YYQ-26136-92681

4 vaccinations 9 coded responses 32 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 603 / IL
Registered: 2021-03-18

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-03-18
Registered in v-safe
2021-03-18
Dose 1 — Moderna
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Dry mouth, Thirst — Feeling: Good · Site: Pain

Free text: Thirsty. Woke up with dryer than usual mouth

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 1
MedDRA: Thirst — Feeling: Good · Site: Pain

Free text: Still thirsty

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Woke up with slightly sore and groggy throat, like I had a mini cold. Not sure if connected to shot or not, or if could be allergies?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Survey response — days 1–6 daily, dose 1
MedDRA: Hypersensitivity, Oropharyngeal pain — Feeling: Good

Free text: Slight sore throat when woke up again? Allergies??

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-01
Survey response — day 14, dose 1
MedDRA: Deafness, Hypersensitivity, Office visit, Pre-existing disease, Tinnitus — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I dont know If connected or not more Tinnitus in right ear may have coincided with time frame of getting shot. Allergic feeling throat (but allergists eee upon us during spring) · Healthcare visit (other): Went to ENT to be sure it wasnt sudden hearing loss (that o had 10 years ago) coming back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-15
Dose 2 — Moderna
2021-04-15
Survey response — day 0, dose 2
MedDRA: Dizziness, Immediate post-injection reaction — Feeling: Good · Site: Pain

Free text: Possible slight dizziness shortly after vaccination while waiting 15 minutes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain, Pain in extremity — Feeling: Good · Site: Pain

Free text: Just still soreness in arm and shot area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-09
Call 1 — Left Voicemail
2021-07-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-10
Dose 3 — Moderna
2022-04-18
Survey response — 12 months, dose 2
MedDRA: Nasopharyngitis, Sputum discoloured — Feeling: Good

Free text: Had a cold with yellow mucus. Went away after about 2-3 weeks

MedDRA releases: 2024-11 · check-in free text available
2022-04-20
Dose 4 — Moderna
2022-04-30
Health check-in — day 7, dose 4
Feeling: Good · Joint pains · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2022-04-30
Report sent to call center — day 7, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-02
Call 1 — Left Voicemail
2022-05-04
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-18
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-20
Survey response — 6 months, dose 4
MedDRA: Nasopharyngitis, Pre-existing disease, Respiratory tract congestion — Feeling: Fair

Free text: Bad cold and congestion. More allergies than sick

MedDRA releases: 2024-11 · check-in free text available
2023-04-22
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-15	Moderna
3	2021-11-10	Moderna	No
4	2022-04-20	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-01	Unsuccessful
2022-04-30	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-19

Systemic reaction (other): Thirsty. Woke up with dryer than usual mouth

Release 6 — days 1–6 daily, dose 1

2021-03-20

Systemic reaction (other): Still thirsty

2021-03-22

Systemic reaction (other): Woke up with slightly sore and groggy throat, like I had a mini cold. Not sure if connected to shot or not, or if could be allergies?

2021-03-23

Systemic reaction (other): Slight sore throat when woke up again? Allergies??

Release 6 — day 14, dose 1

2021-04-01

Symptoms: I dont know If connected or not more Tinnitus in right ear may have coincided with time frame of getting shot. Allergic feeling throat (but allergists eee upon us during spring)

Healthcare visit (other): Went to ENT to be sure it wasnt sudden hearing loss (that o had 10 years ago) coming back.

Release 7 — day 0, dose 2

2021-04-15

Systemic reaction (other): Possible slight dizziness shortly after vaccination while waiting 15 minutes

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): Just still soreness in arm and shot area

Release 11 — 12 months, dose 2

2022-04-18

Symptoms: Had a cold with yellow mucus. Went away after about 2-3 weeks

Release 12 — 6 months, dose 4

2022-10-20

Symptoms: Bad cold and congestion. More allergies than sick

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	Deafness	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Pre-existing disease	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sputum discoloured	·	·	✓
SD	Tinnitus	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dry mouth	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Thirst	✓	✓	✓

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