful
Participant prefers to complete VAERS report online
2021-10-07
Call successful
Participant prefers to complete VAERS report online
2021-10-07
Call successful
Participant prefers to complete VAERS report online
2021-11-02
Dose 3 — Moderna
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Chills, Diarrhoea, Ear pain, Gingival blister, Headache, Hyperhidrosis, Nausea, Pain — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Headache, body aches, nausea, chills, sweats, diarrhea, ear pain, blister on left upper gum

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite, Dizziness — Feeling: Poor · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Absolutely no appetite, dizzy

MedDRA releases: 2024-11 · check-in free text available
2021-11-07
Survey response — days 1–6 daily, dose 3
MedDRA: Ear disorder, Gingival blister, Gingival pain — Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Still have painful blisters on my upper back left gum. I got my injection on the left side and that seems to have messed up my ear as well.

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Chills, Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-11-09
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-11-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-30
Survey response — day 28, dose 3
MedDRA: Dizziness, Headache — Feeling: Good

Free text: Dizziness is slightly worse than normal and headaches are lasting longer.

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Survey response — day 35, dose 3
MedDRA: Diarrhoea, Migraine, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea, nausea, migraines

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Survey response — day 42, dose 3
MedDRA: Decreased appetite, Diarrhoea, Neck pain, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Unrelenting diarrhea, fever, neck pain, loss of appetite

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-03
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-10-05
Dose 4 — Pfizer-BioNTech
2022-10-12
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-10-19
Survey response — day 14, dose 4
MedDRA: Body temperature increased, Ear discomfort, Ear pain, Oropharyngeal pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Very sore throat, clogged and painful ears, elevated temp

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Survey response — day 21, dose 4
MedDRA: Chills, Cough, Pyrexia, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Horrible sinus infection, deep unending cough, fever, chills

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-11-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-16
Survey response — day 42, dose 4
MedDRA: Flatulence, Gastrointestinal pain, Nausea — Feeling: Poor · Be unable to do your normal daily activities

Free text: Gut pain, nauseous most of the time, trapped gas

MedDRA releases: 2024-11 · check-in free text available
2023-01-04
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-04-05
Survey response — 6 months, dose 4
MedDRA: COVID-19, Dizziness, Feeding disorder, Loss of personal independence in daily activities, Migraine, Office visit, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-04-05
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2023-04-06
Call 1 — Left Voicemail
2023-04-06
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-11	Moderna
3	2021-11-02	Moderna	No
4	2022-10-05	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-08	Successful 2021-10-07	Participant prefers to complete VAERS report online
2021-04-22	Successful 2021-10-07	Participant prefers to complete VAERS report online
2021-09-11	Successful 2021-10-07	Participant prefers to complete VAERS report online
2023-04-05	Successful 2023-04-06	Does not wish to fill out VAERS report

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-15

Systemic reaction (other): Severe dizziness, neck pain

2021-02-16

Systemic reaction (other): Sore throat

Release 4 — day 14, dose 1

2021-02-25

Symptoms: The injection site itched like crazy for three days. I also have an intermittent low-grade fever.

Release 5 — day 0, dose 2

2021-03-11

Systemic reaction (other): Injection site does not hurt but my whole arm feels numb

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): My neck is really sore on the injection side

2021-03-15

Systemic reaction (other): Sore throat

2021-03-16

Systemic reaction (other): Sore thtoat

2021-03-17

Systemic reaction (other): Really dizzy

Release 5 — day 7, dose 2

2021-03-18

Systemic reaction (other): Still dizzy

Release 7 — day 28, dose 2

2021-04-08

Symptoms: Uncontrollable dizziness / vertigo. Loud noise in left ear that prohibits sleep

Healthcare visit (other): Waiting for neurologist appointment

Release 7 — day 35, dose 2

2021-04-15

Symptoms: Dizziness / vertigo will not go away. It is constant and unrelenting. It's difficult to sleep and eat and walk without bouncing off of things or having to catch my balance.

Release 7 — day 42, dose 2

2021-04-22

Symptoms: Still incredibly dizzy. Sometimes a lot dizzier than others. No time when I'm not dizzy. Difficult to sleep

Healthcare visit (other): MRI

Release 9 — 6 months, dose 2

2021-09-11

Symptoms: My vertigo has gotten much stronger and more constant. I'm dizzy 95% of the time. I've had MRIs and been to a neurologist and they say it's idiopathic.

Release 10 — days 1–6 daily, dose 3

2021-11-05

Systemic reaction (other): Headache, body aches, nausea, chills, sweats, diarrhea, ear pain, blister on left upper gum

2021-11-06

Systemic reaction (other): Absolutely no appetite, dizzy

2021-11-07

Systemic reaction (other): Still have painful blisters on my upper back left gum. I got my injection on the left side and that seems to have messed up my ear as well.

Release 10 — day 28, dose 3

2021-11-30

Symptoms: Dizziness is slightly worse than normal and headaches are lasting longer.

Release 10 — day 35, dose 3

2021-12-07

Symptoms: Diarrhea, nausea, migraines

Release 10 — day 42, dose 3

2021-12-14

Symptoms: Unrelenting diarrhea, fever, neck pain, loss of appetite

Release 12 — day 14, dose 4

2022-10-19

Symptoms: Very sore throat, clogged and painful ears, elevated temp

Release 12 — day 21, dose 4

2022-10-26

Symptoms: Horrible sinus infection, deep unending cough, fever, chills

Release 12 — day 42, dose 4

2022-11-16

Symptoms: Gut pain, nauseous most of the time, trapped gas

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	Office visit	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Balance disorder	✓	✓	✓
SD	Body temperature increased	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Ear discomfort	·	·	✓
SD	Ear pain	·	·	✓
SD	Feeding disorder	·	·	✓
SD	Flatulence	·	·	✓
SD	Gastrointestinal pain	·	·	✓
SD	Headache	·	·	✓
SD	Injection site pruritus	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Migraine	·	·	✓
SD	Nausea	·	·	✓
SD	Neck pain	·	·	✓
SD	Office visit	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Sleep disorder	✓	✓	✓
SD	Vertigo	✓	✓	✓
SRO	Chills	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Diarrhoea	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear disorder	·	·	✓
SRO	Ear pain	·	·	✓
SRO	Gingival blister	·	·	✓
SRO	Gingival pain	·	·	✓
SRO	Headache	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Hypoaesthesia	✓	✓	✓
SRO	Nausea	·	·	✓
SRO	Neck pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain	·	·	✓

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