2DU-10782-82678

3 vaccinations 8 coded responses 37 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 541 / WI
Registered: 2021-03-04

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

2021-03-04
Registered in v-safe
2021-03-04
Dose 1 — Moderna
2021-03-04
Health check-in — day 0, dose 1
Feeling: Fair · Nausea

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2021-03-11
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-25
Survey response — day 21, dose 1
MedDRA: Headache — Feeling: Good

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Dose 2 — Moderna
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Muscle or body aches

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever · Chills

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Chills, Fatigue or tiredness

Adult check-in
2021-04-08
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-15
Survey response — day 14, dose 2
MedDRA: Hypersensitivity, Rhinorrhoea — Feeling: Good

Free text: Runny nose - probably allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 21, dose 2
MedDRA: Cough, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea — Feeling: Good

Free text: Mild cold symptoms - runny nose, congestion, sore throat, cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Survey response — 6 months, dose 2
MedDRA: Pregnancy — Feeling: Good · 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: Pregnancy

MedDRA releases: 2024-11 · check-in free text available
2021-09-30
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-05
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-26
Dose 3 — Moderna
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness, Nausea

Adult check-in
2021-11-09
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Survey response — day 35, dose 3
MedDRA: Abdominal pain, Dizziness, Nausea, Vomiting — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dizzy, nausea, light headed, vomitting, abdominal cramps

MedDRA releases: 2024-11 · check-in free text available
2021-12-07
Survey response — day 42, dose 3
MedDRA: Cough — Feeling: Fair · Be unable to do your normal daily activities

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Survey response — 3 months, dose 3
MedDRA: Delivery — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Had a baby 1/16

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-27
Call 1 — Left Voicemail
2022-04-26
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-26
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna
3	2021-10-26	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-30	Successful 2021-10-05	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-25	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-05

Systemic reaction (other): Brain fog

Release 6 — day 21, dose 1

2021-03-25

Symptoms: Headache

Release 7 — day 14, dose 2

2021-04-15

Symptoms: Runny nose - probably allergies

Release 7 — day 21, dose 2

2021-04-22

Symptoms: Mild cold symptoms - runny nose, congestion, sore throat, cough

Release 9 — 6 months, dose 2

2021-09-30

Symptoms: Pregnancy

Release 10 — day 35, dose 3

2021-11-30

Symptoms: Dizzy, nausea, light headed, vomitting, abdominal cramps

Release 10 — day 42, dose 3

2021-12-07

Symptoms: Cough

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Had a baby 1/16

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	Cough	✓	✓	✓
SD	Delivery	·	·	✓
SD	Dizziness	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypersensitivity	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Vomiting	·	·	✓
SRO	Feeling abnormal	✓	✓	✓

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