52J-30064-86093

3 vaccinations 6 coded responses 33 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 760 / TX
Registered: 2021-01-31

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

2021-01-28
Dose 1 — Moderna
2021-01-31
Registered in v-safe
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Itching · None

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-18
Survey response — day 21, dose 1
MedDRA: Respiratory tract congestion — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I had to call teledoc for a z pack and some prednisone. I had some unrelated congestion that was driving me CRaZY!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety — Feeling: Good · Headache

Free text: Anxiety

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: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Survey response — day 42, dose 2
MedDRA: Hypersensitivity — Feeling: Good

Free text: Allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-06
Call 1 — Left Voicemail
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sinus infection

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-02
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-22
Dose 3 — Moderna
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-14
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-22
Survey response — 6 months, dose 3
MedDRA: Diabetes mellitus — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Diabetes

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-25
Call 1 — Left Voicemail
2022-10-22
Survey response — 12 months, dose 3
MedDRA: Pregnancy — Feeling: Good

Free text: Pregnant

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-10-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-18	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-08-26	Successful 2021-09-02	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-22	Unsuccessful

Free text

Release 4 — day 21, dose 1

2021-02-18

Symptoms: I had to call teledoc for a z pack and some prednisone. I had some unrelated congestion that was driving me CRaZY!

Release 4 — days 1–6 daily, dose 2

2021-03-01

Systemic reaction (other): Anxiety

Release 7 — day 42, dose 2

2021-04-08

Symptoms: Allergies

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: Sinus infection

Release 11 — 6 months, dose 3

2022-04-22

Symptoms: Diabetes

Release 12 — 12 months, dose 3

2022-10-22

Symptoms: Pregnant

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	Diabetes mellitus	·	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sinusitis	✓	·	✓
SRO	Anxiety	✓	✓	✓

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