6VM-18799-72475

3 vaccinations 7 coded responses 36 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 393 / MS
Registered: 2021-01-19

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

Y4C-33020-50575 Child or adolescent in my care · Female · 2021-12-08

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-19
Registered in v-safe
2021-01-19
Dose 1 — Moderna
2021-01-19
Survey response — day 0, dose 1
MedDRA: Paraesthesia — Feeling: Fair · Chills, Headache

Free text: Tingling fingers in the arm that i received the injection in. Index finger most tingling.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Depression, Tearfulness — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Sense of depression with tearfulness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Depression — Feeling: Good · Headache

Free text: I had severe depression 1-2 days following the injection. Improved on day 3 and 4 following.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-17
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Headache

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 2
Feeling: Good · None

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

Adult check-in
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-22
Dose 3 — Moderna
2021-11-23
Survey response — days 1–6 daily, dose 3
MedDRA: Depressed mood, Tearfulness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sadness and tearfulness

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Chills, Joint pains

Adult check-in
2021-11-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-11-26
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site bruising — Feeling: Good · Site: Pain

Free text: Major bruising at the site of the injection. Did not have this with the first 2 doses

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-28
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site bruising — Feeling: Good

Free text: Brusing still at injection site

MedDRA releases: 2024-11 · check-in free text available
2021-11-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-15
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-20
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-21
Survey response — 3 months, dose 3
MedDRA: Brain fog, COVID-19, Confusional state, Dizziness, Eye haemorrhage, Fatigue, Headache, Nausea, Ocular discomfort, Oropharyngeal pain, Tremor, Vertigo — 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: Fatigue; vertigo; waves of tremors; sore throat for 3 days; headache; pressure in the eyes; blood vessel burst in eye; nausea; dizziness; brain fog; confusion; covid +

MedDRA releases: 2024-11 · check-in free text available
2022-02-21
Report sent to call center — 3 months, dose 3
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)
2022-02-24
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-19	Moderna
2	2021-02-17	Moderna
3	2021-11-22	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-19

Systemic reaction (other): Tingling fingers in the arm that i received the injection in. Index finger most tingling.

Release 2 — days 1–6 daily, dose 1

2021-01-22

Systemic reaction (other): Sense of depression with tearfulness

2021-01-23

Systemic reaction (other): I had severe depression 1-2 days following the injection. Improved on day 3 and 4 following.

Release 10 — days 1–6 daily, dose 3

2021-11-23

Systemic reaction (other): Sadness and tearfulness

2021-11-26

Systemic reaction (other): Major bruising at the site of the injection. Did not have this with the first 2 doses

2021-11-28

Systemic reaction (other): Brusing still at injection site

Release 11 — 3 months, dose 3

2022-02-21

Symptoms: Fatigue; vertigo; waves of tremors; sore throat for 3 days; headache; pressure in the eyes; blood vessel burst in eye; nausea; dizziness; brain fog; confusion; 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	Brain fog	·	·	✓
SD	Confusional state	·	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	·	·	✓
SD	Eye haemorrhage	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Nausea	·	·	✓
SD	Ocular discomfort	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Tremor	·	·	✓
SD	Vertigo	·	·	✓
SRO	Depressed mood	·	·	✓
SRO	Depression	✓	✓	✓
SRO	Injection site bruising	·	·	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Tearfulness	✓	✓	✓

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