5EU-34834-71286

4 vaccinations 8 coded responses 35 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 189 / PA
Registered: 2021-01-28

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
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain

Free text: Dizziness about 10:30 pm last night for an hour or two

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I thought I would take a nap and woke up 5 hours later.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · 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
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Influenza, Nasopharyngitis, Oral herpes, Pain, Pre-existing disease — Feeling: Good

Free text: I got a fever blister on my lip today, which always happens after a cold or flu. Im afraid to take Vsltrex because I dont want to mess with my body as it builds antibodies to Covid. But those cold sores are enormous, painful and last two weeks.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Survey response — day 14, dose 1
MedDRA: Rhinorrhoea — Feeling: Fair

Free text: runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

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

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

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

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

Adult check-in
2021-03-11
Survey response — day 14, dose 2
MedDRA: Oral herpes — Feeling: Good

Free text: Break out of lip herpes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
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
2021-04-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Nipple disorder, Nipple pain — Feeling: Fair

Free text: First the nipple on my left side (vaccination side) became sore, then a little itchy. Then it happened to the right nipple. It stayed like that for a couple months but has mostly gone away now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-14
Dose 3 — Moderna
2022-02-25
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-03-15
Survey response — 6 months, dose 3
MedDRA: Nasopharyngitis, Urinary tract infection — Feeling: Fair · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I keep on getting colds every two weeks. And several UTI's .

MedDRA releases: 2024-11 · check-in free text available
2022-03-15
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-18
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-03
Dose 4 — Moderna
2022-04-14
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-17
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-24
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-01
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-08
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-15
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-03
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-02
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-03
Survey response — 12 months, dose 4
MedDRA: COVID-19 — 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

MedDRA releases: 2024-11
2023-04-03
Report sent to call center — 12 months, dose 4
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)
2023-04-04
Call 1 — Requested Callback
2023-04-04
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-09-14	Moderna	No
4	2022-04-03	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): Dizziness about 10:30 pm last night for an hour or two

2021-01-30

Systemic reaction (other): I thought I would take a nap and woke up 5 hours later.

2021-02-03

Systemic reaction (other): I got a fever blister on my lip today, which always happens after a cold or flu. Im afraid to take Vsltrex because I dont want to mess with my body as it builds antibodies to Covid. But those cold sores are enormous, painful and last two weeks.

Release 4 — day 14, dose 1

2021-02-11

Symptoms: runny nose

Release 5 — day 14, dose 2

2021-03-11

Symptoms: Break out of lip herpes

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: First the nipple on my left side (vaccination side) became sore, then a little itchy. Then it happened to the right nipple. It stayed like that for a couple months but has mostly gone away now.

Release 11 — 6 months, dose 3

2022-03-15

Symptoms: I keep on getting colds every two weeks. And several UTI's .

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	COVID-19	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nipple disorder	✓	✓	✓
SD	Nipple pain	✓	✓	✓
SD	Oral herpes	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Urinary tract infection	·	·	✓
SRO	Condition aggravated	✓	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Influenza	○	✓	○
SRO	Nasopharyngitis	○	✓	○
SRO	Oral herpes	✓	✓	✓
SRO	Pain	✓	·	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Unevaluable event	✓	✓	✓

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