45W-21414-06597

4 vaccinations 11 coded responses 51 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 200 / DC
Registered: 2021-02-20

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

2021-02-19
Dose 1 — Moderna
2021-02-20
Registered in v-safe
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Survey response — days 1–6 daily, dose 1
MedDRA: Initial insomnia, Insomnia — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Ive had trouble falling asleep and staying asleep the last 2 nights (so the day I got the shot and the day after)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-19
Dose 2 — Moderna
2021-03-19
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-03-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-18
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-17
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Moderna
2021-10-28
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Felt very faint like I would pass out when standing up this morning

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Lack of appetite

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — day 7, dose 3
Feeling: Good · None

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
2022-01-27
Survey response — 3 months, dose 3
MedDRA: Decreased appetite, Diarrhoea, Dizziness, Insomnia, Oropharyngeal pain, Respiratory tract congestion — 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 · Telehealth, virtual health, or email health consultation

Free text: Insomnia, dizziness, congestion, sore throat, diarrhea, loss of appetite

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-31
Call 1 — Left Voicemail
2022-04-29
Survey response — 6 months, dose 3
MedDRA: Brain fog, Decreased appetite, Diarrhoea, Fatigue, Myalgia, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Muscle aches, fatigue, brain fog, lack of appetite, diarrhea, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Report sent to call center — 6 months, 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)
2022-05-02
Call successful
Does not wish to fill out VAERS report
2022-10-09
Dose 4 — Moderna
2022-10-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-10-11
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-10-12
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness, Insomnia — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Insomnia, dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-10-13
Survey response — days 1–6 daily, dose 4
MedDRA: Brain fog, Dizziness, Hot flush, Hyperhidrosis — Feeling: Fair · Fever · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain

Free text: Hot flashes and sweaty, dizziness, brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Survey response — days 1–6 daily, dose 4
MedDRA: Brain fog, Dizziness, Sneezing — Feeling: Poor · Headache, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Dizziness, brain fog, sneezing

MedDRA releases: 2024-11 · check-in free text available
2022-10-14
Report sent to call center — days 1–6 daily, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-16
Survey response — day 7, dose 4
MedDRA: Dizziness — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-10-17
Call 1 — Left Voicemail
2022-10-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-23
Survey response — day 14, dose 4
MedDRA: Abdominal pain upper, COVID-19, Decreased appetite, Dizziness, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Positive for Covid-19. Fatigue, dizziness, lack of appetite, some stomach pain.

MedDRA releases: 2024-11 · check-in free text available
2022-10-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-13
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-11-20
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-01-08
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-04-09
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-19	Moderna
2	2021-03-19	Moderna
3	2021-10-28	Moderna	No
4	2022-10-09	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-21

Systemic reaction (other): Ive had trouble falling asleep and staying asleep the last 2 nights (so the day I got the shot and the day after)

Release 10 — days 1–6 daily, dose 3

2021-10-29

Systemic reaction (other): Felt very faint like I would pass out when standing up this morning

2021-10-30

Systemic reaction (other): Lack of appetite

Release 11 — 3 months, dose 3

2022-01-27

Symptoms: Insomnia, dizziness, congestion, sore throat, diarrhea, loss of appetite

Release 11 — 6 months, dose 3

2022-04-29

Symptoms: Muscle aches, fatigue, brain fog, lack of appetite, diarrhea, sore throat

Release 12 — days 1–6 daily, dose 4

2022-10-11

Systemic reaction (other): Dizziness

2022-10-12

Systemic reaction (other): Insomnia, dizziness

2022-10-13

Systemic reaction (other): Hot flashes and sweaty, dizziness, brain fog

2022-10-14

Systemic reaction (other): Dizziness, brain fog, sneezing

Release 12 — day 7, dose 4

2022-10-16

Systemic reaction (other): Dizziness

Release 12 — day 14, dose 4

2022-10-23

Symptoms: Positive for Covid-19. Fatigue, dizziness, lack of appetite, some stomach pain.

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	Abdominal pain upper	·	·	✓
SD	Brain fog	·	·	✓
SD	COVID-19	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Insomnia	·	·	✓
SD	Myalgia	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Brain fog	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Hot flush	·	·	✓
SRO	Hyperhidrosis	·	·	✓
SRO	Initial insomnia	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Sneezing	·	·	✓

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