BJN-28810-36529

3 vaccinations 13 coded responses 39 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 615 / IL
Registered: 2021-01-04

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Registered dependents

29P-15901-17718 Child or adolescent in my care · Female · 2021-06-12

Timeline

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

2021-01-04
Registered in v-safe
2021-01-04
Dose 1 — Moderna
2021-01-04
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Paranasal sinus discomfort — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Sinus pressure in the left side of my face

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-01
Dose 2 — Moderna
2021-02-01
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Blepharospasm, Decreased appetite, Disturbance in attention, Flushing, Foetal hypokinesia, Hot flush, Nasal congestion, Rhinorrhoea, Tension — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Right eye twitching, stuffy/runny nose, hot flashes, limited appetite, facial flushing, decreased fetal movement, difficulty focusing, body tension

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Muscle spasms, Pain in extremity — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Muscle cramps, right sided legged/hip pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-15
Survey response — day 14, dose 2
MedDRA: Fatigue, Foetal hypokinesia, Muscle spasms, Somnolence — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue and leg cramps. Ive really struggle to get up and stay awake throughout the day. Ive had moments of decreased fetal movement.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-01
Survey response — day 28, dose 2
MedDRA: Sinus disorder, Supraventricular extrasystoles, Tachycardia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sinus tachycardia with ectopic atrial beats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-15
Survey response — day 42, dose 2
MedDRA: Cardiac disorder — Feeling: Fair · 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: Still having cardiac issues and am now seeing an electrophysiologist due some abnormalities with my cardiac work ups.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-05-19
Call 1 — Left Voicemail
2021-08-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-13
Dose 3 — Moderna
2022-01-13
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-01-14
Survey response — days 1–6 daily, dose 3
MedDRA: Lymph node pain, Lymphadenopathy — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Swollen lymph nodes in the armpit I got the shot and pain.

MedDRA releases: 2024-11 · check-in free text available
2022-01-15
Survey response — days 1–6 daily, dose 3
MedDRA: Dysphagia, Dyspnoea, Lymphadenopathy, Pharyngeal swelling — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Swollen lymph node in armpit ( same arm I received vaccine in), swollen throat, difficulty breathing and swallowing.

MedDRA releases: 2024-11 · check-in free text available
2022-01-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-01-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2022-01-20
Survey response — day 7, dose 3
MedDRA: Brain fog, Cough, Dizziness, Oropharyngeal pain, Paranasal sinus hypersecretion — Feeling: Fair · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sinus drainage, sore throat, cough, dizziness, foggy

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Survey response — day 14, dose 3
MedDRA: Arthralgia, Chills, Cough, Dehydration, Dizziness, Dyspnoea, Faeces discoloured, Fatigue, Headache, Insomnia, Myalgia, Nasal congestion, Nausea, Peripheral coldness, Pyrexia, Respiratory tract congestion, Rhinorrhoea, Vomiting — Feeling: Fair · Be unable to do your normal daily activities

Free text: HA, nasal and chest congestion, runny nose, cough, dizziness, nausea, vomiting, acidic poop, muscle aches and pains, joint pains, low grade fevers, difficulty breathing( not shortness of breath), fatigue, insomnia, dehydration, chills, cold feet/han

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
Survey response — day 21, dose 3
MedDRA: Dyspnoea exertional, Fatigue, Migraine — Feeling: Poor · Be unable to do your normal daily activities

Free text: Massive fatigue and migraines that come and go. Shot of breath with exertion.

MedDRA releases: 2024-11 · check-in free text available
2022-02-10
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-02-17
Survey response — day 35, dose 3
MedDRA: Dyspnoea, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Tired all the time. Shortness of breathe Congress and goes

MedDRA releases: 2024-11 · check-in free text available
2022-02-24
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-04-14
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-07-14
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2023-01-13
Survey response — 12 months, dose 3
MedDRA: Cough — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-04	Moderna
2	2021-02-01	Moderna
3	2022-01-13	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-15	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-07

Systemic reaction (other): Sinus pressure in the left side of my face

Release 3 — days 1–6 daily, dose 2

2021-02-02

Systemic reaction (other): Right eye twitching, stuffy/runny nose, hot flashes, limited appetite, facial flushing, decreased fetal movement, difficulty focusing, body tension

2021-02-03

Systemic reaction (other): Muscle cramps, right sided legged/hip pain

Release 4 — day 14, dose 2

2021-02-15

Symptoms: Fatigue and leg cramps. Ive really struggle to get up and stay awake throughout the day. Ive had moments of decreased fetal movement.

Release 4 — day 28, dose 2

2021-03-01

Symptoms: Sinus tachycardia with ectopic atrial beats

Release 5 — day 42, dose 2

2021-03-15

Symptoms: Still having cardiac issues and am now seeing an electrophysiologist due some abnormalities with my cardiac work ups.

Release 10 — days 1–6 daily, dose 3

2022-01-14

Systemic reaction (other): Swollen lymph nodes in the armpit I got the shot and pain.

2022-01-15

Systemic reaction (other): Swollen lymph node in armpit ( same arm I received vaccine in), swollen throat, difficulty breathing and swallowing.

Release 10 — day 7, dose 3

2022-01-20

Systemic reaction (other): Sinus drainage, sore throat, cough, dizziness, foggy

Release 11 — day 14, dose 3

2022-01-27

Symptoms: HA, nasal and chest congestion, runny nose, cough, dizziness, nausea, vomiting, acidic poop, muscle aches and pains, joint pains, low grade fevers, difficulty breathing( not shortness of breath), fatigue, insomnia, dehydration, chills, cold feet/han cut off by CDC

Release 11 — day 21, dose 3

2022-02-03

Symptoms: Massive fatigue and migraines that come and go. Shot of breath with exertion.

Release 11 — day 35, dose 3

2022-02-17

Symptoms: Tired all the time. Shortness of breathe Congress and goes

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	Arthralgia	·	·	✓
SD	Cardiac disorder	✓	✓	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Dehydration	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Dyspnoea exertional	·	·	✓
SD	Faeces discoloured	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Foetal hypokinesia	✓	✓	✓
SD	Headache	·	·	✓
SD	Insomnia	·	·	✓
SD	Migraine	·	·	✓
SD	Muscle spasms	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Nausea	·	·	✓
SD	Peripheral coldness	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinus disorder	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Supraventricular extrasystoles	✓	✓	✓
SD	Tachycardia	✓	✓	✓
SD	Vomiting	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Blepharospasm	✓	✓	✓
SRO	Brain fog	·	·	✓
SRO	Cough	·	·	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Disturbance in attention	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Dysphagia	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Flushing	✓	✓	✓
SRO	Foetal hypokinesia	✓	✓	✓
SRO	Hot flush	✓	✓	✓
SRO	Lymph node pain	·	·	✓
SRO	Lymphadenopathy	·	·	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Paranasal sinus discomfort	✓	✓	✓
SRO	Paranasal sinus hypersecretion	·	·	✓
SRO	Pharyngeal swelling	·	·	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Tension	✓	✓	✓

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