2Y4-11678-80354

3 vaccinations 6 coded responses 36 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 481 / MI
Registered: 2021-04-13

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

2021-04-10
Dose 1 — Moderna
2021-04-13
Registered in v-safe
2021-04-13
Survey response — days 1–6 daily, dose 1
MedDRA: Rash — Feeling: Fair · Headache, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Free text: Bumps and redness on chest and neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-18
Health check-in — day 7, dose 1
Feeling: Good · Headache, Diarrhea, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-08
Dose 2 — Moderna
2021-05-08
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Nausea

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Nausea

Adult check-in
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Nausea

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Fatigue or tiredness, Nausea

Adult check-in
2021-05-15
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-05-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-12
Survey response — day 35, dose 2
MedDRA: Heavy menstrual bleeding, Uterine dilation and curettage, Vaginal haemorrhage — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: I have been men starting since my first shot in March had a dnc in may and I am still bleeding · Healthcare visit (other): Had to have a dnc to see if we could get the bleeding to stop

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-12
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-22
Call successful
Participant prefers to complete VAERS report online
2021-08-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-01
Dose 3 — Moderna
2021-12-01
Health check-in — day 0, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site

Adult check-in
2021-12-03
Survey response — days 1–6 daily, dose 3
MedDRA: Hypoaesthesia, Paraesthesia oral, Pruritus, Rash macular, Tongue pruritus — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: The day of injection my hands went numb and my tongue itched and tingled for a few hours the next day my neck was super itchy and had spoiltches

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-12-08
Health check-in — day 7, dose 3
Feeling: Good · Site: Redness, Itching · Headache

Adult check-in
2021-12-15
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-22
Survey response — day 21, dose 3
MedDRA: Headache — Feeling: Fair

Free text: Frequent headaches

MedDRA releases: 2024-11 · check-in free text available
2021-12-31
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-05
Survey response — day 35, dose 3
MedDRA: Diarrhoea — Feeling: Fair

Free text: Diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
Survey response — day 42, dose 3
MedDRA: Chest discomfort, Cough, Nasal pruritus, Oropharyngeal pain, Rhinorrhoea — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sore throat cough chest feels tight and itchy runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-13
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-02
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-03
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-10	Moderna
2	2021-05-08	Moderna
3	2021-12-01	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-12	Successful 2021-06-22	Participant prefers to complete VAERS report online
2022-01-12	Successful 2022-01-13	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-13

Systemic reaction (other): Bumps and redness on chest and neck

Release 9 — day 35, dose 2

2021-06-12

Symptoms: I have been men starting since my first shot in March had a dnc in may and I am still bleeding

Healthcare visit (other): Had to have a dnc to see if we could get the bleeding to stop

Release 10 — days 1–6 daily, dose 3

2021-12-03

Systemic reaction (other): The day of injection my hands went numb and my tongue itched and tingled for a few hours the next day my neck was super itchy and had spoiltches

Release 10 — day 21, dose 3

2021-12-22

Symptoms: Frequent headaches

Release 10 — day 35, dose 3

2022-01-05

Symptoms: Diarrhea

Release 10 — day 42, dose 3

2022-01-12

Symptoms: Sore throat cough chest feels tight and itchy runny nose

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	Uterine dilation and curettage	✓	✓	✓
SD	Chest discomfort	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Headache	·	·	✓
SD	Heavy menstrual bleeding	✓	✓	✓
SD	Nasal pruritus	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Uterine dilation and curettage	✓	✓	✓
SD	Vaginal haemorrhage	✓	✓	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Paraesthesia oral	·	·	✓
SRO	Pruritus	·	·	✓
SRO	Rash	✓	✓	✓
SRO	Rash macular	·	·	✓
SRO	Tongue pruritus	·	·	✓

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