6QW-20647-92985

3 vaccinations 8 coded responses 32 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 481 / MI
Registered: 2021-03-23

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

2021-03-22
Dose 1 — Moderna
2021-03-23
Registered in v-safe
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 1
MedDRA: Asthma, Nasal congestion, Paranasal sinus discomfort — Feeling: Good

Free text: Stuffy nose, sinus pressure, asthma

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-12
Survey response — day 21, dose 1
MedDRA: Neuralgia, Sciatica — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Sciatica nerve pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Dose 2 — Moderna
2021-04-19
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-04-26
Survey response — day 7, dose 2
MedDRA: Paranasal sinus inflammation — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Sinus inflammation

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-26
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-31
Survey response — day 42, dose 2
MedDRA: Headache — Feeling: Fair

Free text: Daily headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-21
Survey response — 3 months, dose 2
MedDRA: Hypersensitivity, Swelling, Urticaria — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Severe Hives/Swelling - unexplained allergic reaction

MedDRA releases: 2024-11 · check-in free text available
2021-07-21
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-23
Call 1 — Left Voicemail
2021-10-20
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-17
Dose 3 — Moderna
2021-11-20
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Chills, Fatigue, Nausea, Pain, Pyrexia — Feeling: Fair · Site: Pain · Headache · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Had fever, chills, nausea, body aches (moderate to severe), joint pains, and extreme tiredness for 24-48 hours after administration of 3rd vaccine

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-24
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-12-01
Survey response — day 14, dose 3
MedDRA: Headache, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Headaches, Rash continuing even while taking steroids

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-02
Call 1 — Left Voicemail
2021-12-15
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-29
Survey response — day 42, dose 3
MedDRA: Fatigue, Headache, Nasal congestion, Rhinorrhoea — Feeling: Fair

Free text: Stuffy/runny nose, headaches, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-02-18
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-18
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-11-19
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-22	Moderna
2	2021-04-19	Moderna
3	2021-11-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-21	Unsuccessful
2021-12-01	Unsuccessful

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-26

Systemic reaction (other): Stuffy nose, sinus pressure, asthma

Release 7 — day 21, dose 1

2021-04-12

Symptoms: Sciatica nerve pain

Release 8 — day 7, dose 2

2021-04-26

Systemic reaction (other): Sinus inflammation

Release 8 — day 42, dose 2

2021-05-31

Symptoms: Daily headaches

Release 9 — 3 months, dose 2

2021-07-21

Symptoms: Severe Hives/Swelling - unexplained allergic reaction

Release 10 — days 1–6 daily, dose 3

2021-11-20

Systemic reaction (other): Had fever, chills, nausea, body aches (moderate to severe), joint pains, and extreme tiredness for 24-48 hours after administration of 3rd vaccine

Release 10 — day 14, dose 3

2021-12-01

Symptoms: Headaches, Rash continuing even while taking steroids

Release 10 — day 42, dose 3

2021-12-29

Symptoms: Stuffy/runny nose, headaches, fatigue

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	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypersensitivity	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Neuralgia	✓	✓	✓
SD	Rash	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sciatica	✓	✓	✓
SD	Swelling	·	·	✓
SD	Urticaria	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Asthma	✓	✓	✓
SRO	Chills	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Nausea	·	·	✓
SRO	Pain	·	·	✓
SRO	Paranasal sinus discomfort	✓	✓	✓
SRO	Paranasal sinus inflammation	✓	✓	✓
SRO	Pyrexia	·	·	✓

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