4SF-24846-45996

2 vaccinations 9 coded responses 23 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 926 / CA
Registered: 2021-02-11

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

2021-02-11
Registered in v-safe
2021-02-11
Dose 1 — Moderna
2021-02-11
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, 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: Worse really bad last night and this morning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-13
Survey response — days 1–6 daily, dose 1
MedDRA: Ear infection, Medical counselling — Feeling: Fair · Site: Pain, Redness, Swelling · Headache · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Have an ear infection now · Healthcare visit (other): Went today after speaking to doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Itching · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-25
Survey response — day 14, dose 1
MedDRA: Skin exfoliation — Feeling: Good

Free text: My arm is peeling where the injunction of the shot was on my arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-11
Survey response — day 28, dose 1
MedDRA: Alopecia — Feeling: Good

Free text: My hair is falling out... I think its from being positive of covid last November

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Dose 2 — Moderna
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Flatulence — Feeling: Good · Site: Pain, Redness, Itching · Chills, Headache, Muscle or body aches, Nausea, Diarrhea, Abdominal pain

Free text: Gas

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-21
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-28
Survey response — day 14, dose 2
MedDRA: Axillary mass — Feeling: Good

Free text: Its actually my other arm where the first injection was... my armpit has a lump again and it hurts Yet my second injection was in the other arm how is this possible

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

Adult check-in
2021-04-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-13
Survey response — 3 months, dose 2
MedDRA: Alopecia, Asthma, Pre-existing disease — Feeling: Fair

Free text: Breathing issues as I have asthma nowI also had loss of hair

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-05
Call 1 — Requested Callback
2021-08-06
Callback requested for
12:00PM ET
2021-08-06
Call successful
Does not wish to fill out VAERS report
2021-09-12
Survey response — 6 months, dose 2
MedDRA: Alopecia, Asthma, Dyspnoea, Office visit, Respiratory disorder — Feeling: Good · 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: Symptoms: Hair loss for 3 monthsand i cut my hair off and it stopedBreathing problems. I have severe asthma now and dont have enough breath when I take in my air · Healthcare visit (other): Respiratory doctor

MedDRA releases: 2024-11 · check-in free text available
2021-09-12
Report sent to call center — 6 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

1 call case(s)
2021-09-15
Call successful
Does not wish to fill out VAERS report
2022-03-14
Survey response — 12 months, dose 2
MedDRA: Alopecia, Pre-existing disease — Feeling: Poor · 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, Emergency room or emergency department visit

Free text: Loss of hair Asthma

MedDRA releases: 2024-11 · check-in free text available
2022-03-14
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 · Emergency room or emergency department visit · 1 call case(s)
2022-03-16
Call 1 — Left Voicemail
2022-05-13
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-11	Moderna
2	2021-03-14	Moderna

Call center

4 call center cases

4 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-12

Healthcare visit (other): Worse really bad last night and this morning

2021-02-13

Systemic reaction (other): Have an ear infection now

Healthcare visit (other): Went today after speaking to doctor

Release 4 — day 14, dose 1

2021-02-25

Symptoms: My arm is peeling where the injunction of the shot was on my arm

Release 5 — day 28, dose 1

2021-03-11

Symptoms: My hair is falling out... I think its from being positive of covid last November

Release 5 — days 1–6 daily, dose 2

2021-03-18

Systemic reaction (other): Gas

Release 6 — day 14, dose 2

2021-03-28

Symptoms: Its actually my other arm where the first injection was... my armpit has a lump again and it hurts Yet my second injection was in the other arm how is this possible

Release 9 — 3 months, dose 2

2021-06-13

Symptoms: Breathing issues as I have asthma nowI also had loss of hair

Release 9 — 6 months, dose 2

2021-09-12

Symptoms: Hair loss for 3 monthsand i cut my hair off and it stopedBreathing problems. I have severe asthma now and dont have enough breath when I take in my air

Healthcare visit (other): Respiratory doctor

Release 11 — 12 months, dose 2

2022-03-14

Symptoms: Loss of hair Asthma

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	Adverse reaction	✓	✓	✓
HCVO	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
SD	Alopecia	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Axillary mass	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory disorder	·	·	✓
SD	Skin exfoliation	✓	✓	✓
SRO	Ear infection	✓	✓	✓
SRO	Flatulence	✓	✓	✓

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