2NQ-17764-67505

3 vaccinations 10 coded responses 38 check-ins 10 free-text entries 5 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 191 / PA
Registered: 2021-01-18

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

2021-01-18
Registered in v-safe
2021-01-26
Dose 1 — Moderna
2021-01-26
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Chills, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Itching · Chills

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

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

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2021-02-02
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-09
Survey response — day 14, dose 1
MedDRA: Headache, Nausea — Feeling: Good

Free text: Nausea on occasion, headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-23
Dose 2 — Moderna
2021-02-23
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Aphasia, Feeling abnormal, Immediate post-injection reaction — Feeling: Fair · Site: Pain

Free text: Yesterday about one hour after the shot my memory was foggy and it was difficult to pronounce words but ended about two three hours later

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-23
Survey response — day 28, dose 2
MedDRA: Abdominal pain upper — Feeling: Good

Free text: Stomach ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — day 35, dose 2
MedDRA: Nausea — Feeling: Good

Free text: Nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Back pain, Chest pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Chest and localized back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-24
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-05
Dose 3 — Moderna
2021-11-05
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling, Itching · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling, Itching · None

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2021-11-12
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-19
Survey response — day 14, dose 3
MedDRA: Rash pruritic — Feeling: Fair · Be unable to do your normal daily activities

Free text: Itchy rash

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Survey response — day 21, dose 3
MedDRA: Rash, Urticaria — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Hives and a rash

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Report sent to call center — day 21, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-30
Call 1 — Left Voicemail
2021-12-03
Survey response — day 28, dose 3
MedDRA: Rash, Unevaluable event, Urticaria — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Still have a traveling rash but no longer have hives · Healthcare visit (other): Prescription

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-07
Call 1 — Left Voicemail
2021-12-10
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-17
Call 2 — Left Voicemail
2021-12-18
Survey response — day 42, dose 3
MedDRA: Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Streaky rash

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-21
Call 1 — Left Voicemail
2022-02-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-05
Survey response — 12 months, dose 3
MedDRA: COVID-19, COVID-19 pneumonia, Frustration tolerance decreased, Menstruation irregular — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Since getting COVID decreased frustration tolerance, my period has been off now also, got COVID pneumonia the booster wore off and took out essential workers

MedDRA releases: 2024-11 · check-in free text available
2022-11-05
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-11-07
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Moderna
2	2021-02-23	Moderna
3	2021-11-05	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-27	Unsuccessful
2021-11-26	Unsuccessful
2021-12-03	Unsuccessful
2021-12-18	Unsuccessful
2022-11-05	Unsuccessful

Free text

Release 3 — day 14, dose 1

2021-02-09

Symptoms: Nausea on occasion, headaches

Release 4 — days 1–6 daily, dose 2

2021-02-24

Systemic reaction (other): Yesterday about one hour after the shot my memory was foggy and it was difficult to pronounce words but ended about two three hours later

Release 6 — day 28, dose 2

2021-03-23

Symptoms: Stomach ache

Release 6 — day 35, dose 2

2021-03-30

Symptoms: Nausea

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: Chest and localized back pain

Release 10 — day 14, dose 3

2021-11-19

Symptoms: Itchy rash

Release 10 — day 21, dose 3

2021-11-26

Symptoms: Hives and a rash

Release 10 — day 28, dose 3

2021-12-03

Symptoms: Still have a traveling rash but no longer have hives

Healthcare visit (other): Prescription

Release 10 — day 42, dose 3

2021-12-18

Symptoms: Streaky rash

Release 12 — 12 months, dose 3

2022-11-05

Symptoms: Since getting COVID decreased frustration tolerance, my period has been off now also, got COVID pneumonia the booster wore off and took out essential workers

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	Back pain	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	COVID-19	·	·	✓
SD	COVID-19 pneumonia	·	·	✓
SD	Frustration tolerance decreased	·	·	✓
SD	Headache	✓	✓	✓
SD	Menstruation irregular	·	·	✓
SD	Nausea	✓	✓	✓
SD	Rash	·	·	✓
SD	Rash pruritic	·	·	✓
SD	Urticaria	·	·	✓
SRO	Aphasia	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓

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