ZL6-10096-01144

3 vaccinations 16 coded responses 40 check-ins 16 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 972 / OR
Registered: 2021-04-21

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

2021-04-21
Registered in v-safe
2021-04-21
Dose 1 — Moderna
2021-04-21
Survey response — day 0, dose 1
MedDRA: Pre-existing disease — Feeling: Good · Site: Pain

Free text: I've been dealing with unrelated back pain for a week (muscle related) and I feel better this afternoon, after the shot. Probably endorphins? Inflammation going elsewhere?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain, Paranasal sinus discomfort — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Free text: Sore throat and sinus pressure ; I'm thinking that's more hay fever despite my regular antihistamine

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

Free text: Runny nose, sore throat (allergies are bad!)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain, Paranasal sinus discomfort — Feeling: Good · Headache, Fatigue or tiredness

Free text: Sinus pressure, sore throat, hay fever probably

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Good

Free text: Mild sore throat and runny nose, maybe allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-04-28
Survey response — day 7, dose 1
MedDRA: Oropharyngeal pain — Feeling: Poor · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Mild sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — day 14, dose 1
MedDRA: Diarrhoea, Medical counselling, Vomiting — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I had vomiting on day 7 and diarrhea on day 7, 8, 10, 11. Doc offered covid test, I was going to take it if symptoms worsened or persisted.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Report sent to call center — day 14, dose 1
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)
2021-05-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-19
Dose 2 — Moderna
2021-05-19
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-05-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-05-26
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-06-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-09
Survey response — day 21, dose 2
MedDRA: Back pain — Feeling: Good

Free text: Probably unrelated: back muscle pain. Likely due to posture but I haven't done anything unusual so I don't know what triggered it

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-27
Dose 3 — Moderna
2021-11-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-11-30
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain, Sinus congestion — Feeling: Fair · Site: Pain · Headache, Nausea

Free text: Sore throat and sinus congestion

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-04
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-18
Survey response — day 21, dose 3
MedDRA: Oropharyngeal pain, Respiratory tract congestion — Feeling: Good

Free text: Mild sore throat and congestion

MedDRA releases: 2024-11 · check-in free text available
2021-12-26
Survey response — day 28, dose 3
MedDRA: Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Good

Free text: Sore throat congestion, comes and goes, at home rapid COVID test negative

MedDRA releases: 2024-11 · check-in free text available
2022-01-01
Survey response — day 35, dose 3
MedDRA: Cough, Nasal congestion — Feeling: Fair

Free text: Cough, nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Survey response — day 42, dose 3
MedDRA: Fatigue, Hyposmia, Nasal congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Earlier this week: Subdued sense of smell, significantly increased fatigue, stronger nasal congestion

MedDRA releases: 2024-11 · check-in free text available
2022-02-26
Survey response — 3 months, dose 3
MedDRA: Nasopharyngitis, Respiratory tract congestion — Feeling: Good

Free text: I've had a few bouts with congestion or cold symptoms that resolve in a few days

MedDRA releases: 2024-11 · check-in free text available
2022-04-15
Call 1 — Left Voicemail
2022-05-28
Survey response — 6 months, dose 3
MedDRA: Adverse drug reaction, COVID-19 — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Got back on ritalin, experienced chest pain, which hasn't happened before (was on it 1997-2003, 2011-12) Hopefully not related to covid in jan 2022

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-31
Call 2 — Left Voicemail
2022-05-31
Call 1 — Left Voicemail
2022-11-29
Survey response — 12 months, dose 3
MedDRA: Nasopharyngitis, Respiratory tract congestion — Feeling: Good · Be unable to work or attend school

Free text: Eh the same cold symptoms going around every winter: stuffy, etc

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-21	Moderna
2	2021-05-19	Moderna
3	2021-11-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-05	Unsuccessful
2022-05-28	Unsuccessful

Free text

Release 7 — day 0, dose 1

2021-04-21

Systemic reaction (other): I've been dealing with unrelated back pain for a week (muscle related) and I feel better this afternoon, after the shot. Probably endorphins? Inflammation going elsewhere?

Release 7 — days 1–6 daily, dose 1

2021-04-22

Systemic reaction (other): Sore throat and sinus pressure ; I'm thinking that's more hay fever despite my regular antihistamine

2021-04-23

Systemic reaction (other): Runny nose, sore throat (allergies are bad!)

2021-04-24

Systemic reaction (other): Sinus pressure, sore throat, hay fever probably

2021-04-25

Systemic reaction (other): Mild sore throat and runny nose, maybe allergies

Release 8 — day 7, dose 1

2021-04-28

Systemic reaction (other): Mild sore throat

Release 8 — day 14, dose 1

2021-05-05

Symptoms: I had vomiting on day 7 and diarrhea on day 7, 8, 10, 11. Doc offered covid test, I was going to take it if symptoms worsened or persisted.

Release 9 — day 21, dose 2

2021-06-09

Symptoms: Probably unrelated: back muscle pain. Likely due to posture but I haven't done anything unusual so I don't know what triggered it

Release 10 — days 1–6 daily, dose 3

2021-11-30

Systemic reaction (other): Sore throat and sinus congestion

Release 10 — day 21, dose 3

2021-12-18

Symptoms: Mild sore throat and congestion

Release 10 — day 28, dose 3

2021-12-26

Symptoms: Sore throat congestion, comes and goes, at home rapid COVID test negative

Release 10 — day 35, dose 3

2022-01-01

Symptoms: Cough, nasal congestion

Release 10 — day 42, dose 3

2022-01-08

Symptoms: Earlier this week: Subdued sense of smell, significantly increased fatigue, stronger nasal congestion

Release 11 — 3 months, dose 3

2022-02-26

Symptoms: I've had a few bouts with congestion or cold symptoms that resolve in a few days

Release 11 — 6 months, dose 3

2022-05-28

Symptoms: Got back on ritalin, experienced chest pain, which hasn't happened before (was on it 1997-2003, 2011-12) Hopefully not related to covid in jan 2022

Release 12 — 12 months, dose 3

2022-11-29

Symptoms: Eh the same cold symptoms going around every winter: stuffy, etc

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	Adverse drug reaction	·	·	✓
SD	Back pain	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Hyposmia	·	·	✓
SD	Medical counselling	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vomiting	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Paranasal sinus discomfort	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sinus congestion	·	·	✓

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