57N-33740-05322

3 vaccinations 5 coded responses 38 check-ins 5 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 060 / CT
Registered: 2021-03-03

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

H2D-16297-60269 Child or adolescent in my care · Male · 2022-04-15

Timeline

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Moderna
2021-03-03
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-03-31
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-21
Survey response — day 21, dose 2
MedDRA: Nausea, Vomiting — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Vomiting and nausea lasting more than a few hours (2 days)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Survey response — 6 months, dose 2
MedDRA: Asthenopia, Headache, Menstruation irregular, Vision blurred — 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: My period has been out of wack. I have an iud and i had my period for 16/21 days with 4 days off between spans. The intensity of it has gotten worse too.I have had eye issues where my focus comes and goes & i have some eye strain causing headaches.

MedDRA releases: 2024-11 · check-in free text available
2021-09-29
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-04
Call successful
Participant prefers to complete VAERS report online
2022-03-31
Survey response — 12 months, dose 2
MedDRA: Anxiety, Stress — 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: Stress and anxiety

MedDRA releases: 2024-11 · check-in free text available
2022-03-31
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-05
Call successful
Does not wish to fill out VAERS report
2022-04-14
Dose 3 — Moderna
2022-04-15
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-04-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2022-04-17
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · Muscle or body aches

Adult check-in
2022-04-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-04-21
Health check-in — day 7, dose 3
Feeling: Good · Headache

Adult check-in
2022-04-28
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-05-05
Survey response — day 21, dose 3
MedDRA: Aphonia, Cough, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Cough, sore throat, loss of voice

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Survey response — day 28, dose 3
MedDRA: Chest pain, Cough, Oropharyngeal pain, Paranasal sinus discomfort, Rhinorrhoea, Upper-airway cough syndrome — Feeling: Fair · Be unable to work or attend school

Free text: Sore throat, cough, chest pains, sinus pressure, runny nose, post nasal drip

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-05-26
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-07-14
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-10-13
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2022-04-14	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 7 — day 21, dose 2

2021-04-21

Symptoms: Vomiting and nausea lasting more than a few hours (2 days)

Release 9 — 6 months, dose 2

2021-09-29

Symptoms: My period has been out of wack. I have an iud and i had my period for 16/21 days with 4 days off between spans. The intensity of it has gotten worse too.I have had eye issues where my focus comes and goes & i have some eye strain causing headaches. cut off by CDC

Release 11 — 12 months, dose 2

2022-03-31

Symptoms: Stress and anxiety

Release 11 — day 21, dose 3

2022-05-05

Symptoms: Cough, sore throat, loss of voice

Release 11 — day 28, dose 3

2022-05-12

Symptoms: Sore throat, cough, chest pains, sinus pressure, runny nose, post nasal drip

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	Anxiety	·	·	✓
SD	Aphonia	·	·	✓
SD	Asthenopia	·	·	✓
SD	Chest pain	·	·	✓
SD	Cough	·	·	✓
SD	Headache	·	·	✓
SD	Menstruation irregular	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Stress	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SD	Vision blurred	·	·	✓
SD	Vomiting	✓	✓	✓

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