5HW-28571-36186

3 vaccinations 6 coded responses 28 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 010 / MA
Registered: 2021-06-23

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

2021-06-18
Dose 1 — Moderna
2021-06-23
Registered in v-safe
2021-06-23
Survey response — days 1–6 daily, dose 1
MedDRA: Premature labour — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Systemic reaction (other): On 6/22 it was discovered my cervix was dilated 2 cm · Healthcare visit (other): For potential preterm labor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Report sent to call center — days 1–6 daily, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-06-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-06-25
Health check-in — day 7, dose 1
Feeling: Fair · None

Adult check-in
2021-06-25
Call 1 — Could Not Reach Participant
2021-07-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-07-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-07-18
Survey response — day 28, dose 1
MedDRA: Delivery — 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 · Hospitalization

Free text: I delivered my twins prematurely at 27 weeks.

MedDRA releases: 2024-11 · check-in free text available
2021-07-18
Report sent to call center — day 28, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-23
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-07-23
Call 1 — Left Voicemail
2021-07-30
Dose 2 — Moderna
2021-07-30
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-07-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Adult check-in
2021-08-01
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain — Feeling: Fair

Free text: Chest pains

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-02
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain — Feeling: Good

Free text: Pain in ear

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-08-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-08-05
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Systemic reaction (other): Chest pains right side on and off · Healthcare visit (other): Still waiting might need to go to the ER

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-06
Health check-in — day 7, dose 2
Feeling: Fair · None

Adult check-in
2021-08-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-08-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-08-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-09-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-09-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-10-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-19
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-01-13
Dose 3 — Moderna
2022-01-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-28
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-03
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-10
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-17
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-24
Survey response — day 42, dose 3
MedDRA: Fatigue, Nasopharyngitis, Oropharyngeal pain, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activities

Free text: Cold symptoms, congestion, sore throat, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-18	Moderna	No
2	2021-07-30	Moderna	No
3	2022-01-13	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-23	Unsuccessful
2021-07-18	Unsuccessful
2021-08-05	Successful 2021-11-19	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 9 — days 1–6 daily, dose 1

2021-06-23

Systemic reaction (other): On 6/22 it was discovered my cervix was dilated 2 cm

Healthcare visit (other): For potential preterm labor

Release 9 — day 28, dose 1

2021-07-18

Symptoms: I delivered my twins prematurely at 27 weeks.

Release 9 — days 1–6 daily, dose 2

2021-08-01

Systemic reaction (other): Chest pains

2021-08-02

Systemic reaction (other): Pain in ear

2021-08-05

Systemic reaction (other): Chest pains right side on and off

Healthcare visit (other): Still waiting might need to go to the ER

Release 11 — day 42, dose 3

2022-02-24

Symptoms: Cold symptoms, congestion, sore throat, fatigue

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	Premature labour	✓	✓	✓
HCVO	Unevaluable event	✓	·	✓
SD	Delivery	·	·	✓
SD	Fatigue	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Chest pain	✓	·	✓
SRO	Ear pain	✓	·	✓
SRO	Premature labour	✓	✓	✓

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