2JC-13300-42215

3 vaccinations 9 coded responses 28 check-ins 9 free-text entries 2 call cases

Sex: —
Age at first dose: 31-35
ZIP prefix: 554 / MN
Registered: 2021-01-28

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-11
Survey response — day 14, dose 1
MedDRA: Chest pain, Dizziness, Erythema, Feeling abnormal, Heart rate increased, Pain in extremity, Peripheral swelling, Pruritus — Feeling: Good

Free text: My arm started getting a large, red, swollen spot. It was itchy and very achy. It has cleared up since and only lasted a few days. I experienced a few days of rapid a heart rate, dizzy spells and brain fog. Also 24 hours of a pain in my chest.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-26
Survey response — day 28, dose 1
MedDRA: Dizziness, Vertigo — Feeling: Fair · Be unable to work, 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: Developed vertigo on 2/20. Have had lasting dizziness since.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Report sent to call center — day 28, 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)
2021-02-27
Dose 2 — Moderna
2021-02-27
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Diarrhea

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Diarrhea

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

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal, Taste disorder — Feeling: Fair · Site: Redness, Swelling, Itching · Nausea, Diarrhea

Free text: Gross taste in my mouth, brain fog, dizziness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Dysgeusia, Feeling abnormal — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Nausea, Diarrhea

Free text: Brain fog, dizziness and gross taste in my mouth.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 7, dose 2
Feeling: Fair · Site: Itching · Headache, Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-13
Survey response — day 14, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Constant headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — day 21, dose 2
MedDRA: Blood pressure increased, Heart rate increased — Feeling: Good

Free text: Increased heart rate and blood pressure.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-30
Survey response — 3 months, dose 2
MedDRA: Anxiety, Fatigue, Heavy menstrual bleeding, Infertility, Menstrual disorder, Oligomenorrhoea, Vaccine interaction — Feeling: Good

Free text: Menstrual cycles have been extremely off. Late, heavy and long. I've also stopped responding to fertility medications. I'm very worried and hoping I'm experiencing temporary infertility.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-28
Survey response — 6 months, dose 2
MedDRA: Therapeutic product ineffective — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Since my 2nd shot, I have not responded to my fertility medication as I previously did.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-28
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-02
Call successful
Participant prefers to complete VAERS report online
2021-11-02
Dose 3 — Moderna
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache

Adult check-in
2021-12-09
Survey response — day 35, dose 3
MedDRA: SARS-CoV-2 test positive — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tested positive for COVID

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-27	Moderna
3	2021-11-02	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-11

Symptoms: My arm started getting a large, red, swollen spot. It was itchy and very achy. It has cleared up since and only lasted a few days. I experienced a few days of rapid a heart rate, dizzy spells and brain fog. Also 24 hours of a pain in my chest.

Release 4 — day 28, dose 1

2021-02-26

Symptoms: Developed vertigo on 2/20. Have had lasting dizziness since.

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Gross taste in my mouth, brain fog, dizziness.

2021-03-05

Systemic reaction (other): Brain fog, dizziness and gross taste in my mouth.

Release 5 — day 14, dose 2

2021-03-13

Symptoms: Constant headache.

Release 6 — day 21, dose 2

2021-03-22

Symptoms: Increased heart rate and blood pressure.

Release 8 — 3 months, dose 2

2021-05-30

Symptoms: Menstrual cycles have been extremely off. Late, heavy and long. I've also stopped responding to fertility medications. I'm very worried and hoping I'm experiencing temporary infertility.

Release 9 — 6 months, dose 2

2021-08-28

Symptoms: Since my 2nd shot, I have not responded to my fertility medication as I previously did.

Release 10 — day 35, dose 3

2021-12-09

Symptoms: Tested positive for COVID

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	Anxiety	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Heart rate increased	✓	✓	✓
SD	Heavy menstrual bleeding	✓	✓	✓
SD	Infertility	✓	✓	✓
SD	Menstrual disorder	✓	✓	✓
SD	Oligomenorrhoea	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Therapeutic product ineffective	✓	·	✓
SD	Vaccine interaction	✓	✓	✓
SD	Vertigo	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Taste disorder	✓	✓	✓

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