4MJ-12249-60923

3 vaccinations 8 coded responses 26 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 21-25
ZIP prefix: 443 / OH
Registered: 2020-12-31

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

2020-12-30
Dose 1 — Moderna
2020-12-31
Registered in v-safe
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Insomnia — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Insomnia

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

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Diarrhea

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-13
Survey response — day 14, dose 1
MedDRA: Fatigue, Injection site erythema, Injection site rash, Injection site warmth, Migraine — Feeling: Good · Be unable to do your normal daily activities

Free text: Large area of redness and rash on arm near vaccination site that is warm to the touch; constant migraine headache that has lasted for five days and fatigue that accompanied headache first four days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-27
Dose 2 — Moderna
2021-01-27
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Sore throat

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: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Swelling · Headache

Free text: Sore throat, mild

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

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-24
Survey response — day 28, dose 2
MedDRA: Chest discomfort, Diarrhoea, Headache — Feeling: Good

Free text: Diarrhea, headache, tightness of chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-28
Survey response — 6 months, dose 2
MedDRA: Cystitis, Diarrhoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Bladder infectionDiarrhea

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-28
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-02
Call 3 — Left Voicemail
2021-12-16
Dose 3 — Moderna
2022-01-27
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-06-21
Survey response — 6 months, dose 3
MedDRA: COVID-19, Pregnancy — 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, Outpatient clinic or urgent care clinic visit

Free text: Pregnancy Positive covid infection

MedDRA releases: 2024-11 · check-in free text available
2022-06-21
Report sent to call center — 6 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-22
Call 1 — Could Not Reach Participant
2022-06-22
Call 1 — Could Not Reach Participant
2022-06-27
Call 2 — Could Not Reach Participant
2022-06-27
Call 2 — Could Not Reach Participant
2022-12-16
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-27	Moderna
3	2021-12-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-13	priority 2/3
2021-07-28	Unsuccessful
2022-06-21	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): Insomnia

Release 1 — day 14, dose 1

2021-01-13

Symptoms: Large area of redness and rash on arm near vaccination site that is warm to the touch; constant migraine headache that has lasted for five days and fatigue that accompanied headache first four days

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): Sore throat

2021-02-01

Systemic reaction (other): Sore throat, mild

2021-02-02

Systemic reaction (other): Sore throat

Release 4 — day 28, dose 2

2021-02-24

Symptoms: Diarrhea, headache, tightness of chest

Release 9 — 6 months, dose 2

2021-07-28

Symptoms: Bladder infectionDiarrhea

Release 12 — 6 months, dose 3

2022-06-21

Symptoms: Pregnancy Positive covid infection

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	Chest discomfort	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Cystitis	✓	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Migraine	✓	✓	✓
SD	Pregnancy	·	·	✓
SRO	Insomnia	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓

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