5ML-17063-56686

3 vaccinations 13 coded responses 30 check-ins 13 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 619 / IL
Registered: 2021-02-24

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
Dose 1 — Moderna
2021-02-24
Registered in v-safe
2021-02-24
Dose 2 — Moderna
2021-02-24
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Headache

Free text: Mild Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite, Syncope — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Loss of appetite, Fainting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal discomfort, Abdominal distension — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Stomach upset/bloating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Intermenstrual bleeding, Pelvic pain — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Pelvic ache, very light menstrual spotting (not during period)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-03-03
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Survey response — day 35, dose 2
MedDRA: Cyst, Mammogram, Ultrasound scan — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Benign Cyst detected on routine mammogram/ultrasound. Spotting between periods-have appointment with doctor next week to check it out. · Healthcare visit (other): Had to go for diagnostic mammogram and ultrasound after routine screening mammogram.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

no matching call case
2021-04-07
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-08
Dose 3 — Moderna
2022-01-08
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches

Adult check-in
2022-01-09
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Reduced appetite

MedDRA releases: 2024-11 · check-in free text available
2022-01-10
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal discomfort, Flatulence — Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Stomach upset/gas

MedDRA releases: 2024-11 · check-in free text available
2022-01-11
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal discomfort, Flatulence — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to work or attend school

Free text: Digestive upset/gas

MedDRA releases: 2024-11 · check-in free text available
2022-01-12
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal discomfort — Feeling: Fair · Site: Pain · Fever · Headache

Free text: Digestive upset

MedDRA releases: 2024-11 · check-in free text available
2022-01-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-01-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-01-15
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-01-22
Survey response — day 14, dose 3
MedDRA: Nasal congestion, Paranasal sinus discomfort — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nasal congestion, sinus pressure

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Survey response — day 21, dose 3
MedDRA: Cough, Fatigue, Headache, Myalgia, Nasal congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Nasal congestion, headache, fatigue, muscle aches, and slight cough.

MedDRA releases: 2024-11 · check-in free text available
2022-02-05
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-12
Survey response — day 35, dose 3
MedDRA: Cartilage injury — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: New diagnosis of hip labral tear.

MedDRA releases: 2024-11 · check-in free text available
2022-02-12
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-17
Call successful
Participant prefers to complete VAERS report online
2022-02-19
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-04-09
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-11
Survey response — 6 months, dose 3
MedDRA: Cartilage injury, Hip surgery — 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

Free text: Hip surgery to repair a small labrum tear.

MedDRA releases: 2024-11 · check-in free text available
2022-07-11
Report sent to call center — 6 months, dose 3
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)
2022-07-12
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-24	Moderna
3	2022-01-08	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

1 check-in flagged for a call with no call center case on record

See the call center timeline

Free text

Release 4 — day 0, dose 2

2021-02-24

Systemic reaction (other): Mild Dizziness

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): Loss of appetite, Fainting

2021-02-26

Systemic reaction (other): Stomach upset/bloating

2021-02-27

Systemic reaction (other): Pelvic ache, very light menstrual spotting (not during period)

Release 6 — day 35, dose 2

2021-04-01

Symptoms: Benign Cyst detected on routine mammogram/ultrasound. Spotting between periods-have appointment with doctor next week to check it out.

Healthcare visit (other): Had to go for diagnostic mammogram and ultrasound after routine screening mammogram.

Release 10 — days 1–6 daily, dose 3

2022-01-09

Systemic reaction (other): Reduced appetite

2022-01-10

Systemic reaction (other): Stomach upset/gas

2022-01-11

Systemic reaction (other): Digestive upset/gas

2022-01-12

Systemic reaction (other): Digestive upset

Release 11 — day 14, dose 3

2022-01-22

Symptoms: Nasal congestion, sinus pressure

Release 11 — day 21, dose 3

2022-01-29

Symptoms: Nasal congestion, headache, fatigue, muscle aches, and slight cough.

Release 11 — day 35, dose 3

2022-02-12

Symptoms: New diagnosis of hip labral tear.

Release 12 — 6 months, dose 3

2022-07-11

Symptoms: Hip surgery to repair a small labrum tear.

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	Mammogram	✓	✓	✓
HCVO	Ultrasound scan	✓	✓	✓
SD	Cartilage injury	·	·	✓
SD	Cough	·	·	✓
SD	Cyst	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Hip surgery	·	·	✓
SD	Myalgia	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Abdominal distension	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Flatulence	·	·	✓
SRO	Intermenstrual bleeding	✓	✓	✓
SRO	Pelvic pain	✓	✓	✓
SRO	Syncope	✓	✓	✓

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