3QN-22735-60611

3 vaccinations 5 coded responses 23 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 952 / CA
Registered: 2021-03-02

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

2021-03-01
Dose 1 — Moderna
2021-03-02
Registered in v-safe
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-08
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-26
Dose 2 — Moderna
2021-03-26
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Toothache — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Teeth hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-04-02
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-16
Survey response — day 21, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Weird pain throbbing ( different than normal headache) in head above left ear.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 42, dose 2
MedDRA: Polyp, Uterine disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Heavy, Long (8+ day) period, had ultrasound now have thick uneven uterine lining, polips , need D & C.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-25
Survey response — 3 months, dose 2
MedDRA: Contusion, Endometrial hyperplasia — Feeling: Good · 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: Abnormal uterine lining, having surgery next month for. Lots of random brusing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-01
Call successful
Participant prefers to complete VAERS report online
2021-12-18
Dose 3 — Moderna
2021-12-28
Health check-in — day 7, dose 3
Feeling: Poor · Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Adult check-in
2021-12-28
Report sent to call center — day 7, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-29
Call 1 — Left Voicemail
2022-01-01
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-01-22
Survey response — day 35, dose 3
MedDRA: Thrombosis — Feeling: Fair · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Blood clot in shoulder

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-01-24
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-03-26	Moderna
3	2021-12-18	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-07	Successful	Participant prefers to complete VAERS report online
2021-06-25	Successful 2021-07-01	Participant prefers to complete VAERS report online
2021-12-28	Successful	Participant prefers to complete VAERS report online
2022-01-22	Successful 2022-01-24	Participant prefers to complete VAERS report online

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-27

Systemic reaction (other): Teeth hurt

Release 7 — day 21, dose 2

2021-04-16

Symptoms: Weird pain throbbing ( different than normal headache) in head above left ear.

Release 8 — day 42, dose 2

2021-05-07

Symptoms: Heavy, Long (8+ day) period, had ultrasound now have thick uneven uterine lining, polips , need D & C.

Release 9 — 3 months, dose 2

2021-06-25

Symptoms: Abnormal uterine lining, having surgery next month for. Lots of random brusing.

Release 11 — day 35, dose 3

2022-01-22

Symptoms: Blood clot in shoulder

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	Contusion	✓	✓	✓
SD	Endometrial hyperplasia	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Polyp	✓	✓	✓
SD	Thrombosis	·	·	✓
SD	Uterine disorder	✓	✓	✓
SRO	Toothache	✓	✓	✓

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