57Q-17520-68856

2 vaccinations 11 coded responses 25 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 958 / CA
Registered: 2021-03-15

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

2021-03-15
Registered in v-safe
2021-03-17
Dose 1 — Moderna
2021-03-17
Survey response — day 0, dose 1
MedDRA: Pruritus — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Itchiness on vaccine arm but no visible rash

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Confusional state, Dizziness — Feeling: Poor · Site: Pain, Swelling · Headache, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness, confusion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-31
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-07
Survey response — day 21, dose 1
MedDRA: Fatigue, Headache, Menstruation irregular, Postpartum state — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache, exhaustion. Could be hormones. I'm 48, postpartum by 5 years, and my period schedule is goofy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Dose 2 — Moderna
2021-04-14
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Dysmenorrhoea, Intermenstrual bleeding — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Menstrual spotting and cramping though my period ended a few days ago. This is not normal for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Menstrual cramps

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Chills, Headache, Joint pains

Free text: Menstrual aching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills

Adult check-in
2021-04-21
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-04-28
Survey response — day 14, dose 2
MedDRA: Chills, Fatigue, Headache, Pyrexia — Feeling: Fair

Free text: Maybe I have a coldChills and a hint of a fever, exhaustion, headache. Needed extra sleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — day 21, dose 2
MedDRA: Chills, Cough, Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: I think I had a common cold. Exhaustion, chills, lots of coughingMy child had one days before I did, and he was very congested, but since I take allergy medicine it's hard to know if that was something that happened to me or not

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — day 42, dose 2
MedDRA: No adverse event, Vertigo — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Vertigo - worse than usual. Probably totally unrelated to vaccine. · Healthcare visit (other): None

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-14
Survey response — 3 months, dose 2
MedDRA: Fatigue, Pre-existing disease, Vertigo — Feeling: Fair · Be unable to do your normal daily activities

Free text: Vertigo and exhaustionI don't know that it's related to vaccination or long covid but maybe

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-13
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-14
Survey response — 12 months, dose 2
MedDRA: Viral infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Several non covid viruses

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-17	Moderna
2	2021-04-14	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-05-27	Successful 2022-04-27	Not applicable - Accidental Reporting

Free text

Release 5 — day 0, dose 1

2021-03-17

Systemic reaction (other): Itchiness on vaccine arm but no visible rash

Release 5 — days 1–6 daily, dose 1

2021-03-18

Systemic reaction (other): Dizziness, confusion

Release 7 — day 21, dose 1

2021-04-07

Symptoms: Headache, exhaustion. Could be hormones. I'm 48, postpartum by 5 years, and my period schedule is goofy.

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Menstrual spotting and cramping though my period ended a few days ago. This is not normal for me.

2021-04-16

Systemic reaction (other): Menstrual cramps

2021-04-19

Systemic reaction (other): Menstrual aching

Release 8 — day 14, dose 2

2021-04-28

Symptoms: Maybe I have a coldChills and a hint of a fever, exhaustion, headache. Needed extra sleep

Release 8 — day 21, dose 2

2021-05-05

Symptoms: I think I had a common cold. Exhaustion, chills, lots of coughingMy child had one days before I did, and he was very congested, but since I take allergy medicine it's hard to know if that was something that happened to me or not

Release 8 — day 42, dose 2

2021-05-27

Symptoms: Vertigo - worse than usual. Probably totally unrelated to vaccine.

Healthcare visit (other): None

Release 9 — 3 months, dose 2

2021-07-14

Symptoms: Vertigo and exhaustionI don't know that it's related to vaccination or long covid but maybe

Release 11 — 12 months, dose 2

2022-04-14

Symptoms: Several non covid viruses

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	No adverse event	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Menstruation irregular	✓	✓	✓
SD	Postpartum state	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Vertigo	✓	✓	✓
SD	Viral infection	·	·	✓
SRO	Confusional state	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysmenorrhoea	✓	✓	✓
SRO	Intermenstrual bleeding	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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