H8X-46528-68561

3 vaccinations 12 coded responses 25 check-ins 12 free-text entries 9 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 180 / PA
Registered: 2021-01-19

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

2020-12-23
Dose 1 — Moderna
2021-01-19
Registered in v-safe
2021-01-19
Dose 2 — Moderna
2021-01-19
Health check-in — day 0, dose 2
Feeling: Good · Headache

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Adult check-in
2021-01-22
Report sent to call center — days 1–6 daily, dose 2
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)
2021-01-23
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain, Redness · Fever · Headache, Fatigue or tiredness · 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
2021-01-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Joint pains, Fatigue or tiredness

Adult check-in
2021-01-26
Survey response — day 7, dose 2
MedDRA: Anaphylaxis treatment, Ear infection, Malaise — Feeling: Good · Fever · Fatigue or tiredness

Free text: Ill on abx w ear infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — day 14, dose 2
MedDRA: Feeling hot — Feeling: Good

Free text: Arm was hot again randomly for a few hours yesterday

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

Adult check-in
2021-02-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-20
Survey response — 3 months, dose 2
MedDRA: Arthralgia, Condition aggravated, Fatigue, Office visit, Pre-existing disease — Feeling: Good · 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

Free text: Had a flare up of my autoimmune disorder- severe joint pain, fatigue. Stated after second vaccine and became severe a couple weeks ago lasting 5 days with a pred course. Initially urgent.care ruled out covid then rheum ^inflammatory markers

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — 3 months, dose 2
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)
2021-05-30
Call successful
Does not wish to fill out VAERS report
2021-07-20
Survey response — 6 months, dose 2
MedDRA: Asthma, Cough, Pre-existing disease, Respiratory tract infection viral — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Respiratory virus with cough, remains Then asthma exacerbation

MedDRA releases: 2024-11 · check-in free text available
2021-07-20
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

1 call case(s)
2021-07-22
Call 1 — Left Voicemail
2021-11-03
Dose 3 — Moderna
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-11-07
Survey response — days 1–6 daily, dose 3
MedDRA: Pregnancy — Feeling: Good · Site: Pain · Headache

Free text: Pregnant 27 weeks

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-10
Health check-in — day 7, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-17
Survey response — day 14, dose 3
MedDRA: Headache, Lacrimation increased, Nasal dryness, Oropharyngeal pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: sore throat, Dry nose. Watery ears. headache · Healthcare visit (other): Apt on Friday

MedDRA releases: 2024-11 · check-in free text available
2021-11-17
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-18
Call successful
Participant prefers to complete VAERS report online
2021-11-26
Survey response — day 21, dose 3
MedDRA: Asthma, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Asthma exacerbation 6 days

MedDRA releases: 2024-11 · check-in free text available
2021-11-26
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-29
Call 1 — Left Voicemail
2021-12-01
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-10
Survey response — day 35, dose 3
MedDRA: Ear discomfort, Ear tube insertion, Respiratory tract congestion — 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: Congregation, ear pressure, had tube placed

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-13
Call 1 — Left Voicemail
2021-12-15
Survey response — day 42, dose 3
MedDRA: Asthma, Pre-existing disease, Pregnancy, Upper respiratory tract infection — 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 · Outpatient clinic or urgent care clinic visit

Free text: Uri and asthma exacerbation 32 weeks pregnant

MedDRA releases: 2024-11 · check-in free text available
2021-12-15
Report sent to call center — day 42, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-16
Call 1 — Left Voicemail
2022-02-02
Survey response — 3 months, dose 3
MedDRA: Pregnancy, Vulval haematoma — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Vaginal Labor with vulva hematoma post labor

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

Hospitalization · 1 call case(s)
2022-02-03
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-04
Survey response — 6 months, dose 3
MedDRA: Asthma, Pre-existing disease — 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: Asthma reoccurring

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-05
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-23	Moderna
2	2021-01-19	Moderna
3	2021-11-03	Moderna	No

Call center

9 call center cases

9 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 2

2021-01-23

Systemic reaction (other): Sore throat

Release 2 — day 7, dose 2

2021-01-26

Systemic reaction (other): Ill on abx w ear infection

Release 3 — day 14, dose 2

2021-02-02

Symptoms: Arm was hot again randomly for a few hours yesterday

Release 7 — 3 months, dose 2

2021-04-20

Symptoms: Had a flare up of my autoimmune disorder- severe joint pain, fatigue. Stated after second vaccine and became severe a couple weeks ago lasting 5 days with a pred course. Initially urgent.care ruled out covid then rheum ^inflammatory markers

Release 9 — 6 months, dose 2

2021-07-20

Symptoms: Respiratory virus with cough, remains Then asthma exacerbation

Release 10 — days 1–6 daily, dose 3

2021-11-07

Systemic reaction (other): Pregnant 27 weeks

Release 10 — day 14, dose 3

2021-11-17

Symptoms: sore throat, Dry nose. Watery ears. headache

Healthcare visit (other): Apt on Friday

Release 10 — day 21, dose 3

2021-11-26

Symptoms: Asthma exacerbation 6 days

Release 10 — day 35, dose 3

2021-12-10

Symptoms: Congregation, ear pressure, had tube placed

Release 10 — day 42, dose 3

2021-12-15

Symptoms: Uri and asthma exacerbation 32 weeks pregnant

Release 11 — 3 months, dose 3

2022-02-02

Symptoms: Vaginal Labor with vulva hematoma post labor

Release 11 — 6 months, dose 3

2022-05-04

Symptoms: Asthma reoccurring

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
HCVO	Unevaluable event	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Asthma	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Cough	·	·	✓
SD	Ear discomfort	·	·	✓
SD	Ear tube insertion	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Headache	·	·	✓
SD	Lacrimation increased	·	·	✓
SD	Nasal dryness	·	·	✓
SD	Office visit	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Respiratory tract infection viral	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Vulval haematoma	·	·	✓
SRO	Anaphylaxis treatment	✓	✓	✓
SRO	Ear infection	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pregnancy	·	·	✓

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