3T3-13822-68540

2 vaccinations 6 coded responses 20 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 473 / IN
Registered: 2021-01-02

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

2021-01-02
Registered in v-safe
2021-01-02
Dose 1 — Moderna
2021-01-02
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-03
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling, 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

Adult check-in
2021-01-04
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-30
Dose 2 — Moderna
2021-01-30
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Eye pain, Unevaluable event — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Vision and eye pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Bladder pain, Decreased appetite — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Bladder pain loss of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Nightmare — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Horrible nightmares since day 1 of vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Survey response — day 7, dose 2
MedDRA: Nightmare, Visual impairment — Feeling: Good · Site: Redness

Free text: Nightmares and seeing things out of the corner of my eye

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-22
Survey response — day 21, dose 2
MedDRA: Menstrual disorder, Nipple pain — Feeling: Fair

Free text: Sore nipples and a menstrual cycle (I've not had one in over 4 years. Had an ablation sterilization procedure, tubal burn and d&c)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-31
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-01
Survey response — 12 months, dose 2
MedDRA: COVID-19, Norovirus infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Covid-19 and Norovirus

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-02
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-02	Moderna
2	2021-01-30	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-03	priority 2/3
2021-01-04	priority 2/3
2022-02-01	Successful 2022-02-02	Participant prefers to complete VAERS report online

Free text

Release 3 — days 1–6 daily, dose 2

2021-01-31

Systemic reaction (other): Vision and eye pain

2021-02-01

Systemic reaction (other): Bladder pain loss of appetite

2021-02-04

Systemic reaction (other): Horrible nightmares since day 1 of vaccine

Release 3 — day 7, dose 2

2021-02-06

Systemic reaction (other): Nightmares and seeing things out of the corner of my eye

Release 4 — day 21, dose 2

2021-02-22

Symptoms: Sore nipples and a menstrual cycle (I've not had one in over 4 years. Had an ablation sterilization procedure, tubal burn and d&c)

Release 11 — 12 months, dose 2

2022-02-01

Symptoms: Covid-19 and Norovirus

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	COVID-19	·	·	✓
SD	Menstrual disorder	✓	✓	✓
SD	Nipple pain	✓	✓	✓
SD	Norovirus infection	·	·	✓
SRO	Bladder pain	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Nightmare	✓	✓	✓
SRO	Unevaluable event	·	·	✓
SRO	Visual impairment	✓	✓	✓

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