4BF-22438-34861

3 vaccinations 13 coded responses 22 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 482 / MI
Registered: 2021-03-13

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

2021-03-13
Registered in v-safe
2021-03-13
Dose 1 — Moderna
2021-03-13
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: A little dizzy but not much

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Irritability — Feeling: Good · Site: Pain, Redness, Swelling · Fever · Fatigue or tiredness

Free text: Irritable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Office visit — Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Fatigue or tiredness, Nausea, Diarrhea · Get care from a doctor or other healthcare professional

Free text: In person regular medical visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-03-19
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle tightness, Skin tightness, Swelling of eyelid — Feeling: Good · Site: Swelling · Chills, Fatigue or tiredness

Free text: Left eye lid swollen and tightness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — day 7, dose 1
MedDRA: Eye irritation, Skin swelling, Skin tightness — Feeling: Good · Site: Itching

Free text: Still some L eye irritation: swollen & skin is tight near outer corner

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-10
Dose 2 — Moderna
2021-04-18
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-04-24
Survey response — day 14, dose 2
MedDRA: Fatigue, Irritability, Nausea — Feeling: Poor · Be unable to do your normal daily activities

Free text: Extremely tired and irritable, nauseous but didnt throw up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-24
Survey response — day 42, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extremely tired and exhausted

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Survey response — 3 months, dose 2
MedDRA: Chest pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Some chest pains, but nothing too painful

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-10
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-15
Call successful
Does not wish to fill out VAERS report
2021-10-09
Survey response — 6 months, dose 2
MedDRA: Pyrexia, Rhinorrhoea — Feeling: Good

Free text: Runny nose , and a fever ever now and then but it goes away (without taking anything)

MedDRA releases: 2024-11 · check-in free text available
2022-03-05
Dose 3 — Moderna
2022-04-10
Survey response — 12 months, dose 2
MedDRA: Chest pain — Feeling: Good

Free text: Some chest pains.... nothing major. It went away after 3-5 minutes. It's happened 2 times.

MedDRA releases: 2024-11 · check-in free text available
2022-06-04
Survey response — 3 months, dose 3
MedDRA: Dry skin, Medical counselling, Pruritus — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Very dry scalp.... itchy · Healthcare visit (other): Phone call to dr

MedDRA releases: 2024-11 · check-in free text available
2022-06-04
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-06
Call 1 — Left Voicemail
2022-06-06
Call 1 — Left Voicemail
2022-06-06
Call 1 — Left Voicemail
2022-09-03
Survey response — 6 months, dose 3
MedDRA: Breast pain, Fatigue, Paraesthesia — Feeling: Fair

Free text: Some pains under my breasts, but it goes away. And an ODD tingling in my R forearm every now & then. Tired more often- but I think thats just life. Ive not seen a dr yet, but I plan too, soon. Health issues may or may not be from vaccine, who knows

MedDRA releases: 2024-11 · check-in free text available
2023-03-05
Survey response — 12 months, dose 3
MedDRA: Cough, Daydreaming — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Moderna
2	2021-04-10	Moderna
3	2022-03-05	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

2 waits over 3 months for a first call

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-13

Systemic reaction (other): A little dizzy but not much

Release 5 — days 1–6 daily, dose 1

2021-03-14

Systemic reaction (other): Irritable

2021-03-15

Healthcare visit (other): In person regular medical visit

2021-03-19

Systemic reaction (other): Left eye lid swollen and tightness

Release 6 — day 7, dose 1

2021-03-20

Systemic reaction (other): Still some L eye irritation: swollen & skin is tight near outer corner

Release 7 — day 14, dose 2

2021-04-24

Symptoms: Extremely tired and irritable, nauseous but didnt throw up

Release 8 — day 42, dose 2

2021-05-24

Symptoms: Extremely tired and exhausted

Release 9 — 3 months, dose 2

2021-07-10

Symptoms: Some chest pains, but nothing too painful

Release 10 — 6 months, dose 2

2021-10-09

Symptoms: Runny nose , and a fever ever now and then but it goes away (without taking anything)

Release 11 — 12 months, dose 2

2022-04-10

Symptoms: Some chest pains.... nothing major. It went away after 3-5 minutes. It's happened 2 times.

Release 11 — 3 months, dose 3

2022-06-04

Symptoms: Very dry scalp.... itchy

Healthcare visit (other): Phone call to dr

Release 12 — 6 months, dose 3

2022-09-03

Symptoms: Some pains under my breasts, but it goes away. And an ODD tingling in my R forearm every now & then. Tired more often- but I think thats just life. Ive not seen a dr yet, but I plan too, soon. Health issues may or may not be from vaccine, who knows cut off by CDC

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	Medical counselling	·	·	✓
HCVO	Office visit	✓	✓	✓
SD	Breast pain	·	·	✓
SD	Chest pain	✓	✓	✓
SD	Cough	·	·	✓
SD	Daydreaming	·	·	✓
SD	Dry skin	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Irritability	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Paraesthesia	·	·	✓
SD	Pruritus	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Eye irritation	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Muscle tightness	✓	✓	○
SRO	Skin swelling	✓	✓	✓
SRO	Skin tightness	✓	✓	✓
SRO	Swelling of eyelid	✓	✓	✓

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