4TS-20198-14605

3 vaccinations 11 coded responses 25 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 010 / MA
Registered: 2021-01-29

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

2021-01-29
Registered in v-safe
2021-01-29
Dose 1 — Moderna
2021-01-29
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — day 7, dose 1
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-19
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-26
Dose 2 — Moderna
2021-02-26
Survey response — day 0, dose 2
MedDRA: Dizziness, Feeling abnormal — Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy and mental fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal, Vision blurred — Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy, blurred vision and mental fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspepsia, Eructation, Feeling abnormal — Feeling: Poor · Site: Pain, Itching · 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: Heartburn, burping, mental fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal, Vision blurred — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Dizzy, blurred vision and mental fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · Chills, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 28, dose 2
MedDRA: Fatigue, Headache, Hyperhidrosis, Nausea, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Feverish, sweats, headache, nausea and fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 35, dose 2
MedDRA: Diarrhoea, Dizziness, Headache, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dizzy, headache, nausea and diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-27
Survey response — 6 months, dose 2
MedDRA: Asthma, Emergency care, Headache, Herpes zoster, Pain, Respiratory disorder — 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: Daily headaches, increased breathing problems, ER trip for asthma, shingles, and on going aches and pains

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-27
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)
2021-10-07
Call successful
Participant prefers to complete VAERS report online
2021-11-11
Dose 3 — Moderna
Co-administered: Flu:Pneumonia
2022-02-28
Survey response — 12 months, dose 2
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school

Free text: Covid

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Survey response — 6 months, dose 3
MedDRA: COVID-19, Headache, Nausea, Pre-existing disease, Vertigo — 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

Free text: Covid positive Jan 20 And again April 14th Ongoing post Covid symptoms including nausea, headaches and vertigo

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-13
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-13
Survey response — 12 months, dose 3
MedDRA: COVID-19, Dizziness, Headache, Herpes zoster, Nausea, Neck pain — Feeling: Poor · Be unable to work or attend school

Free text: Headaches Dizziness Nausea Neck pain Shingles three times Covid three times

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-11-11	Moderna	Flu:Pneumonia

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-01-29

Systemic reaction (other): Dizzy

Release 4 — day 0, dose 2

2021-02-26

Systemic reaction (other): Dizzy and mental fog

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Dizzy, blurred vision and mental fog

2021-02-28

Systemic reaction (other): Heartburn, burping, mental fog

2021-03-01

Systemic reaction (other): Dizzy, blurred vision and mental fog

Release 6 — day 28, dose 2

2021-03-26

Symptoms: Feverish, sweats, headache, nausea and fatigue

Release 6 — day 35, dose 2

2021-04-02

Symptoms: Dizzy, headache, nausea and diarrhea

Release 9 — 6 months, dose 2

2021-08-27

Symptoms: Daily headaches, increased breathing problems, ER trip for asthma, shingles, and on going aches and pains

Release 11 — 12 months, dose 2

2022-02-28

Symptoms: Covid

Release 11 — 6 months, dose 3

2022-05-12

Symptoms: Covid positive Jan 20 And again April 14th Ongoing post Covid symptoms including nausea, headaches and vertigo

Release 12 — 12 months, dose 3

2022-11-13

Symptoms: Headaches Dizziness Nausea Neck pain Shingles three times Covid three times

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	Asthma	✓	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Emergency care	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Herpes zoster	✓	·	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Neck pain	·	·	✓
SD	Pain	✓	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory disorder	✓	·	✓
SD	Vertigo	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Eructation	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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