DVP-13617-20262

3 vaccinations 7 coded responses 36 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 018 / MA
Registered: 2021-03-15

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

Registered dependents

QZS-17099-05215 Child or adolescent in my care · Female · 2022-06-30

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-13
Dose 1 — Moderna
2021-03-15
Registered in v-safe
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-10
Dose 2 — Moderna
2021-04-10
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-24
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-09
Survey response — 6 months, dose 2
MedDRA: Menstruation irregular — Feeling: Good · Be unable to do your normal daily activities

Free text: Very irregular period

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Dose 3 — Moderna
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness · Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-12-05
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Swollen lymph nodes under both armpits

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-07
Survey response — days 1–6 daily, dose 3
MedDRA: Alopecia, Lymphadenopathy — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Hair loss, swollen lymph nodes under both armpits

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Survey response — day 7, dose 3
MedDRA: Lymphadenopathy — Feeling: Good · Fatigue or tiredness

Free text: Swollen lymph nodes under both armpits

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 21, dose 3
Feeling: Good

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

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

Adult check-in
2022-01-12
Survey response — day 42, dose 3
MedDRA: Pregnancy — Feeling: Good

Free text: Pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-03-02
Survey response — 3 months, dose 3
MedDRA: Abortion spontaneous — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Pregnancy loss beginning at 8 weeks, miscarriage completed at 10 weeks

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Survey response — 6 months, dose 3
MedDRA: Abortion spontaneous — Feeling: Good · Be unable to do your normal daily activities

Free text: Miscarriage at 10 weeks

MedDRA releases: 2024-11 · check-in free text available
2022-12-03
Health check-in — 12 months, dose 3
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-13	Moderna
2	2021-04-10	Moderna
3	2021-12-01	Moderna	No

Free text

Release 10 — 6 months, dose 2

2021-10-09

Symptoms: Very irregular period

Release 10 — days 1–6 daily, dose 3

2021-12-05

Systemic reaction (other): Swollen lymph nodes under both armpits

2021-12-07

Systemic reaction (other): Hair loss, swollen lymph nodes under both armpits

Release 10 — day 7, dose 3

2021-12-10

Systemic reaction (other): Swollen lymph nodes under both armpits

Release 10 — day 42, dose 3

2022-01-12

Symptoms: Pregnancy

Release 11 — 3 months, dose 3

2022-03-02

Symptoms: Pregnancy loss beginning at 8 weeks, miscarriage completed at 10 weeks

Release 11 — 6 months, dose 3

2022-06-01

Symptoms: Miscarriage at 10 weeks

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	Abortion spontaneous	·	·	✓
SD	Menstruation irregular	·	·	✓
SD	Pregnancy	·	·	✓
SRO	Alopecia	·	·	✓
SRO	Lymphadenopathy	·	·	✓

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