3AE-50355-98727

3 vaccinations 6 coded responses 38 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 26-30
ZIP prefix: 305 / GA
Registered: 2020-12-30

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

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

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

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-28
Dose 2 — Moderna
2021-01-28
Survey response — day 0, dose 2
MedDRA: Injection site bruising — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Bruise at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
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 · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-30
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site bruising — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Bruise at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 28, dose 2
Feeling: Good

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

Adult check-in
2021-03-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-01-06
Dose 3 — Moderna
2022-01-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-08
Survey response — days 1–6 daily, dose 3
MedDRA: Respiratory tract congestion, Sinus pain — Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sinus pain and congestion

MedDRA releases: 2024-11 · check-in free text available
2022-01-09
Survey response — days 1–6 daily, dose 3
MedDRA: Respiratory tract congestion, Sinus pain — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sinus pain and congestion

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Respiratory tract congestion, Sinus pain — Feeling: Fair · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sinus pain,congestion, cough

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Survey response — days 1–6 daily, dose 3
MedDRA: SARS-CoV-2 test — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: COVID testing

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · None

Adult check-in
2022-01-12
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-13
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-01-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-27
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-05
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-10
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-07
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-07
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2023-01-06
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-28	Moderna
3	2022-01-06	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-01-11	Successful 2022-01-12	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 2 — day 0, dose 2

2021-01-28

Systemic reaction (other): Bruise at injection site

Release 3 — days 1–6 daily, dose 2

2021-01-30

Systemic reaction (other): Bruise at injection site

Release 10 — days 1–6 daily, dose 3

2022-01-08

Systemic reaction (other): Sinus pain and congestion

2022-01-09

Systemic reaction (other): Sinus pain and congestion

2022-01-10

Systemic reaction (other): Sinus pain,congestion, cough

2022-01-11

Healthcare visit (other): COVID testing

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	SARS-CoV-2 test	·	·	✓
SRO	Cough	·	·	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Sinus pain	·	·	✓

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