JGH-57190-56077

4 vaccinations 6 coded responses 36 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 222 / VA
Registered: 2021-03-02

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

Registered dependents

B5W-59931-61328 Child or adolescent in my care · Female · 2022-11-07

Timeline

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

2021-03-02
Registered in v-safe
2021-03-02
Dose 1 — Moderna
2021-03-02
Survey response — day 0, dose 1
MedDRA: Musculoskeletal stiffness — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Muscle stiffness; not aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain, Rash — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site

Free text: Please note, the above symptoms were primarily last night and were most severe starting around 8 hours after the vaccination. As they occurred after yesterdays survey, I wanted to ensure they were reported. Today, the only remaining symptoms are soreness at the injection site and a rash (not at the injection site, but that appeared last night).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-11
Health check-in — day 7, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-30
Dose 2 — Moderna
2021-03-30
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Diarrhea

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-29
Survey response — 3 months, dose 2
MedDRA: SARS-CoV-2 test negative, Sinusitis — Feeling: Fair · 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: Sinus/ear infection; tested negative for COVID

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-29
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-06
Call successful
Participant prefers to complete VAERS report online
2021-09-28
Survey response — 6 months, dose 2
MedDRA: Pregnancy — Feeling: Fair · 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: Pregnancy

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-09-30
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-18
Dose 3 — Moderna
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-11-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2021-12-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-18
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-25
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-30
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-05-19
Survey response — 6 months, dose 3
MedDRA: Delivery, Foetal growth restriction — Feeling: Good

Free text: Delivered daughter - healthy but some concerns with growth/weight - IUGR in pregnancy

MedDRA releases: 2024-11 · check-in free text available
2022-09-07
Dose 4 — Moderna
2022-09-17
Survey response — day 7, dose 4
MedDRA: Injection site pain, Myalgia — Feeling: Good

Free text: On day of vaccine, had mild muscle aches on whole side of body where shot was administered. Resolved by next day except mild soreness at point of injection.

MedDRA releases: 2024-11 · check-in free text available
2022-09-21
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-12
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-03-09
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-03-30	Moderna
3	2021-11-18	Moderna	No
4	2022-09-07	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-03-02

Systemic reaction (other): Muscle stiffness; not aches

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): Please note, the above symptoms were primarily last night and were most severe starting around 8 hours after the vaccination. As they occurred after yesterdays survey, I wanted to ensure they were reported. Today, the only remaining symptoms are soreness at the injection site and a rash (not at the injection site, but that appeared last night).

Release 9 — 3 months, dose 2

2021-06-29

Symptoms: Sinus/ear infection; tested negative for COVID

Release 9 — 6 months, dose 2

2021-09-28

Symptoms: Pregnancy

Release 11 — 6 months, dose 3

2022-05-19

Symptoms: Delivered daughter - healthy but some concerns with growth/weight - IUGR in pregnancy

Release 12 — day 7, dose 4

2022-09-17

Systemic reaction (other): On day of vaccine, had mild muscle aches on whole side of body where shot was administered. Resolved by next day except mild soreness at point of injection.

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	Delivery	·	·	✓
SD	Foetal growth restriction	·	·	✓
SD	Pregnancy	·	·	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Sinusitis	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Musculoskeletal stiffness	✓	✓	✓
SRO	Myalgia	·	·	✓
SRO	Rash	✓	✓	✓

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