69K-44384-95971

4 vaccinations 11 coded responses 36 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 730 / OK
Registered: 2021-03-04

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

2021-03-04
Registered in v-safe
2021-03-04
Dose 1 — Moderna
2021-03-04
Health check-in — day 0, dose 1
Feeling: Good · Fever · Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

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

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — day 7, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-03-18
Survey response — day 14, dose 1
MedDRA: Dizziness, Dyspnoea, Nausea — Feeling: Good · Be unable to work, 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: Shortness of breath, nausea, lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 14, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-01
Dose 2 — Moderna
2021-04-01
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains

Adult check-in
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Anxiety — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Anxiety

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

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 — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-04
Dose 3 — Moderna
2021-12-08
Call successful
Does not wish to fill out VAERS report
2022-04-01
Survey response — 12 months, dose 2
MedDRA: Dyspnoea, Palpitations — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Shortness of breath and heart palpations

MedDRA releases: 2024-11 · check-in free text available
2022-04-01
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-06
Call successful
Does not wish to fill out VAERS report
2022-11-27
Dose 4 — Moderna
2022-11-27
Health check-in — day 0, dose 4
Feeling: Good · Fever · None

Adult check-in
2022-11-28
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-29
Survey response — days 1–6 daily, dose 4
MedDRA: Asthma, Chest pain, Dyspnoea, Pre-existing disease — Feeling: Fair · Site: Pain

Free text: Shortness of breath/asthma exacerbation and chest pain

MedDRA releases: 2024-11 · check-in free text available
2022-11-30
Survey response — days 1–6 daily, dose 4
MedDRA: Asthma, Dyspnoea, Pre-existing disease — Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Asthma exacerbation, shortness of breath needing asthma rescue inhaler

MedDRA releases: 2024-11 · check-in free text available
2022-12-01
Survey response — days 1–6 daily, dose 4
MedDRA: Asthma, Chest discomfort, Dyspnoea, Pre-existing disease — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shortness of breath, lung discomfort, asthma exacerbation

MedDRA releases: 2024-11 · check-in free text available
2022-12-02
Survey response — days 1–6 daily, dose 4
MedDRA: Asthma, Dyspnoea, Pre-existing disease — Feeling: Good

Free text: Mild shortness of breath/asthma exacerbation.

MedDRA releases: 2024-11 · check-in free text available
2022-12-04
Survey response — day 7, dose 4
MedDRA: Asthma, Dyspnoea, Pre-existing disease — Feeling: Fair

Free text: Asthma exacerbation, shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2022-12-11
Survey response — day 14, dose 4
MedDRA: Asthma, Dyspnoea, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Asthma exacerbation, shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2022-12-18
Survey response — day 21, dose 4
MedDRA: Asthma, Dyspnoea, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Shortness of breath, continues asthma exacerbation

MedDRA releases: 2024-11 · check-in free text available
2022-12-27
Survey response — day 28, dose 4
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Exacerbation of shortness of breath loss without relief from albuterol inhaler

MedDRA releases: 2024-11 · check-in free text available
2023-01-08
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-05-28
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna
3	2021-12-04	Moderna	No
4	2022-11-27	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-18

Symptoms: Shortness of breath, nausea, lightheaded

Release 6 — days 1–6 daily, dose 2

2021-04-04

Systemic reaction (other): Anxiety

Release 11 — 12 months, dose 2

2022-04-01

Symptoms: Shortness of breath and heart palpations

Release 12 — days 1–6 daily, dose 4

2022-11-29

Systemic reaction (other): Shortness of breath/asthma exacerbation and chest pain

2022-11-30

Systemic reaction (other): Asthma exacerbation, shortness of breath needing asthma rescue inhaler

2022-12-01

Systemic reaction (other): Shortness of breath, lung discomfort, asthma exacerbation

2022-12-02

Systemic reaction (other): Mild shortness of breath/asthma exacerbation.

Release 12 — day 7, dose 4

2022-12-04

Systemic reaction (other): Asthma exacerbation, shortness of breath

Release 12 — day 14, dose 4

2022-12-11

Symptoms: Asthma exacerbation, shortness of breath

Release 12 — day 21, dose 4

2022-12-18

Symptoms: Shortness of breath, continues asthma exacerbation

Release 12 — day 28, dose 4

2022-12-27

Symptoms: Exacerbation of shortness of breath loss without relief from albuterol inhaler

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	Asthma	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Palpitations	·	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Anxiety	✓	✓	✓
SRO	Asthma	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Pre-existing disease	·	·	✓

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