CPR-15375-04519

2 vaccinations 7 coded responses 22 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 027 / MA
Registered: 2021-01-02

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

2021-01-02
Registered in v-safe
2021-01-02
Dose 1 — Moderna
2021-01-02
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-01-16
Survey response — day 14, dose 1
MedDRA: Medical counselling, Pityriasis rosea, Rash, Rash erythematous, Rash pruritic — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Skin rash started or noticed day after vaccination #1. PCP gave steroid cream just progressed to my entire body. Itchy red bumps. Dermatologist diagnosed me with pityrasis rosacea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-23
Survey response — day 21, dose 1
MedDRA: Gastrointestinal disorder, Headache, Nausea, Pain, Vomiting — Feeling: Poor · Be unable to work

Free text: Gi issues nausea vomiting and pain headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — day 28, dose 1
MedDRA: Cardiac failure congestive, Cardiomyopathy — Feeling: Poor · Be unable to work, 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, Hospitalization

Free text: Cardiomyopathy. CHF unsure if related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
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)
2021-02-11
Dose 2 — Moderna
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Abdominal pain

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Survey response — day 14, dose 2
MedDRA: Blood pressure increased, Chest pain, Dizziness, Palpitations — Feeling: Fair · Be unable to work

Free text: Chest pain and elevated blood pressure dizziness and pounding heart rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 21, dose 2
MedDRA: Blood pressure increased, Cardiomyopathy, Fatigue — Feeling: Fair · Be unable to work

Free text: Cardiomyopathy. Increased fatigue elevated BP.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-16
Call successful
Completed over the phone
2021-03-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Survey response — 6 months, dose 2
MedDRA: Anxiety, Impaired gastric emptying, Unevaluable event — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Gastropersis, Anxiety, CVS, and CHF

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-12
Survey response — 12 months, dose 2
MedDRA: Gastrointestinal disorder — 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: Now I have a lot of GI issues. My heart has been good!

MedDRA releases: 2024-11 · check-in free text available
2022-02-12
Report sent to call center — 12 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)
2022-02-15
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-02	Moderna
2	2021-02-11	Moderna

Call center

3 call center cases

2 successful · 1 unsuccessful

VAERS report filed, before or during a call: 2

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-16

Symptoms: Skin rash started or noticed day after vaccination #1. PCP gave steroid cream just progressed to my entire body. Itchy red bumps. Dermatologist diagnosed me with pityrasis rosacea.

Release 2 — day 21, dose 1

2021-01-23

Symptoms: Gi issues nausea vomiting and pain headache

Release 3 — day 28, dose 1

2021-01-30

Symptoms: Cardiomyopathy. CHF unsure if related.

Release 4 — day 14, dose 2

2021-02-25

Symptoms: Chest pain and elevated blood pressure dizziness and pounding heart rate

Release 5 — day 21, dose 2

2021-03-04

Symptoms: Cardiomyopathy. Increased fatigue elevated BP.

Release 9 — 6 months, dose 2

2021-08-12

Symptoms: Gastropersis, Anxiety, CVS, and CHF

Release 11 — 12 months, dose 2

2022-02-12

Symptoms: Now I have a lot of GI issues. My heart has been good!

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	Anxiety	✓	·	✓
SD	Blood pressure increased	✓	✓	✓
SD	Cardiac failure congestive	✓	✓	✓
SD	Cardiomyopathy	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Impaired gastric emptying	✓	·	✓
SD	Medical counselling	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Pityriasis rosea	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	Unevaluable event	✓	·	✓
SD	Vomiting	✓	✓	✓

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