2VD-52988-72854

3 vaccinations 12 coded responses 24 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 776 / TX
Registered: 2021-03-18

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

2021-03-18
Registered in v-safe
2021-03-18
Dose 1 — Moderna
2021-03-18
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Palpitations — Feeling: Good · Headache, Fatigue or tiredness, Nausea

Free text: Palpitations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 7, dose 1
MedDRA: Palpitations — Feeling: Good · Site: Itching · Headache, Abdominal pain

Free text: Palpitations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-05-04
Dose 2 — Moderna
2021-05-05
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Blood pressure diastolic increased, Ocular discomfort, Palpitations — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sudden continued pain in left knee soft tissue, pain & pressure behind eyes, palpitations, pulsating vision, increased diastolic blood pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Fair · Site: Pain, Redness · Fever · Headache, Fatigue or tiredness

Free text: Congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Respiratory tract congestion — Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Free text: Slight headache and congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea

Free text: Congested

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-11
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-05-25
Survey response — day 21, dose 2
MedDRA: Fatigue, Ocular discomfort, Periorbital swelling — Feeling: Good

Free text: Tiredness, eyes feel puffy with pressure behind them.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Survey response — day 35, dose 2
MedDRA: Eye pain — Feeling: Good

Free text: Pain behind my eyes daily. Not constant, but comes and goes. Sometimes mild, sometimes very painful. I see a neuro-opthamologist about it on a couple weeks.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-11-03
Survey response — 6 months, dose 2
MedDRA: Alopecia, Fatigue, Inguinal mass, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Hair loss, lump in groin area, fatigue · Healthcare visit (other): General practitioner appointments

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-08
Call 1 — Could Not Reach Participant
2021-11-11
Call successful
Does not wish to fill out VAERS report
2021-12-21
Dose 3 — Moderna
2021-12-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-12-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Abdominal pain

Adult check-in
2021-12-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-30
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2022-01-18
Survey response — day 28, dose 3
MedDRA: Headache, Paranasal sinus discomfort, Sinus congestion — Feeling: Fair · Be unable to work or attend school

Free text: Headache, sinus pressure and congestion

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-03-22
Survey response — 3 months, dose 3
MedDRA: Sigmoid sinus thrombosis, Transverse sinus thrombosis — Feeling: Poor · 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: 2 blood cots in my brain. Left verebral sigmoid sinus clot and left transverse sinus clot.

MedDRA releases: 2024-11 · check-in free text available
2022-03-22
Report sent to call center — 3 months, dose 3
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)
2022-03-23
Call successful
Does not wish to fill out VAERS report
2022-12-23
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-05-04	Moderna
3	2021-12-21	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-03	Successful 2021-11-11	Does not wish to fill out VAERS report
2022-03-22	Successful 2022-03-23	Does not wish to fill out VAERS report

Free text

Release 5 — day 0, dose 1

2021-03-18

Systemic reaction (other): Dizzy

Release 6 — days 1–6 daily, dose 1

2021-03-24

Systemic reaction (other): Palpitations

Release 6 — day 7, dose 1

2021-03-25

Systemic reaction (other): Palpitations

Release 8 — days 1–6 daily, dose 2

2021-05-05

Systemic reaction (other): Sudden continued pain in left knee soft tissue, pain & pressure behind eyes, palpitations, pulsating vision, increased diastolic blood pressure

2021-05-07

Systemic reaction (other): Congestion

2021-05-08

Systemic reaction (other): Slight headache and congestion

2021-05-09

Systemic reaction (other): Congested

Release 8 — day 21, dose 2

2021-05-25

Symptoms: Tiredness, eyes feel puffy with pressure behind them.

Release 9 — day 35, dose 2

2021-06-11

Symptoms: Pain behind my eyes daily. Not constant, but comes and goes. Sometimes mild, sometimes very painful. I see a neuro-opthamologist about it on a couple weeks.

Release 10 — 6 months, dose 2

2021-11-03

Symptoms: Hair loss, lump in groin area, fatigue

Healthcare visit (other): General practitioner appointments

Release 10 — day 28, dose 3

2022-01-18

Symptoms: Headache, sinus pressure and congestion

Release 11 — 3 months, dose 3

2022-03-22

Symptoms: 2 blood cots in my brain. Left verebral sigmoid sinus clot and left transverse sinus clot.

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	Office visit	·	·	✓
SD	Alopecia	·	·	✓
SD	Eye pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Inguinal mass	·	·	✓
SD	Ocular discomfort	✓	✓	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Periorbital swelling	✓	✓	✓
SD	Sigmoid sinus thrombosis	·	·	✓
SD	Sinus congestion	·	·	✓
SD	Transverse sinus thrombosis	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Blood pressure diastolic increased	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Ocular discomfort	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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