3RP-63705-47778

3 vaccinations 10 coded responses 38 check-ins 10 free-text entries 5 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 282 / NC
Registered: 2021-03-02

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-02
Registered in v-safe
2021-03-02
Dose 1 — Moderna
2021-03-02
Health check-in — day 0, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Hypotension — Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Low BP in AM, very tired

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

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: Good · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Abdominal pain

Adult check-in
2021-03-09
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Survey response — day 14, dose 1
MedDRA: Blood pressure increased, Hypertension — Feeling: Fair · Be unable to do your normal daily activities

Free text: High BP today it may be due to eating carbs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-30
Dose 2 — Moderna
2021-03-30
Health check-in — day 0, dose 2
Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

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

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Constipation, Vaccine positive rechallenge — Feeling: Good · Site: Pain

Free text: Constipation with first and second shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Constipation — Feeling: Good

Free text: Constipation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-04
Survey response — day 35, dose 2
MedDRA: Hepatic pain, Liver disorder, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I have an auto immune liver disease. I forgot to mention. 2 days after my first immunization on 3/2/2021 that I had really bad liver pain that Ive never had before that required a Dr visit, ultra sound & MRI. · Healthcare visit (other): Dr office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-11
Survey response — day 42, dose 2
MedDRA: Blood pressure fluctuation, Fatigue — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Tiredness, BP up and down

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

1 call case(s)
2021-06-29
Survey response — 3 months, dose 2
MedDRA: Autoimmune disorder — Feeling: Good · Be unable to do your normal daily activities

Free text: I have autoimmune bile duct disease and after 1st shot Im still dealing with complications that I never had prior to shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-28
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Office visit, Pre-existing disease, Tachycardia — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: My tachycardia and BP seems to be worse · Healthcare visit (other): Dr office

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-30
Call 1 — Left Voicemail
2021-09-30
Call successful
Participant prefers to complete VAERS report online
2021-10-28
Dose 3 — Moderna
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · None

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Abdominal pain

Adult check-in
2021-11-04
Health check-in — day 7, dose 3
Feeling: Good · Abdominal pain

Adult check-in
2021-11-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-28
Survey response — 3 months, dose 3
MedDRA: Office visit, Vulval eczema — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Eczema in vagina area. I've never had eczema in my 65 years. · Healthcare visit (other): Dr office

MedDRA releases: 2024-11 · check-in free text available
2022-01-28
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-02
Call 1 — Left Voicemail
2022-02-04
Call successful
Participant prefers to complete VAERS report online
2022-10-28
Survey response — 12 months, dose 3
MedDRA: Blood glucose increased, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: High glucose · Healthcare visit (other): Regular dr visit

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-31
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-03-30	Moderna
3	2021-10-28	Moderna	No

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): Low BP in AM, very tired

Release 5 — day 14, dose 1

2021-03-16

Symptoms: High BP today it may be due to eating carbs

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): Constipation with first and second shot

2021-04-02

Systemic reaction (other): Constipation

Release 8 — day 35, dose 2

2021-05-04

Symptoms: I have an auto immune liver disease. I forgot to mention. 2 days after my first immunization on 3/2/2021 that I had really bad liver pain that Ive never had before that required a Dr visit, ultra sound & MRI.

Healthcare visit (other): Dr office visit

Release 8 — day 42, dose 2

2021-05-11

Symptoms: Tiredness, BP up and down

Release 9 — 3 months, dose 2

2021-06-29

Symptoms: I have autoimmune bile duct disease and after 1st shot Im still dealing with complications that I never had prior to shot.

Release 9 — 6 months, dose 2

2021-09-28

Symptoms: My tachycardia and BP seems to be worse

Healthcare visit (other): Dr office

Release 11 — 3 months, dose 3

2022-01-28

Symptoms: Eczema in vagina area. I've never had eczema in my 65 years.

Healthcare visit (other): Dr office

Release 12 — 12 months, dose 3

2022-10-28

Symptoms: High glucose

Healthcare visit (other): Regular dr visit

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	Autoimmune disorder	✓	✓	✓
SD	Blood glucose increased	·	·	✓
SD	Blood pressure fluctuation	✓	✓	✓
SD	Blood pressure increased	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Hepatic pain	✓	✓	✓
SD	Hypertension	✓	✓	○
SD	Liver disorder	✓	✓	✓
SD	Office visit	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Tachycardia	·	·	✓
SD	Vulval eczema	·	·	✓
SRO	Constipation	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Hypotension	✓	✓	✓
SRO	Vaccine positive rechallenge	✓	✓	✓

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