6SB-24957-30810

4 vaccinations 8 coded responses 34 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 452 / OH
Registered: 2021-01-07

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Paraesthesia — Feeling: Good · Site: Pain, Swelling

Free text: Tingles in the hand of the arm of the injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-28
Survey response — day 21, dose 1
MedDRA: Breast swelling, Breast tenderness, Pain in extremity — Feeling: Good

Free text: My left breast has been swollen and tender and my left arm has tenderness distal to where I got the vaccine. The breast swelling and tenderness seems to have resolved.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Dose 2 — Moderna
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 2
MedDRA: Breast tenderness — Feeling: Fair · Site: Pain, Swelling · Fever · Fatigue or tiredness

Free text: Breast tenderness in just the left breast-the side thatIgot the injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Cold sweat, Hyperhidrosis, Pyrexia — Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness

Free text: Feel feverish and then clammy and having sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 42, dose 2
MedDRA: Breast tenderness — Feeling: Good

Free text: Left breast tenderness-mild, but noticeable

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-05
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Dose 3 — Moderna
2022-02-06
Survey response — 12 months, dose 2
MedDRA: Postmenopausal haemorrhage, Uterine dilation and curettage — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: Post menopausal bleeding · Healthcare visit (other): Diagnostic D&C

MedDRA releases: 2024-11 · check-in free text available
2022-02-06
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 · Hospitalization · 1 call case(s)
2022-02-08
Call 1 — Left Voicemail
2022-04-27
Dose 4 — Moderna
2022-04-27
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-04-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · Headache, Abdominal pain

Adult check-in
2022-04-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-04-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-03
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness, Feeling drunk — Feeling: Good

Free text: A weird light headed, drunk feeling for about 2 hours last night. No alcohol involved. Fine today.

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-05-18
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-31
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-01
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-08
Survey response — day 42, dose 4
MedDRA: Limb injury — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Shoulder injury

MedDRA releases: 2024-11 · check-in free text available
2022-06-08
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)
2022-06-09
Call 2 — Left Voicemail
2022-06-09
Call 1 — Left Voicemail
2022-07-27
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-26
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-27
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2021-11-05	Moderna	No
4	2022-04-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-06	Unsuccessful
2022-06-08	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): Tingles in the hand of the arm of the injection

Release 2 — day 21, dose 1

2021-01-28

Symptoms: My left breast has been swollen and tender and my left arm has tenderness distal to where I got the vaccine. The breast swelling and tenderness seems to have resolved.

Release 3 — days 1–6 daily, dose 2

2021-02-06

Systemic reaction (other): Breast tenderness in just the left breast-the side thatIgot the injection

2021-02-08

Systemic reaction (other): Feel feverish and then clammy and having sweats

Release 5 — day 42, dose 2

2021-03-18

Symptoms: Left breast tenderness-mild, but noticeable

Release 11 — 12 months, dose 2

2022-02-06

Symptoms: Post menopausal bleeding

Healthcare visit (other): Diagnostic D&C

Release 11 — days 1–6 daily, dose 4

2022-05-03

Systemic reaction (other): A weird light headed, drunk feeling for about 2 hours last night. No alcohol involved. Fine today.

Release 11 — day 42, dose 4

2022-06-08

Symptoms: Shoulder injury

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
HCVO	Uterine dilation and curettage	·	·	✓
SD	Breast swelling	✓	✓	✓
SD	Breast tenderness	✓	✓	✓
SD	Limb injury	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Postmenopausal haemorrhage	·	·	✓
SRO	Breast tenderness	✓	✓	✓
SRO	Cold sweat	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Feeling drunk	·	·	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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