4V6-19309-93763

2 vaccinations 8 coded responses 20 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 337 / FL
Registered: 2021-03-15

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-15
Registered in v-safe
2021-03-15
Dose 1 — Moderna
2021-03-15
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain

Free text: Lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-21
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Good

Free text: Dry cough at night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-12
Dose 2 — Moderna
2021-04-12
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy, lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Survey response — day 7, dose 2
MedDRA: Diarrhoea — Feeling: Fair · Diarrhea

Free text: Diarrhea all week I didnt mark down

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-12
Survey response — 3 months, dose 2
MedDRA: Chest pain, Palpitations — Feeling: Fair

Free text: Chest pain racing heart its been awhile! This is only after moderna shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-11
Survey response — 6 months, dose 2
MedDRA: Cluster headache, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Cluster headaches · Healthcare visit (other): Regular DR visit

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-18
Call successful
Does not wish to fill out VAERS report
2022-04-12
Survey response — 12 months, dose 2
MedDRA: Antinuclear antibody positive, COVID-19, Immunodeficiency, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I did not know I had an immune deficiency disorder. Not sure if Covid flirted up and that's how I did additional studies to find out I'm being referred to a rheumatologist as I tested positive for ANA looks like I may have lupus. · Healthcare visit (other): Regular DR

MedDRA releases: 2024-11 · check-in free text available
2022-04-12
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-13
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Moderna
2	2021-04-12	Moderna

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-15

Systemic reaction (other): Lightheaded

Release 6 — days 1–6 daily, dose 1

2021-03-21

Systemic reaction (other): Dry cough at night

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): Dizzy, lightheaded

2021-04-14

Systemic reaction (other): Dizzy

Release 7 — day 7, dose 2

2021-04-19

Systemic reaction (other): Diarrhea all week I didnt mark down

Release 9 — 3 months, dose 2

2021-07-12

Symptoms: Chest pain racing heart its been awhile! This is only after moderna shot.

Release 10 — 6 months, dose 2

2021-10-11

Symptoms: Cluster headaches

Healthcare visit (other): Regular DR visit

Release 11 — 12 months, dose 2

2022-04-12

Symptoms: I did not know I had an immune deficiency disorder. Not sure if Covid flirted up and that's how I did additional studies to find out I'm being referred to a rheumatologist as I tested positive for ANA looks like I may have lupus.

Healthcare visit (other): Regular DR

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	Office visit	·	·	✓
SD	Antinuclear antibody positive	·	·	✓
SD	Chest pain	✓	✓	✓
SD	Cluster headache	·	·	✓
SD	COVID-19	·	·	✓
SD	Immunodeficiency	·	·	✓
SD	Office visit	·	·	✓
SD	Palpitations	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness	✓	✓	✓

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