8UA-28629-19214

3 vaccinations 8 coded responses 29 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 853 / AZ
Registered: 2021-01-16

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

2021-01-16
Registered in v-safe
2021-03-11
Dose 1 — Moderna
2021-03-15
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Fair · Muscle or body aches

Free text: Feet hurt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Rash macular, Skin discolouration — Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Weird purple blotches under the skin on the arm I received injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-20
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-01
Survey response — day 21, dose 1
MedDRA: Nasopharyngitis — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: A severe head cold

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 28, dose 1
MedDRA: Gastroenteritis viral, Sinusitis — 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 · Outpatient clinic or urgent care clinic visit

Free text: I've gotten a sinus infection now followed by the stomach flu.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — day 28, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-09
Dose 2 — Moderna
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Good · Site: Itching · Muscle or body aches

Free text: Allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 7, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-04-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-04
Dose 3 — Moderna
2021-09-04
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Fever · Headache, Muscle or body aches, Nausea

Adult check-in
2021-09-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · 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
2021-09-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-09-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-09-08
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-09-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Nausea

Adult check-in
2021-09-11
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-09-18
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-09-25
Survey response — day 21, dose 3
MedDRA: Abdominal discomfort, Dizziness, Nausea, Tinnitus — 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 · Telehealth, virtual health, or email health consultation

Free text: Nausea, upset stomach, lightheaded,ringing in ears

MedDRA releases: 2024-11 · check-in free text available
2021-09-25
Report sent to call center — day 21, 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-09-28
Call 1 — Left Voicemail
2021-10-03
Survey response — day 28, dose 3
MedDRA: Influenza like illness, Nausea — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Flu-like symptoms, night time nausea

MedDRA releases: 2024-11 · check-in free text available
2021-10-03
Report sent to call center — day 28, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-08
Call successful
Does not wish to fill out VAERS report
2021-10-09
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-10-16
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-07
Survey response — 6 months, dose 3
MedDRA: Ischaemic stroke, Pregnancy, Ventilation perfusion mismatch — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Ischemic Stroke, pregnancy, right to left shunt in lungs

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-11	Moderna
2	2021-04-09	Moderna
3	2021-09-04	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-15

Systemic reaction (other): Feet hurt

2021-03-16

Systemic reaction (other): Weird purple blotches under the skin on the arm I received injection

Release 6 — day 21, dose 1

2021-04-01

Symptoms: A severe head cold

Release 7 — day 28, dose 1

2021-04-08

Symptoms: I've gotten a sinus infection now followed by the stomach flu.

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Allergies

Release 9 — day 21, dose 3

2021-09-25

Symptoms: Nausea, upset stomach, lightheaded,ringing in ears

Release 9 — day 28, dose 3

2021-10-03

Symptoms: Flu-like symptoms, night time nausea

Release 11 — 6 months, dose 3

2022-03-07

Symptoms: Ischemic Stroke, pregnancy, right to left shunt in lungs

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	Abdominal discomfort	·	·	✓
SD	Dizziness	·	·	✓
SD	Gastroenteritis viral	✓	✓	✓
SD	Influenza like illness	·	·	✓
SD	Ischaemic stroke	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Nausea	·	·	✓
SD	Pregnancy	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Tinnitus	·	·	✓
SD	Ventilation perfusion mismatch	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rash macular	✓	✓	✓
SRO	Skin discolouration	✓	✓	✓

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