5MB-79391-49538

5 vaccinations 4 coded responses 46 check-ins 3 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 857 / AZ
Registered: 2021-03-03

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

2021-03-03
Registered in v-safe
2021-03-03
Dose 1 — Moderna
2021-03-03
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Blood glucose increased, Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Diarrhea

Free text: Higher blood sugars (I have cf related diabetes and wear a cgm)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · Joint pains, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness · None

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 — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-03-31
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 7, dose 2
Feeling: Good · Diarrhea

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

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

Adult check-in
2021-04-28
Health check-in — day 28, dose 2
Feeling: Good

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

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-13
Dose 3 — Moderna
2022-03-31
Survey response — 12 months, dose 2
MedDRA: Respiratory tract infection viral — Feeling: Good · Be unable to do your normal daily activities

Free text: I have had 2 non Covid respiratory viruses in the past month

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Dose 4 — Moderna
Co-administered: Tetanus
2022-05-14
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-14
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-10
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-29
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-19
Dose 5 — Moderna
2022-09-19
Health check-in — day 0, dose 5
Feeling: Fair · Site: Pain · None

Adult check-in
2022-09-20
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-09-21
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2022-09-22
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2022-09-23
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2022-09-24
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-25
Survey response — days 1–6 daily, dose 5
MedDRA: Nasopharyngitis — Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Common cold

MedDRA releases: 2024-11 · check-in free text available
2022-09-26
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-03
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-10
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-17
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-24
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-31
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-03-20
Survey response — 6 months, dose 5
MedDRA: Constipation, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-03-20
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-03-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2021-11-13	Moderna	No
4	2022-04-29	Moderna	Tetanus
5	2022-09-19	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2023-03-20	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): Higher blood sugars (I have cf related diabetes and wear a cgm)

Release 11 — 12 months, dose 2

2022-03-31

Symptoms: I have had 2 non Covid respiratory viruses in the past month

Release 12 — days 1–6 daily, dose 5

2022-09-25

Systemic reaction (other): Common cold

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	Unevaluable event	·	·	✓
SD	Constipation	·	·	✓
SD	Respiratory tract infection viral	·	·	✓
SRO	Blood glucose increased	✓	✓	✓
SRO	Nasopharyngitis	·	·	✓
SRO	Pre-existing disease	✓	✓	✓

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