22E-10245-26498

2 vaccinations 8 coded responses 24 check-ins 8 free-text entries 5 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 956 / CA
Registered: 2021-01-05

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

2021-01-04
Dose 1 — Moderna
2021-01-05
Registered in v-safe
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Dry eye, Pyrexia — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Last night my fever was much higher and I had uncontrollable chills and dry eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-06
Survey response — days 1–6 daily, dose 1
MedDRA: Breast feeding, Cold sweat, Hot flush, Night sweats, Unevaluable event — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): I am breastfeeding and my baby also has a rash. I am at the er with him now to get him checked out. I am also having bad night sweats saturating my clothing and cold sweats with hot flashes during the day. · Healthcare visit (other): I had to take my baby to the er and I am calling my doctor as soon as my babies taken care of.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Report sent to call center — days 1–6 daily, 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)
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Breast feeding, Rash — Feeling: Fair · Site: Pain, Itching · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: My babies rash is almost gone. I am breastfeeding.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

no matching call case
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Blepharospasm — Feeling: Poor · Site: Pain, Swelling, Itching · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Left eye twitching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-10
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-11
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-25
Survey response — day 21, dose 1
MedDRA: Abdominal pain upper, Hypersomnia, Nausea, Vomiting — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: I got bad stomach pain yesterday out of nowhere and vomited which I never do and then slept for almost 24 hours. The stomach pain radiated to my head and I had bad nausea. I am not pregnant.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Dose 2 — Moderna
2021-02-01
Survey response — day 0, dose 2
MedDRA: Palpitations — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Racing heart beat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Breast feeding — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Im breastfeeding

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-09
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-12
Call successful
Participant prefers to complete VAERS report online
2021-02-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-05
Survey response — 3 months, dose 2
MedDRA: Diarrhoea, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Diarrhea, hearing problems. I have had serious problems hearing since I had covid in August 2020.After I got vaccinated my hearing drastically improved but the past two weeks it has been worsening again. · Healthcare visit (other): Referral for hearing tests

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-14
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-08-02
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-02-01	Moderna

Call center

5 call center cases

5 successful

1 check-in flagged for a call with no call center case on record

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-05

Systemic reaction (other): Last night my fever was much higher and I had uncontrollable chills and dry eyes

2021-01-06

Systemic reaction (other): I am breastfeeding and my baby also has a rash. I am at the er with him now to get him checked out. I am also having bad night sweats saturating my clothing and cold sweats with hot flashes during the day.

Healthcare visit (other): I had to take my baby to the er and I am calling my doctor as soon as my babies taken care of.

2021-01-07

Systemic reaction (other): My babies rash is almost gone. I am breastfeeding.

2021-01-08

Systemic reaction (other): Left eye twitching

Release 2 — day 21, dose 1

2021-01-25

Symptoms: I got bad stomach pain yesterday out of nowhere and vomited which I never do and then slept for almost 24 hours. The stomach pain radiated to my head and I had bad nausea. I am not pregnant.

Release 3 — day 0, dose 2

2021-02-01

Systemic reaction (other): Racing heart beat

Release 3 — days 1–6 daily, dose 2

2021-02-02

Systemic reaction (other): Im breastfeeding

Release 8 — 3 months, dose 2

2021-05-05

Symptoms: Diarrhea, hearing problems. I have had serious problems hearing since I had covid in August 2020.After I got vaccinated my hearing drastically improved but the past two weeks it has been worsening again.

Healthcare visit (other): Referral for hearing tests

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	Unevaluable event	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Hypersomnia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Blepharospasm	✓	✓	✓
SRO	Breast feeding	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Cold sweat	✓	✓	✓
SRO	Dry eye	✓	✓	✓
SRO	Hot flush	✓	✓	✓
SRO	Maternal exposure during breast feeding	○	○	○
SRO	Night sweats	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓

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