5AQ-63754-86853

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

Sex: Female
Age at first dose: 51-55
ZIP prefix: 034 / NH
Registered: 2021-03-05

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

2021-03-04
Dose 1 — Moderna
2021-03-05
Registered in v-safe
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, 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 · Site: Pain, Swelling · Fatigue or tiredness, Diarrhea

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 — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 21, dose 1
MedDRA: Unevaluable event — Feeling: Poor · Be unable to work

Free text: Ive had a hysteroscopy w d&c, colonoscopy and a full hysterectomy - I feel dreadful but none related to my cv vax

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — day 28, dose 1
MedDRA: Hysterectomy — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: I had a full/complete hysterectomy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Report sent to call center — day 28, dose 1
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)
2021-04-03
Dose 2 — Moderna
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Hysterectomy, Migraine — Feeling: Good · Site: Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I am also get migraines & am 16 days post op complete hysterectomy so my symptoms overlap

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-12
Health check-in — day 7, dose 2
Feeling: Fair · Chills, Headache, Joint pains, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-03
Survey response — day 28, dose 2
MedDRA: Chills, Fatigue, Headache, Hyperhidrosis, Hysterectomy — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Relating to my hysterectomy probably-Exhaustion/extreme fatigue, mild chills/sweats, headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Report sent to call center — day 28, 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)
2021-05-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-09
Call 1 — Left Voicemail
2022-04-03
Survey response — 12 months, dose 2
MedDRA: Aphasia, Depression, Fatigue, Irritable bowel syndrome, Weight increased — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Fatigue, ibs, increased difficulty with remembering the right words, depression, weight gain

MedDRA releases: 2024-11 · check-in free text available
2022-04-03
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-04
Call 1 — Could Not Reach Participant
2022-04-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

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

Call center

Reported	Outcome	VAERS-related outcome
2021-04-01	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-03	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-03	Successful 2022-04-04	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 5 — day 14, dose 1

2021-03-18

Symptoms: Fatigue

Release 6 — day 21, dose 1

2021-03-25

Symptoms: Ive had a hysteroscopy w d&c, colonoscopy and a full hysterectomy - I feel dreadful but none related to my cv vax

Release 6 — day 28, dose 1

2021-04-01

Symptoms: I had a full/complete hysterectomy

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): I am also get migraines & am 16 days post op complete hysterectomy so my symptoms overlap

Release 8 — day 28, dose 2

2021-05-03

Symptoms: Relating to my hysterectomy probably-Exhaustion/extreme fatigue, mild chills/sweats, headache

Release 11 — 12 months, dose 2

2022-04-03

Symptoms: Fatigue, ibs, increased difficulty with remembering the right words, depression, weight gain

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	Aphasia	·	·	✓
SD	Chills	✓	✓	✓
SD	Depression	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Hysterectomy	✓	✓	✓
SD	Irritable bowel syndrome	·	·	✓
SD	Unevaluable event	✓	✓	✓
SD	Weight increased	·	·	✓
SRO	Hysterectomy	✓	✓	✓
SRO	Migraine	✓	✓	✓

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