3H9-15652-74280

2 vaccinations 6 coded responses 9 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 222 / VA
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
2021-01-18
Dose 1 — Moderna
2021-01-18
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain

Free text: Yes- the link wouldnt cooperate with me yesterday, but I had a fever of 100.1. Was rough. Much better now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Pyrexia — Feeling: Good · Fatigue or tiredness

Free text: I had a fever two nights after shot (shot was Monday, fever Tuesday). Could not get checklist to work that day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Dose 2 — Moderna
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Chromaturia — Feeling: Poor · Site: Redness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Red urine. Is there someone I can talk to about it??

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Bacterial test positive, Blood urine present, Chromaturia, Emergency care, Feeling abnormal, Office visit, Pyrexia, Reaction to previous exposure to any vaccine, Unevaluable event — Feeling: Poor · Site: Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, 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: Systemic reaction (other): My urine was discolored during the high fever. I thought it was dehydration. Yesterday, it turned pink, and I realized it was blood. I went to urgent care last night. The doctor there said there was some bacteria in my urine sample. Prescribed keflex, which I began taking right away. I still feel awful and have pink urine. I am convinced this is related to the vaccine. I was fine before this. I dont believe I shouldve had the second shot, after my reaction to the first. · Healthcare visit (other): I have a feeling Im not done with this.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Blood urine present — Feeling: Fair · Site: Pain, Redness, Itching · Chills, Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: There is still blood in my urine. I am taking antibiotics.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-11
Survey response — day 21, dose 2
MedDRA: Blood urine present, Office visit, Protein urine, Unevaluable event, Urinary tract infection, Urine analysis abnormal — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I cant say it enough- something happened when I had that second shot. I have to see a urologist now. · Healthcare visit (other): Going to the office on Friday, was at my gynecologists this last Friday. (I had was peeing blood after the shot. Was treated for UTI. Still have sons blood and protein in urine.)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

no matching call case
2021-08-04
Call 1 — Left Voicemail
2021-08-06
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-18	Moderna
2	2021-02-15	Moderna

Call center

3 call center cases

3 successful

1 wait over 3 months for a first call

1 check-in flagged for a call with no call center case on record

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-21

Systemic reaction (other): Yes- the link wouldnt cooperate with me yesterday, but I had a fever of 100.1. Was rough. Much better now.

2021-01-22

Systemic reaction (other): I had a fever two nights after shot (shot was Monday, fever Tuesday). Could not get checklist to work that day.

Release 4 — days 1–6 daily, dose 2

2021-02-17

Systemic reaction (other): Red urine. Is there someone I can talk to about it??

2021-02-18

Systemic reaction (other): My urine was discolored during the high fever. I thought it was dehydration. Yesterday, it turned pink, and I realized it was blood. I went to urgent care last night. The doctor there said there was some bacteria in my urine sample. Prescribed keflex, which I began taking right away. I still feel awful and have pink urine. I am convinced this is related to the vaccine. I was fine before this. I dont believe I shouldve had the second shot, after my reaction to the first.

Healthcare visit (other): I have a feeling Im not done with this.

2021-02-19

Systemic reaction (other): There is still blood in my urine. I am taking antibiotics.

Release 5 — day 21, dose 2

2021-03-11

Symptoms: I cant say it enough- something happened when I had that second shot. I have to see a urologist now.

Healthcare visit (other): Going to the office on Friday, was at my gynecologists this last Friday. (I had was peeing blood after the shot. Was treated for UTI. Still have sons blood and protein in urine.)

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	Blood urine present	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Protein urine	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
HCVO	Urinary tract infection	✓	✓	✓
HCVO	Urine analysis abnormal	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Bacterial test	○	·	○
SRO	Bacterial test positive	✓	·	✓
SRO	Blood urine present	✓	✓	✓
SRO	Chromaturia	✓	✓	✓
SRO	Emergency care	○	✓	○
SRO	Feeling abnormal	✓	✓	✓
SRO	Office visit	✓	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Reaction to previous exposure to any vaccine	✓	·	✓
SRO	Unevaluable event	✓	✓	✓

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