579-10561-85256

3 vaccinations 17 coded responses 37 check-ins 17 free-text entries 6 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 805 / CO
Registered: 2021-02-04

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

2021-02-04
Registered in v-safe
2021-02-04
Dose 1 — Moderna
2021-02-04
Survey response — day 0, dose 1
MedDRA: Pruritus — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Generalized itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus, Urticaria — Feeling: Fair · Site: Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: General itching, some scattered hives

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Nausea

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Headache

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Headache

Adult check-in
2021-02-11
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-18
Survey response — day 14, dose 1
MedDRA: Abdominal pain lower, Headache — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Increased right lower abdominal pain since injection, increased headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-25
Survey response — day 21, dose 1
MedDRA: Abdominal pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-04
Dose 2 — Moderna
2021-03-04
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dizziness and swelling in axilla nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Lymphadenopathy-moderate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Abdominal pain

Free text: Lymphadenopathy- axilla, cervical, supraclavicular, thoracic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Diarrhea, Abdominal pain

Free text: Lymphadenopathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness · Muscle or body aches, Abdominal pain

Free text: Lymphadenopathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Diarrhea, Abdominal pain

Free text: Lymphadenopathy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains

Adult check-in
2021-03-18
Survey response — day 14, dose 2
MedDRA: Abdominal pain — Feeling: Good

Free text: Abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 21, dose 2
MedDRA: Abdominal pain, Axillary pain, Neuropathy peripheral, Pyrexia — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Axilla pain, fevers, abdominal pain, neuropathy in hands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-08
Survey response — day 35, dose 2
MedDRA: Abdominal pain — Feeling: Fair · 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: Sever abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — day 35, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-05
Survey response — 3 months, dose 2
MedDRA: Lymphadenopathy, Peritonitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Infection in peritoneal area Ongoing lymphadenopathy since second vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-16
Call 1 — Left Voicemail
2021-06-22
Call successful
Does not wish to fill out VAERS report
2021-09-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-06
Dose 3 — Moderna
2021-11-06
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-09
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Swollen lymph nodes

MedDRA releases: 2024-11 · check-in free text available
2021-11-11
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school

Free text: Lymphadenopathy

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Health check-in — day 7, dose 3
Feeling: Fair · Headache

Adult check-in
2021-11-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-05
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-05-07
Survey response — 6 months, dose 3
MedDRA: COVID-19, Headache, Herpes simplex encephalitis, Hospitalisation — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Headaches daily since I had Covid. Hospitalized for HSV encephalitis concern

MedDRA releases: 2024-11 · check-in free text available
2022-05-07
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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-05-09
Call successful
Participant prefers to complete VAERS report online
2022-11-08
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-04	Moderna
3	2021-11-06	Moderna	No

Call center

6 call center cases

6 successful

See the call center timeline

Free text

Release 3 — day 0, dose 1

2021-02-04

Systemic reaction (other): Generalized itching

Release 3 — days 1–6 daily, dose 1

2021-02-05

Systemic reaction (other): General itching, some scattered hives

Release 4 — day 14, dose 1

2021-02-18

Symptoms: Increased right lower abdominal pain since injection, increased headaches

Release 4 — day 21, dose 1

2021-02-25

Symptoms: Abdominal pain

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): Dizziness and swelling in axilla nodes

2021-03-06

Systemic reaction (other): Lymphadenopathy-moderate

2021-03-07

Systemic reaction (other): Lymphadenopathy- axilla, cervical, supraclavicular, thoracic

2021-03-08

Systemic reaction (other): Lymphadenopathy

2021-03-09

Systemic reaction (other): Lymphadenopathy

2021-03-10

Systemic reaction (other): Lymphadenopathy

Release 5 — day 14, dose 2

2021-03-18

Symptoms: Abdominal pain

Release 6 — day 21, dose 2

2021-03-25

Symptoms: Axilla pain, fevers, abdominal pain, neuropathy in hands

Release 7 — day 35, dose 2

2021-04-08

Symptoms: Sever abdominal pain

Release 8 — 3 months, dose 2

2021-06-05

Symptoms: Infection in peritoneal area Ongoing lymphadenopathy since second vaccine

Release 10 — days 1–6 daily, dose 3

2021-11-09

Systemic reaction (other): Swollen lymph nodes

2021-11-11

Systemic reaction (other): Lymphadenopathy

Release 11 — 6 months, dose 3

2022-05-07

Symptoms: Headaches daily since I had Covid. Hospitalized for HSV encephalitis concern

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	Abdominal pain	✓	✓	✓
SD	Abdominal pain lower	✓	✓	✓
SD	Axillary pain	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Headache	✓	✓	✓
SD	Herpes simplex encephalitis	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Neuropathy peripheral	✓	✓	✓
SD	Peritonitis	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Urticaria	✓	✓	✓

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