4AM-83665-52931

4 vaccinations 6 coded responses 45 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 672 / KS
Registered: 2021-01-03

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
Dose 1 — Moderna
2021-01-03
Registered in v-safe
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Metallic Taste

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-09
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-01-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-28
Dose 2 — Moderna
2021-01-28
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · 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

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

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

Adult check-in
2021-02-13
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-03
Dose 3 — Pfizer-BioNTech
2021-11-03
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Dysphagia, Dysphonia, Emergency care, Heart rate increased, Hypersensitivity, Immediate post-injection reaction, Medical observation, Nausea, Oral pruritus, Self-medication — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Allergic reaction ~30 minutes after administration. Trouble swallowing, itchy mouth, hoarse voice, coughing, nausea, rapid heart rate: resolved with Benadryl · Healthcare visit (other): I stayed in the EMS observation room for about an hour yesterday

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Report sent to call center — days 1–6 daily, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school

Adult check-in
2021-11-09
Survey response — days 1–6 daily, dose 3
MedDRA: Rash, Rash erythematous, Rash papular, Rash pruritic — Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: A 4in strip on both inner forearms had an itchy, red, swollen rash for about 5 minutes. After 5 minutes, the area was only itchy, not red or swollen.

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-11-11
Health check-in — day 7, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2021-11-19
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-04
Survey response — 6 months, dose 3
MedDRA: Nasopharyngitis — Feeling: Good · Be unable to work or attend school

Free text: Cold-like symptoms last week

MedDRA releases: 2024-11 · check-in free text available
2022-10-04
Dose 4 — Moderna
2022-10-04
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-10-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-10-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2022-10-08
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-10-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-11
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-20
Survey response — day 14, dose 4
MedDRA: Urticaria — Feeling: Fair

Free text: Hives

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 28, dose 4
Feeling: Good

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

Adult check-in
2023-01-05
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-11
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-02	Moderna
2	2021-01-28	Moderna
3	2021-11-03	Pfizer-BioNTech	No
4	2022-10-04	Moderna	No

Call center

1 call center case

1 successful

VAERS report filed, before or during a call: 1

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-03

Systemic reaction (other): Metallic Taste

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): Dizzy

Release 10 — days 1–6 daily, dose 3

2021-11-04

Systemic reaction (other): Allergic reaction ~30 minutes after administration. Trouble swallowing, itchy mouth, hoarse voice, coughing, nausea, rapid heart rate: resolved with Benadryl

Healthcare visit (other): I stayed in the EMS observation room for about an hour yesterday

2021-11-09

Systemic reaction (other): A 4in strip on both inner forearms had an itchy, red, swollen rash for about 5 minutes. After 5 minutes, the area was only itchy, not red or swollen.

Release 11 — 6 months, dose 3

2022-05-04

Symptoms: Cold-like symptoms last week

Release 12 — day 14, dose 4

2022-10-20

Symptoms: Hives

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	Emergency care	·	·	✓
HCVO	Medical observation	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Urticaria	·	·	✓
SRO	Cough	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Dysphagia	·	·	✓
SRO	Dysphonia	·	·	✓
SRO	Heart rate increased	·	·	✓
SRO	Hypersensitivity	·	·	✓
SRO	Immediate post-injection reaction	·	·	✓
SRO	Nausea	·	·	✓
SRO	Oral pruritus	·	·	✓
SRO	Rash	·	·	✓
SRO	Rash erythematous	·	·	✓
SRO	Rash papular	·	·	✓
SRO	Rash pruritic	·	·	✓
SRO	Self-medication	·	·	✓

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