2FQ-30177-27455

4 vaccinations 14 coded responses 47 check-ins 13 free-text entries 2 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 070 / NJ
Registered: 2021-03-17

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

2021-03-17
Registered in v-safe
2021-03-17
Dose 1 — Moderna
2021-03-17
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Mild dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Survey response — days 1–6 daily, dose 1
MedDRA: Food allergy, Respiratory tract congestion — Feeling: Good

Free text: Seasonal Allergies - stuffy head

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: Fatigue, Hypersensitivity, Pre-existing disease, Respiratory tract congestion — Feeling: Good

Free text: Seasonal Allergies - tired, stuffy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Survey response — day 14, dose 1
MedDRA: Eye pruritus, Fatigue, Injection site erythema, Nasal congestion, Oropharyngeal pain, Seasonal allergy — Feeling: Good

Free text: New symptom - shoulder is red around the shot location - for a few daysWorsening - seasonal allergies symptoms - itchy eyes, sore throat, stuffy nose, tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-14
Dose 2 — Moderna
2021-04-14
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Mild dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-04-18
Survey response — days 1–6 daily, dose 2
MedDRA: Seasonal allergy — Feeling: Good · Fatigue or tiredness

Free text: Seasonal allergies

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 · Headache, Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-28
Survey response — day 14, dose 2
MedDRA: Headache — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Headaches, bad on some days - although may be due to different cause

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — day 21, dose 2
MedDRA: Anxiety, Back pain, Condition aggravated, Depression, Neck pain, Pre-existing disease, Seasonal allergy — Feeling: Good

Free text: Seasonal allergies upon being outsideBack and neck pain from old injuryAnxiety/depression

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-14
Survey response — 3 months, dose 2
MedDRA: Abortion spontaneous, Seasonal allergy — Feeling: Fair

Free text: Increased seasonal allergies, early miscarriage

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-13
Survey response — 6 months, dose 2
MedDRA: Abortion spontaneous, Pregnancy — Feeling: Fair

Free text: 1 miscarriage and a new Pregnant

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Dose 3 — Moderna
2021-12-10
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-12-11
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache

Adult check-in
2021-12-17
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-24
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-31
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-07
Survey response — day 28, dose 3
MedDRA: Epistaxis, Pregnancy — Feeling: Good

Free text: Nose bleeds - but likely due to pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-01-15
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-21
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-11
Survey response — 3 months, dose 3
MedDRA: Dizziness, Epistaxis, Pregnancy — Feeling: Good

Free text: Nose bleeds and dizziness, but typical of pregnancy!

MedDRA releases: 2024-11 · check-in free text available
2022-06-12
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-02
Dose 4 — Moderna
2022-11-04
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-11-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-11-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-11-16
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-30
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-08
Survey response — day 35, dose 4
MedDRA: Dizziness, Vertigo — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Daily Dizziness/Vertigo

MedDRA releases: 2024-11 · check-in free text available
2022-12-08
Report sent to call center — day 35, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-12-09
Call 1 — Left Voicemail
2022-12-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-02-01
Survey response — 3 months, dose 4
MedDRA: Cough, Dizziness, Exposure to SARS-CoV-2, Nausea, Oropharyngeal pain, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-02-01
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-02-02
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-02-02
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-08
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Moderna
2	2021-04-14	Moderna
3	2021-12-10	Moderna	No
4	2022-11-02	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-12-08	Successful 2023-02-02	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-02-01	Successful 2023-02-02	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5 — day 0, dose 1

2021-03-17

Systemic reaction (other): Mild dizziness

Release 6 — days 1–6 daily, dose 1

2021-03-22

Systemic reaction (other): Seasonal Allergies - stuffy head

2021-03-23

Systemic reaction (other): Seasonal Allergies - tired, stuffy

Release 6 — day 14, dose 1

2021-03-31

Symptoms: New symptom - shoulder is red around the shot location - for a few daysWorsening - seasonal allergies symptoms - itchy eyes, sore throat, stuffy nose, tired

Release 7 — day 0, dose 2

2021-04-14

Systemic reaction (other): Mild dizziness

Release 7 — days 1–6 daily, dose 2

2021-04-18

Systemic reaction (other): Seasonal allergies

Release 8 — day 14, dose 2

2021-04-28

Symptoms: Headaches, bad on some days - although may be due to different cause

Release 8 — day 21, dose 2

2021-05-05

Symptoms: Seasonal allergies upon being outsideBack and neck pain from old injuryAnxiety/depression

Release 9 — 3 months, dose 2

2021-07-14

Symptoms: Increased seasonal allergies, early miscarriage

Release 10 — 6 months, dose 2

2021-10-13

Symptoms: 1 miscarriage and a new Pregnant

Release 10 — day 28, dose 3

2022-01-07

Symptoms: Nose bleeds - but likely due to pregnancy

Release 11 — 3 months, dose 3

2022-03-11

Symptoms: Nose bleeds and dizziness, but typical of pregnancy!

Release 12 — day 35, dose 4

2022-12-08

Symptoms: Daily Dizziness/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	Abortion spontaneous	✓	✓	✓
SD	Anxiety	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Cough	·	·	✓
SD	Depression	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Epistaxis	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Eye pruritus	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Nausea	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Seasonal allergy	✓	✓	✓
SD	Vertigo	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Food allergy	✓	✓	✓
SRO	Hypersensitivity	○	✓	○
SRO	Pre-existing disease	✓	·	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Seasonal allergy	✓	✓	✓

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