5T8-19595-54995

4 vaccinations 3 coded responses 51 check-ins 2 free-text entries 2 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 665 / KS
Registered: 2020-12-29

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Registered dependents

VQF-13091-72325 Child or adolescent in my care · Female · 2022-06-26

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Nausea

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-24
Dose 3 — Moderna
2021-10-24
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-07
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-21
Survey response — day 28, dose 3
MedDRA: Abdominal pain, Diarrhoea, Vomiting — Feeling: Poor · 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: Vomiting, diarrhea, abdominal pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Report sent to call center — day 28, dose 3
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)
2021-11-23
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-28
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-23
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-24
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-01
Dose 4 — Moderna
2022-10-01
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-10-02
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-10-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-08
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-15
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-22
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-29
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-12
Survey response — day 42, dose 4
MedDRA: Conjunctivitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Conjunctivitis

MedDRA releases: 2024-11 · check-in free text available
2022-11-12
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-14
Call 1 — Left Voicemail
2022-11-22
Call successful
Not applicable - Accidental Reporting
2022-12-31
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-04-01
Survey response — 6 months, dose 4
MedDRA: Nasopharyngitis — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna
3	2021-10-24	Moderna	No
4	2022-10-01	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-11-21	Successful 2021-11-23	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-11-12	Successful 2022-11-22	Not applicable - Accidental Reporting

Free text

Release 10 — day 28, dose 3

2021-11-21

Symptoms: Vomiting, diarrhea, abdominal pain

Release 12 — day 42, dose 4

2022-11-12

Symptoms: Conjunctivitis

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	Abdominal pain	·	·	✓
SD	Conjunctivitis	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Vomiting	·	·	✓

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