6WY-32647-30179

4 vaccinations 9 coded responses 42 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 157 / PA
Registered: 2021-03-28

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

Timeline

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

2021-03-08
Dose 1 — Moderna
2021-03-28
Registered in v-safe
2021-03-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-05
Dose 2 — Moderna
2021-04-05
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Fatigue or tiredness

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain — Feeling: Good

Free text: I have been experiencing some abdominal pain since yesterday. It happens whenever I eat, and after an hour or so, it goes away.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain — Feeling: Good

Free text: A little abdominal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-03
Survey response — day 28, dose 2
MedDRA: Headache — Feeling: Good

Free text: Light headaches for three or four days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-05
Survey response — 3 months, dose 2
MedDRA: Alopecia — Feeling: Good

Free text: I didnt start Vsafe checkups right after my first dose, so I never had the chance to mention that I lost a lot of hair starting a week after my first dose. It continued for a while after my second dose, and then, stopped completely.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-04
Survey response — 6 months, dose 2
MedDRA: Dysmenorrhoea, Loss of consciousness, Ovarian cyst ruptured — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: On September 2, I had my period (regular schedule). September 3, I was in a severe pain and consequently I passed out. After a checkup, it turned out that I had an ovarian cyst that burst and caused the issue.

MedDRA releases: 2024-11 · check-in free text available
2021-10-04
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-11
Call 1 — Left Voicemail
2021-10-14
Callback requested for
2021-10-14
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-08
Dose 3 — Moderna
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-11-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-11-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-11-15
Health check-in — day 7, dose 3
Feeling: Good · Abdominal pain

Adult check-in
2021-11-22
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-20
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-07
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-10
Survey response — 6 months, dose 3
MedDRA: Dysmenorrhoea, Headache, Heavy menstrual bleeding — Feeling: Good

Free text: Persistent headaches. Painful periods with heavy bleeding.

MedDRA releases: 2024-11 · check-in free text available
2022-09-28
Dose 4 — Moderna
2022-09-28
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-09-29
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches · Be unable to work or attend school

Adult check-in
2022-10-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache

Adult check-in
2022-10-04
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-07
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-12
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-10-19
Survey response — day 21, dose 4
MedDRA: Herpes zoster, Medical counselling — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I have had shingles starting October 12. · Healthcare visit (other): Health Center at my university

MedDRA releases: 2024-11 · check-in free text available
2022-10-19
Report sent to call center — day 21, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-10-20
Call 1 — Left Voicemail
2022-10-27
Survey response — day 28, dose 4
MedDRA: Herpes zoster, Office visit — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I have had shingles. · Healthcare visit (other): University Health Center and my dentist.

MedDRA releases: 2024-11 · check-in free text available
2022-10-27
Report sent to call center — day 28, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-10-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-02
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-09
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-30
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-29
Survey response — 6 months, dose 4
MedDRA: Herpes zoster, Influenza, Rash — Feeling: Fair · 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

MedDRA releases: 2024-11
2023-03-29
Report sent to call center — 6 months, dose 4
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)
2023-03-30
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna
2	2021-04-05	Moderna
3	2021-11-08	Moderna	No
4	2022-09-28	Moderna	No

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): I have been experiencing some abdominal pain since yesterday. It happens whenever I eat, and after an hour or so, it goes away.

2021-04-08

Systemic reaction (other): A little abdominal pain

Release 8 — day 28, dose 2

2021-05-03

Symptoms: Light headaches for three or four days.

Release 9 — 3 months, dose 2

2021-07-05

Symptoms: I didnt start Vsafe checkups right after my first dose, so I never had the chance to mention that I lost a lot of hair starting a week after my first dose. It continued for a while after my second dose, and then, stopped completely.

Release 10 — 6 months, dose 2

2021-10-04

Symptoms: On September 2, I had my period (regular schedule). September 3, I was in a severe pain and consequently I passed out. After a checkup, it turned out that I had an ovarian cyst that burst and caused the issue.

Release 11 — 6 months, dose 3

2022-05-10

Symptoms: Persistent headaches. Painful periods with heavy bleeding.

Release 12 — day 21, dose 4

2022-10-19

Symptoms: I have had shingles starting October 12.

Healthcare visit (other): Health Center at my university

Release 12 — day 28, dose 4

2022-10-27

Symptoms: I have had shingles.

Healthcare visit (other): University Health Center and my dentist.

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	Medical counselling	·	·	✓
HCVO	Office visit	·	·	✓
SD	Alopecia	✓	✓	✓
SD	Dysmenorrhoea	·	·	✓
SD	Headache	✓	✓	✓
SD	Heavy menstrual bleeding	·	·	✓
SD	Herpes zoster	·	·	✓
SD	Influenza	·	·	✓
SD	Loss of consciousness	·	·	✓
SD	Ovarian cyst ruptured	·	·	✓
SD	Rash	·	·	✓
SRO	Abdominal pain	✓	✓	✓

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