3MN-13982-96241
4 vaccinations
9 coded responses
52 check-ins
8 free-text entries
1 call case
- Sex
- Female
- Age at first dose
- 21-25
- ZIP prefix
- 802 / CO
- Registered
- 2021-03-10
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Registered dependents
FY9-16317-81047
Child or adolescent in my care · Male · 2022-06-25
Timeline
-
2021-03-07
Dose 1 — Moderna
-
2021-03-10
Registered in v-safe
- 2021-03-10
- 2021-03-11
- 2021-03-12
- 2021-03-13
- 2021-03-14
- 2021-03-21
- 2021-03-29
-
2021-04-04
Dose 2 — Moderna
-
2021-04-04
Health check-in — day 0, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body achesAdult check-in
-
2021-04-05
Survey response — days 1–6 daily, dose 2MedDRA: Heart rate increased — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activitiesFree text: High heart rateMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-06
- 2021-04-07
- 2021-04-08
- 2021-04-09
- 2021-04-10
- 2021-04-11
- 2021-04-18
- 2021-04-25
-
2021-05-02
Survey response — day 28, dose 2MedDRA: Heavy menstrual bleeding, Hypomenorrhoea — Feeling: GoodFree text: My period was longer and lighter than normal.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-09
- 2021-05-16
-
2021-07-04
Survey response — 3 months, dose 2MedDRA: Heavy menstrual bleeding — Feeling: GoodFree text: Really really heavy period.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-10-03
-
2021-11-01
Dose 3 — Moderna
- 2021-11-01
-
2021-11-02
Health check-in — days 1–6 daily, dose 3Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Nausea · Be unable to work or attend school, Be unable to do your normal daily activitiesAdult check-in
-
2021-11-03
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness · Fever · Chills, Joint pains, Muscle or body achesAdult check-in
-
2021-11-04
Health check-in — days 1–6 daily, dose 3Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body achesAdult check-in
-
2021-11-05
Survey response — days 1–6 daily, dose 3MedDRA: Lymphadenopathy — Feeling: FairFree text: Slight lymph node swellingMedDRA releases: 2024-11 · check-in free text available
-
2021-11-06
Survey response — days 1–6 daily, dose 3MedDRA: Aphthous ulcer, Lymphadenopathy — Feeling: FairFree text: Swollen lymph nodes and a canker sore in my mouthMedDRA releases: 2024-11 · check-in free text available
- 2021-11-07
- 2021-11-08
- 2021-11-15
- 2021-11-22
- 2021-11-29
- 2021-12-06
-
2021-12-13
Survey response — day 42, dose 3MedDRA: Chills, Pain — Feeling: PoorFree text: Chills and body achesMedDRA releases: 2024-11 · check-in free text available
- 2022-01-31
- 2022-05-02
-
2022-09-15
Dose 4 — ModernaCo-administered: Flu
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2022-09-15
Health check-in — day 0, dose 4Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tirednessAdult check-in
-
2022-09-16
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness, NauseaAdult check-in
-
2022-09-17
Health check-in — days 1–6 daily, dose 4Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tirednessAdult check-in
- 2022-09-18
- 2022-09-19
- 2022-09-20
- 2022-09-21
- 2022-09-22
- 2022-09-29
-
2022-10-06
Survey response — day 21, dose 4MedDRA: Menstruation irregular — Feeling: FairFree text: My period immediately following the shot was late, and then I got my next one early. Not a big deal. But worth saying.MedDRA releases: 2024-11 · check-in free text available
- 2022-10-15
- 2022-10-20
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2022-10-27
Survey response — day 42, dose 4MedDRA: Bell's palsy — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visitFree text: I was diagnosed with Bells Palsy on 10/24/22MedDRA releases: 2024-11 · check-in free text available
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2022-10-27
Report sent to call center — day 42, dose 4Get care from a doctor or other healthcare professionalEmergency room or emergency department visit · 1 call case(s)
-
2022-10-28
Call successfulParticipant prefers to complete VAERS report online
- 2022-12-15
-
2023-03-16
Survey response — 6 months, dose 4MedDRA: Polycystic ovarian syndrome — Feeling: GoodMedDRA releases: 2024-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-07 | Moderna | |
| 2 | 2021-04-04 | Moderna | |
| 3 | 2021-11-01 | Moderna | No |
| 4 | 2022-09-15 | Moderna | Flu |
Call center
| Reported | Outcome | VAERS-related outcome |
|---|---|---|
| 2022-10-27 | Successful 2022-10-28 |
Participant prefers to complete VAERS report online |
Free text
Release 7 — days 1–6 daily, dose 2
Systemic reaction (other): High heart rate
Release 8 — day 28, dose 2
Symptoms: My period was longer and lighter than normal.
Release 9 — 3 months, dose 2
Symptoms: Really really heavy period.
Release 10 — days 1–6 daily, dose 3
Systemic reaction (other): Slight lymph node swelling
Systemic reaction (other): Swollen lymph nodes and a canker sore in my mouth
Release 10 — day 42, dose 3
Symptoms: Chills and body aches
Release 12 — day 21, dose 4
Symptoms: My period immediately following the shot was late, and then I got my next one early. Not a big deal. But worth saying.
Release 12 — day 42, dose 4
Symptoms: I was diagnosed with Bells Palsy on 10/24/22
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 |
|---|---|---|---|---|
| SD | Bell's palsy | · | · | ✓ |
| SD | Chills | · | · | ✓ |
| SD | Heavy menstrual bleeding | ✓ | ✓ | ✓ |
| SD | Hypomenorrhoea | ✓ | ✓ | ✓ |
| SD | Menstruation irregular | · | · | ✓ |
| SD | Pain | · | · | ✓ |
| SD | Polycystic ovarian syndrome | · | · | ✓ |
| SRO | Aphthous ulcer | · | · | ✓ |
| SRO | Heart rate increased | ✓ | ✓ | ✓ |
| SRO | Lymphadenopathy | · | · | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release