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5HW-18838-60714

4 vaccinations 5 coded responses 36 check-ins 5 free-text entries 1 call case
Sex
Female
Age at first dose
36-40
ZIP prefix
601 / IL
Registered
2021-03-16
Relationship
Self
Race
White
Ethnicity
Not Hispanic or Latino

Timeline

  1. 2021-03-16
    Registered in v-safe
  2. 2021-03-16
    Dose 1 — Moderna
  3. 2021-03-16
    Survey response — day 0, dose 1
    MedDRA: Immediate post-injection reaction, Syncope — Feeling: Fair · Site: Pain · Chills
    Free text: Faint 5 minutes after injection
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  4. 2021-03-17
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities
    Adult check-in
  5. 2021-03-18
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Site: Pain · None
    Adult check-in
  6. 2021-03-19
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  7. 2021-03-20
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  8. 2021-03-21
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · Diarrhea
    Adult check-in
  9. 2021-03-22
    Health check-in — days 1–6 daily, dose 1
    Feeling: Good · None
    Adult check-in
  10. 2021-03-23
    Health check-in — day 7, dose 1
    Feeling: Good · None
    Adult check-in
  11. 2021-03-30
    Survey response — day 14, dose 1
    MedDRA: Dehydration, Nausea — Feeling: Good
    Free text: Ive felt slightly dehydrated despite drinking normal or above normal amounts of water. Some intermittent nausea 2-3 times since injection.
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  12. 2021-04-06
    Health check-in — day 21, dose 1
    Feeling: Good
    Adult check-in
  13. 2021-04-13
    Dose 2 — Moderna
  14. 2021-04-13
    Health check-in — day 0, dose 2
    Feeling: Good · None
    Adult check-in
  15. 2021-04-14
    Health check-in — days 1–6 daily, dose 2
    Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities
    Adult check-in
  16. 2021-04-15
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  17. 2021-04-16
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · Site: Pain · None
    Adult check-in
  18. 2021-04-17
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  19. 2021-04-18
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  20. 2021-04-19
    Health check-in — days 1–6 daily, dose 2
    Feeling: Good · None
    Adult check-in
  21. 2021-04-20
    Health check-in — day 7, dose 2
    Feeling: Good · None
    Adult check-in
  22. 2021-04-27
    Health check-in — day 14, dose 2
    Feeling: Good
    Adult check-in
  23. 2021-05-04
    Survey response — day 21, dose 2
    MedDRA: Nausea — Feeling: Fair · Be unable to do your normal daily activities
    Free text: Nausea
    MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
  24. 2021-05-11
    Health check-in — day 28, dose 2
    Feeling: Good
    Adult check-in
  25. 2021-05-18
    Health check-in — day 35, dose 2
    Feeling: Good
    Adult check-in
  26. 2021-05-25
    Health check-in — day 42, dose 2
    Feeling: Good
    Adult check-in
  27. 2021-07-13
    Health check-in — 3 months, dose 2
    Feeling: Good
    Adult check-in
  28. 2021-10-12
    Health check-in — 6 months, dose 2
    Feeling: Good
    Adult check-in
  29. 2021-11-27
    Dose 3 — Moderna
  30. 2022-04-15
    Survey response — 12 months, dose 2
    MedDRA: Emergency care, Heavy menstrual bleeding, Menstruation irregular — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit
    Free text: Heavy menstral bleeding that led to emergency room visit. Overall having a more irregular period
    MedDRA releases: 2024-11 · check-in free text available
  31. 2022-04-15
    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
    Emergency room or emergency department visit · 1 call case(s)
  32. 2022-04-21
  33. 2022-04-21
    Call successful
    Does not wish to fill out VAERS report
  34. 2022-09-30
    Dose 4 — Moderna
  35. 2022-10-05
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  36. 2022-10-06
    Health check-in — days 1–6 daily, dose 4
    Feeling: Good · None
    Adult check-in
  37. 2022-10-07
    Health check-in — day 7, dose 4
    Feeling: Good · None
    Adult check-in
  38. 2022-10-14
    Health check-in — day 14, dose 4
    Feeling: Good
    Adult check-in
  39. 2022-10-21
    Health check-in — day 21, dose 4
    Feeling: Good
    Adult check-in
  40. 2022-10-28
    Health check-in — day 28, dose 4
    Feeling: Good
    Adult check-in
  41. 2022-11-04
    Health check-in — day 35, dose 4
    Feeling: Good
    Adult check-in
  42. 2022-11-11
    Survey response — day 42, dose 4
    MedDRA: Depression, Headache, Heavy menstrual bleeding, Menstruation irregular, Polymenorrhoea, Reaction to previous exposure to any vaccine — Feeling: Good · Be unable to do your normal daily activities
    Free text: Changes to my period. Shorter in length but more intense symptoms (heavier bleeding, headache, and severe, temporary depression). I have experienced menstrual changes after each vaccination.
    MedDRA releases: 2024-11 · check-in free text available
  43. 2022-12-30
    Health check-in — 3 months, dose 4
    Feeling: Good
    Adult check-in
  44. 2023-04-02
    Health check-in — 6 months, dose 4
    Feeling: Good
    Adult check-in

Vaccinations

DoseDateManufacturerCo-administered
12021-03-16Moderna
22021-04-13Moderna
32021-11-27Moderna No
42022-09-30Moderna No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-16

Systemic reaction (other): Faint 5 minutes after injection

Release 6 — day 14, dose 1

2021-03-30

Symptoms: Ive felt slightly dehydrated despite drinking normal or above normal amounts of water. Some intermittent nausea 2-3 times since injection.

Release 8 — day 21, dose 2

2021-05-04

Symptoms: Nausea

Release 11 — 12 months, dose 2

2022-04-15

Symptoms: Heavy menstral bleeding that led to emergency room visit. Overall having a more irregular period

Release 12 — day 42, dose 4

2022-11-11

Symptoms: Changes to my period. Shorter in length but more intense symptoms (heavier bleeding, headache, and severe, temporary depression). I have experienced menstrual changes after each vaccination.

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

FieldPreferred term2021-092023-042024-11
SDDehydration ✓ ✓ ✓
SDDepression · · ✓
SDEmergency care · · ✓
SDHeadache · · ✓
SDHeavy menstrual bleeding · · ✓
SDMenstruation irregular · · ✓
SDNausea ✓ ✓ ✓
SDPolymenorrhoea · · ✓
SDReaction to previous exposure to any vaccine · · ✓
SROImmediate post-injection reaction ✓ ✓ ✓
SROSyncope ✓ ✓ ✓

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

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