7AV-28454-31412

3 vaccinations 15 coded responses 36 check-ins 15 free-text entries 2 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 604 / IL
Registered: 2021-02-26

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-02-26
Registered in v-safe
2021-02-26
Dose 1 — Moderna
2021-02-26
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None · Be unable to do your normal daily activities

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: Muscle spasms — Feeling: Good

Free text: Foot spasms in right toes /foot since 2/26/2021

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — day 7, dose 1
MedDRA: Muscle spasms — Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Right foot spasm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Survey response — day 14, dose 1
MedDRA: Dizziness, Fatigue, Headache — Feeling: Good · Be unable to do your normal daily activities

Free text: Headache and,random spells of dizziness & fatigue in the middle of work.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-26
Dose 2 — Moderna
2021-03-26
Survey response — day 0, dose 2
MedDRA: Dizziness, Hypotension, Syncope — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Free text: Fainting,low blood pressure dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Hypotension, Syncope — Feeling: Fair · Site: Swelling · Fever · Chills, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Low bp,dizziness,fainting spells

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lightheaded dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness-lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — day 7, dose 2
MedDRA: Dizziness — Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lightheaded

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

Adult check-in
2021-04-16
Survey response — day 21, dose 2
MedDRA: Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Constant exhaustion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Survey response — day 28, dose 2
MedDRA: Chills, Fatigue, Headache — Feeling: Good · Be unable to do your normal daily activities

Free text: Chills,headache & fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — day 35, dose 2
Feeling: Poor

Adult check-in
2021-05-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-25
Survey response — 3 months, dose 2
MedDRA: Blister, Eczema — Feeling: Good

Free text: Facial reaction since second shot eczema lasting scar on jawbone with a blister result currently

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-24
Survey response — 6 months, dose 2
MedDRA: Cyst, Office visit, Upper respiratory tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Cysts on face and more frequent upper respiratory infections requiring antibiotics · Healthcare visit (other): See specialist dermatologist

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
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)
2021-09-28
Call 1 — Left Voicemail
2021-12-27
Dose 3 — Moderna
2021-12-27
Survey response — day 0, dose 3
MedDRA: Dizziness, Syncope — Feeling: Poor · Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Fainting dizziness

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-01-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-01-04
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-01-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-31
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-12-27
Survey response — 12 months, dose 3
MedDRA: COVID-19 — 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: I contacted Covid

MedDRA releases: 2024-11 · check-in free text available
2022-12-27
Report sent to call center — 12 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)
2022-12-28
Call 2 — Left Voicemail
2022-12-28
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-26	Moderna
2	2021-03-26	Moderna
3	2021-12-27	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-09-24	Unsuccessful
2022-12-27	Unsuccessful

Free text

Release 4 — day 0, dose 1

2021-02-26

Systemic reaction (other): Lightheaded

Release 5 — days 1–6 daily, dose 1

2021-03-04

Systemic reaction (other): Foot spasms in right toes /foot since 2/26/2021

Release 5 — day 7, dose 1

2021-03-05

Systemic reaction (other): Right foot spasm

Release 5 — day 14, dose 1

2021-03-12

Symptoms: Headache and,random spells of dizziness & fatigue in the middle of work.

Release 6 — day 0, dose 2

2021-03-26

Systemic reaction (other): Fainting,low blood pressure dizziness

Release 6 — days 1–6 daily, dose 2

2021-03-28

Systemic reaction (other): Low bp,dizziness,fainting spells

2021-03-31

Systemic reaction (other): Lightheaded dizziness

2021-04-01

Systemic reaction (other): Dizziness-lightheaded

Release 6 — day 7, dose 2

2021-04-02

Systemic reaction (other): Lightheaded

Release 7 — day 21, dose 2

2021-04-16

Symptoms: Constant exhaustion

Release 7 — day 28, dose 2

2021-04-25

Symptoms: Chills,headache & fatigue

Release 9 — 3 months, dose 2

2021-06-25

Symptoms: Facial reaction since second shot eczema lasting scar on jawbone with a blister result currently

Release 9 — 6 months, dose 2

2021-09-24

Symptoms: Cysts on face and more frequent upper respiratory infections requiring antibiotics

Healthcare visit (other): See specialist dermatologist

Release 10 — day 0, dose 3

2021-12-27

Systemic reaction (other): Fainting dizziness

Release 12 — 12 months, dose 3

2022-12-27

Symptoms: I contacted 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
HCVO	Office visit	·	·	✓
SD	Blister	✓	✓	✓
SD	Chills	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Cyst	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Eczema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Hypotension	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Syncope	✓	✓	✓

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