A6A-66523-00101

4 vaccinations 8 coded responses 44 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 537 / WI
Registered: 2021-04-05

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

Registered dependents

Y8B-66668-05118 Child or adolescent in my care · Female · 2021-12-01

Timeline

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

2021-04-04
Dose 1 — Moderna
2021-04-05
Registered in v-safe
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-04-25
Survey response — day 21, dose 1
MedDRA: Fatigue, Oropharyngeal pain, Pain, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Fatigue, mild sore throat, body aches midweek. Covid test was negative.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-25
Report sent to call center — day 21, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-02
Dose 2 — Moderna
2021-05-02
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-05-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills

Adult check-in
2021-05-09
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-05-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-23
Survey response — day 21, dose 2
MedDRA: Fatigue, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test negative, Sneezing — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Sore throat, fever, sneezing, body aches, fatigue. Negative covid test.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-01
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-31
Survey response — 6 months, dose 2
MedDRA: Pregnancy — 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Pregnancy related headaches and nausea (not related to vaccine most likely)

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Report sent to call center — 6 months, dose 2
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 · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-11-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-12-01
Dose 3 — Moderna
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-08
Survey response — day 7, dose 3
MedDRA: Anxiety — Feeling: Fair · Fatigue or tiredness

Free text: Increased anxiety

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-12-22
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-12-29
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-05
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-12
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-02
Survey response — 3 months, dose 3
MedDRA: Pregnancy — 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, Outpatient clinic or urgent care clinic visit

Free text: Pregnancy-related

MedDRA releases: 2024-11 · check-in free text available
2022-03-02
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-03
Call successful
Does not wish to fill out VAERS report
2022-06-01
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-11-29
Dose 4 — Moderna
2022-12-01
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in
2022-12-01
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-12-02
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-12-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness, Abdominal pain

Adult check-in
2022-12-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-12-22
Survey response — day 21, dose 4
MedDRA: Cough, Nasopharyngitis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Cold and cough

MedDRA releases: 2024-11 · check-in free text available
2023-01-06
Survey response — day 35, dose 4
MedDRA: COVID-19 — Feeling: Poor · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-01-10
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-04	Moderna
2	2021-05-02	Moderna
3	2021-12-01	Moderna	No
4	2022-11-29	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-10

Systemic reaction (other): Sore throat

Release 7 — day 21, dose 1

2021-04-25

Symptoms: Fatigue, mild sore throat, body aches midweek. Covid test was negative.

Release 8 — day 21, dose 2

2021-05-23

Symptoms: Sore throat, fever, sneezing, body aches, fatigue. Negative covid test.

Release 10 — 6 months, dose 2

2021-10-31

Symptoms: Pregnancy related headaches and nausea (not related to vaccine most likely)

Release 10 — day 7, dose 3

2021-12-08

Systemic reaction (other): Increased anxiety

Release 11 — 3 months, dose 3

2022-03-02

Symptoms: Pregnancy-related

Release 12 — day 21, dose 4

2022-12-22

Symptoms: Cold and cough

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	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Sneezing	✓	✓	✓
SRO	Anxiety	·	·	✓
SRO	Oropharyngeal pain	✓	✓	✓

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