6CW-45076-75378

2 vaccinations 6 coded responses 25 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 450 / OH
Registered: 2020-12-29

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

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Health check-in — day 0, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2020-12-29
Report sent to call center — day 0, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2020-12-30
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

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

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

Adult check-in
2021-01-06
Survey response — day 7, dose 1
MedDRA: Dyspnoea — Feeling: Good · Fatigue or tiredness

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-20
Survey response — day 21, dose 1
MedDRA: Dysgeusia, Taste disorder — Feeling: Good

Free text: Changes in taste (still able to taste, everything just tastes funny).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 0, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-01-28
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, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling, Itching · Headache, Joint pains

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache, Diarrhea

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Diarrhea

Adult check-in
2021-02-02
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-16
Survey response — day 21, dose 2
MedDRA: Pityriasis rosea, Rash, Unevaluable event — Feeling: Good

Free text: Skin rash that looks like pityriasis rosea-has not been diagnosed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — day 28, dose 2
MedDRA: Pityriasis rosea — Feeling: Good

Free text: Worsening pityriasis rosea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-11
Survey response — day 42, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good

Free text: Worsening pityriasis rosea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-29
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-01-26
Survey response — 12 months, dose 2
MedDRA: COVID-19 — 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: I got covid

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Report sent to call center — 12 months, dose 2
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)
2022-01-27
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2020-12-29	priority 2/3
2020-12-30	priority 2/3
2022-01-26	Successful 2022-01-27	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 1 — day 7, dose 1

2021-01-06

Systemic reaction (other): Shortness of breath

Release 2 — day 21, dose 1

2021-01-20

Symptoms: Changes in taste (still able to taste, everything just tastes funny).

Release 4 — day 21, dose 2

2021-02-16

Symptoms: Skin rash that looks like pityriasis rosea-has not been diagnosed.

Release 4 — day 28, dose 2

2021-02-23

Symptoms: Worsening pityriasis rosea

Release 5 — day 42, dose 2

2021-03-11

Symptoms: Worsening pityriasis rosea

Release 11 — 12 months, dose 2

2022-01-26

Symptoms: I got covid

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	Condition aggravated	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Dysgeusia	✓	✓	✓
SD	Pityriasis rosea	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Taste disorder	✓	✓	✓
SD	Unevaluable event	○	✓	○
SRO	Dyspnoea	✓	✓	✓

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