3EY-21343-55476

4 vaccinations 6 coded responses 28 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 522 / IA
Registered: 2021-03-20

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

2021-02-26
Dose 1 — Moderna
2021-03-19
Dose 2 — Moderna
2021-03-20
Registered in v-safe
2021-03-20
Survey response — day 21, dose 1
MedDRA: Asthenia, Chills, Decreased appetite, Fatigue, Nausea, Pyrexia — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Chills, fever, fatigue, nausea, lack of appetite, weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Weakness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-21
Dose 3 — Pfizer-BioNTech
2022-03-19
Survey response — 12 months, dose 2
MedDRA: Coeliac disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I was diagnosed with celiac disease

MedDRA releases: 2024-11 · check-in free text available
2022-03-19
Report sent to call center — 12 months, dose 2
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
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-10-01
Dose 4 — Moderna
2022-10-02
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-10-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2022-10-04
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Swelling · Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-10-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Adult check-in
2022-10-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · Headache

Adult check-in
2022-10-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · None

Adult check-in
2022-10-08
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-15
Survey response — day 14, dose 4
MedDRA: Headache — Feeling: Good

Free text: Headaches

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-01
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-31
Survey response — 3 months, dose 4
MedDRA: Office visit, Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: 39 weeks pregnant and baby is potentially over 9 lbs so being induced today · Healthcare visit (other): Determined at an outpatient clinic but will be hospitalized for the next few days

MedDRA releases: 2024-11 · check-in free text available
2022-12-31
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2023-01-03
Call 1 — Left Voicemail
2023-04-01
Survey response — 6 months, dose 4
MedDRA: Delivery, Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-01
Report sent to call center — 6 months, dose 4
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)
2023-04-03
Call 2 — Left Voicemail
2023-04-03
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-19	Moderna
3	2021-11-21	Pfizer-BioNTech	No
4	2022-10-01	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-03-19	Successful 2022-03-23	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-12-31	Unsuccessful
2023-04-01	Unsuccessful

Free text

Release 6 — day 21, dose 1

2021-03-20

Symptoms: Chills, fever, fatigue, nausea, lack of appetite, weakness

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Weakness

Release 11 — 12 months, dose 2

2022-03-19

Symptoms: I was diagnosed with celiac disease

Release 12 — day 14, dose 4

2022-10-15

Symptoms: Headaches

Release 12 — 3 months, dose 4

2022-12-31

Symptoms: 39 weeks pregnant and baby is potentially over 9 lbs so being induced today

Healthcare visit (other): Determined at an outpatient clinic but will be hospitalized for the next few days

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	Asthenia	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Coeliac disease	·	·	✓
SD	Decreased appetite	✓	✓	✓
SD	Delivery	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Asthenia	✓	✓	✓

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