YXZ-12822-58070

3 vaccinations 15 coded responses 31 check-ins 15 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 971 / OR
Registered: 2020-12-26

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

2020-12-26
Registered in v-safe
2020-12-26
Dose 1 — Moderna
2020-12-26
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2020-12-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Stomatitis, Throat lesion — Feeling: Fair · Joint pains, Muscle or body aches, Diarrhea

Free text: Mouth and throat sores

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Survey response — day 7, dose 1
MedDRA: Ear pain, Oropharyngeal pain, Pharyngeal ulceration, Stomatitis — Feeling: Fair · Joint pains, Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Sore throat, white sores in throat and mouth, earache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Report sent to call center — day 7, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-09
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-18
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-01-21
Dose 2 — Moderna
2021-01-22
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Dizziness, Gastrointestinal pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Low back pain and lower intestinal pain, dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Irritability

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 2
MedDRA: Clumsiness, Hunger, Irritability — Feeling: Fair · Site: Pain

Free text: Irritability, clumsiness, hunger

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal distension — Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Bloating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — day 7, dose 2
MedDRA: Abdominal distension, Dizziness, Flatulence, Nasal congestion, Throat irritation — Feeling: Fair · Joint pains, Muscle or body aches

Free text: Bloating, gas, dizziness, throat irritation, nasal congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — day 14, dose 2
MedDRA: Fatigue, Headache, Menstrual disorder — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Headache, fatigue, monthly cycle issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-02-18
Survey response — day 28, dose 2
MedDRA: Diarrhoea — Feeling: Fair

Free text: Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-04-24
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Myalgia — Feeling: Fair · Be unable to work, 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: Joint and muscle pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-07
Call successful
Not applicable - Accidental Reporting
2021-07-22
Survey response — 6 months, dose 2
MedDRA: Abdominal pain, Back pain, Pelvic pain — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Severe low back, pelvic, and abdominal pain

MedDRA releases: 2024-11 · check-in free text available
2021-12-02
Dose 3 — Moderna
2021-12-02
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 3
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

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling · Headache, Joint pains, Muscle or body aches, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Swelling · Headache, Joint pains, Muscle or body aches, Abdominal pain

Adult check-in
2021-12-25
Survey response — day 21, dose 3
MedDRA: Malaise — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Feel sick

MedDRA releases: 2024-11 · check-in free text available
2022-01-01
Survey response — day 28, dose 3
MedDRA: Chills, Cough, Dyspnoea, Ear pain, Fatigue, Headache, Hyperhidrosis, Otorrhoea, Pain, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Shortness of breath, body aches, fatigue, cough, headache, chest congestion, ear pain and drainage, chills, sweats

MedDRA releases: 2024-11 · check-in free text available
2022-01-06
Survey response — day 35, dose 3
MedDRA: Back pain, Bradycardia, Dyspnoea, Ear pain, Fatigue, Intermenstrual bleeding, Menstruation irregular, Muscle twitching, Purulent discharge, Uterine pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Period entire week early, two weeks ago. Now, severe uterine pain and spotting, and low and mid-back pain. Earache and purlent drainage, air hunger, bradycardia, muscle twitching, and fatigue. Not able to see primary care because booked out too far.

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Survey response — 6 months, dose 3
MedDRA: Abdominal pain, Fatigue, Lymphadenopathy, Menstruation irregular, Pelvic pain, Pre-existing disease, Vertigo — 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: Severe fatigue, intolerance to onions, abdominal and pelvic pain, disruption in menstrual cycle, chronic headaches, swollen lymph nodes, vertigo

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Report sent to call center — 6 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)
2022-06-03
Call 1 — Requested Callback
2022-06-06
Call 2 — Left Voicemail
2022-06-06
Callback requested for

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-26	Moderna
2	2021-01-21	Moderna
3	2021-12-02	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-02	priority 2/3
2021-04-24	Successful 2021-06-07	Not applicable - Accidental Reporting
2022-06-02	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-01

Systemic reaction (other): Mouth and throat sores

Release 1 — day 7, dose 1

2021-01-02

Systemic reaction (other): Sore throat, white sores in throat and mouth, earache

Release 2 — days 1–6 daily, dose 2

2021-01-22

Systemic reaction (other): Low back pain and lower intestinal pain, dizziness

2021-01-23

Systemic reaction (other): Irritability

2021-01-24

Systemic reaction (other): Irritability, clumsiness, hunger

2021-01-27

Systemic reaction (other): Bloating

Release 3 — day 7, dose 2

2021-01-28

Systemic reaction (other): Bloating, gas, dizziness, throat irritation, nasal congestion

Release 3 — day 14, dose 2

2021-02-04

Symptoms: Headache, fatigue, monthly cycle issues

Release 4 — day 28, dose 2

2021-02-18

Symptoms: Diarrhea

Release 7 — 3 months, dose 2

2021-04-24

Symptoms: Joint and muscle pain

Release 9 — 6 months, dose 2

2021-07-22

Symptoms: Severe low back, pelvic, and abdominal pain

Release 10 — day 21, dose 3

2021-12-25

Symptoms: Feel sick

Release 10 — day 28, dose 3

2022-01-01

Symptoms: Shortness of breath, body aches, fatigue, cough, headache, chest congestion, ear pain and drainage, chills, sweats

Release 10 — day 35, dose 3

2022-01-06

Symptoms: Period entire week early, two weeks ago. Now, severe uterine pain and spotting, and low and mid-back pain. Earache and purlent drainage, air hunger, bradycardia, muscle twitching, and fatigue. Not able to see primary care because booked out too far. cut off by CDC

Release 11 — 6 months, dose 3

2022-06-02

Symptoms: Severe fatigue, intolerance to onions, abdominal and pelvic pain, disruption in menstrual cycle, chronic headaches, swollen lymph nodes, vertigo

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	Abdominal pain	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Back pain	·	·	✓
SD	Bradycardia	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Ear pain	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hyperhidrosis	·	·	✓
SD	Intermenstrual bleeding	·	·	✓
SD	Lymphadenopathy	·	·	✓
SD	Malaise	·	·	✓
SD	Menstrual disorder	✓	✓	✓
SD	Menstruation irregular	·	·	✓
SD	Muscle twitching	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Otorrhoea	·	·	✓
SD	Pain	·	·	✓
SD	Pelvic pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Purulent discharge	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Uterine pain	·	·	✓
SD	Vertigo	·	·	✓
SRO	Abdominal distension	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Clumsiness	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Gastrointestinal pain	✓	✓	✓
SRO	Hunger	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pharyngeal ulceration	✓	✓	✓
SRO	Stomatitis	✓	✓	✓
SRO	Throat irritation	✓	✓	✓
SRO	Throat lesion	✓	✓	✓

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