6QW-12790-17019

2 vaccinations 10 coded responses 19 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 947 / CA
Registered: 2020-12-31

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

2020-12-31
Registered in v-safe
2020-12-31
Dose 1 — Moderna
2020-12-31
Health check-in — day 0, dose 1
Feeling: Good · None

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

Adult check-in
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Cold sweat — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Cold sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Night sweats — Feeling: Good · Chills

Free text: Night sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site lymphadenopathy, Injection site pain — Feeling: Fair

Free text: Painful swollen axillary lymph node proximal to injection site in left deltoid

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Survey response — day 7, dose 1
MedDRA: Lymphadenopathy, Tenderness — Feeling: Good

Free text: Proximal axillary lymphadenopathy and tenderness

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

Adult check-in
2021-01-21
Survey response — day 21, dose 1
MedDRA: Night sweats, Syncope — Feeling: Good · Be unable to work

Free text: Unexplained syncopal episode on 1/19Near nightly cold night sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — day 28, dose 1
MedDRA: Dizziness, Syncope — Feeling: Good

Free text: Repeated dizziness and fainting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Dose 2 — Moderna
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Fatigue, Pain, Pyrexia — Feeling: Good · Fatigue or tiredness

Free text: Fever up to 102.5, body aches, joint pain, and fatigue on 1/30. Was not contacted that day for vsafe check in on the day after my second shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-02
Survey response — 3 months, dose 2
MedDRA: Dizziness, Night sweats — Feeling: Fair

Free text: Intermittent dizziness/near fainting. Night -sweats.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-30
Survey response — 6 months, dose 2
MedDRA: Nausea, Night sweats — Feeling: Fair

Free text: Persistent night sweats and nausea

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-01-31
Survey response — 12 months, dose 2
MedDRA: Blood prolactin increased, Blood thyroid stimulating hormone increased, Laboratory test abnormal, Menstruation irregular, Nausea, Vomiting — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Menstrual irregularities: new nausea and vomiting before period x 1 year, elevated prolactin, TSH, and E2

MedDRA releases: 2024-11 · check-in free text available
2022-01-31
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-03
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-29	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-02

Systemic reaction (other): Cold sweats

2021-01-05

Systemic reaction (other): Night sweats

2021-01-06

Systemic reaction (other): Painful swollen axillary lymph node proximal to injection site in left deltoid

Release 1 — day 7, dose 1

2021-01-07

Systemic reaction (other): Proximal axillary lymphadenopathy and tenderness

Release 2 — day 21, dose 1

2021-01-21

Symptoms: Unexplained syncopal episode on 1/19Near nightly cold night sweats

Release 2 — day 28, dose 1

2021-01-28

Symptoms: Repeated dizziness and fainting

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Fever up to 102.5, body aches, joint pain, and fatigue on 1/30. Was not contacted that day for vsafe check in on the day after my second shot.

Release 8 — 3 months, dose 2

2021-05-02

Symptoms: Intermittent dizziness/near fainting. Night -sweats.

Release 9 — 6 months, dose 2

2021-07-30

Symptoms: Persistent night sweats and nausea

Release 11 — 12 months, dose 2

2022-01-31

Symptoms: Menstrual irregularities: new nausea and vomiting before period x 1 year, elevated prolactin, TSH, and E2

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	Blood prolactin increased	·	·	✓
SD	Blood thyroid stimulating hormone increased	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Laboratory test abnormal	·	·	✓
SD	Menstruation irregular	·	·	✓
SD	Nausea	✓	·	✓
SD	Night sweats	✓	✓	✓
SD	Syncope	✓	✓	✓
SD	Vomiting	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Cold sweat	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Injection site lymphadenopathy	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Tenderness	✓	✓	✓

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