DNA-16166-96973

5 vaccinations 4 coded responses 53 check-ins 4 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 140 / NY
Registered: 2020-12-28

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

2020-12-28
Registered in v-safe
2020-12-28
Dose 1 — Moderna
2020-12-28
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

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

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, 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
2021-01-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-25
Dose 2 — Moderna
2021-01-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Redness, Itching · Headache, Muscle or body aches

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Diarrhea

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Diarrhea, Abdominal pain

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache

Adult check-in
2021-02-01
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-26
Survey response — 3 months, dose 2
MedDRA: Menometrorrhagia, Polyp — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Menses after 6 months of no menses (peri-menopausal). Started on daybof 2nd vaccine, 1/26/21. Appeared as normal period but in March The bleeding lasted 4 weeks. Endometrial biopsy found a polyp. Will be having a D&C. No indication of abnormal cells.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-26
Survey response — 6 months, dose 2
MedDRA: Uterine haemorrhage — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Uterine bleeding

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-26
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-27
Call successful
Participant prefers to complete VAERS report online
2021-10-23
Dose 3 — Moderna
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-10-30
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-20
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-04
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-29
Dose 4 — Moderna
2022-04-23
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-04-27
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-06-30
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-09
Dose 5 — Moderna
2022-09-11
Survey response — days 1–6 daily, dose 5
MedDRA: Ear pain — Feeling: Good · Site: Pain

Free text: Ear pain

MedDRA releases: 2024-11 · check-in free text available
2022-09-12
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-16
Survey response — day 7, dose 5
MedDRA: Ear pain, Hypoacusis, Paranasal sinus discomfort — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Left earache with sinus pressure and decreased hearing

MedDRA releases: 2024-11 · check-in free text available
2022-09-16
Report sent to call center — day 7, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-19
Call 1 — Left Voicemail
2022-09-25
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-01
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-08
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-14
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-23
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-16
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-10
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-28	Moderna
2	2021-01-25	Moderna
3	2021-10-23	Moderna	No
4	2022-03-29	Moderna	No
5	2022-09-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-26	Successful
2021-07-26	Successful 2021-07-27	Participant prefers to complete VAERS report online
2022-09-16	Unsuccessful

Free text

Release 8 — 3 months, dose 2

2021-04-26

Symptoms: Menses after 6 months of no menses (peri-menopausal). Started on daybof 2nd vaccine, 1/26/21. Appeared as normal period but in March The bleeding lasted 4 weeks. Endometrial biopsy found a polyp. Will be having a D&C. No indication of abnormal cells. cut off by CDC

Release 9 — 6 months, dose 2

2021-07-26

Symptoms: Uterine bleeding

Release 12 — days 1–6 daily, dose 5

2022-09-11

Systemic reaction (other): Ear pain

Release 12 — day 7, dose 5

2022-09-16

Systemic reaction (other): Left earache with sinus pressure and decreased hearing

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	Menometrorrhagia	✓	✓	✓
SD	Polyp	✓	✓	✓
SD	Uterine haemorrhage	✓	·	✓
SRO	Ear pain	·	·	✓
SRO	Hypoacusis	·	·	✓
SRO	Paranasal sinus discomfort	·	·	✓

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