KGZ-12740-86999

3 vaccinations 9 coded responses 27 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 199 / DE
Registered: 2021-03-02

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

2021-03-01
Dose 1 — Moderna
2021-03-02
Registered in v-safe
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Redness · Headache

Adult check-in
2021-03-10
Health check-in — day 7, dose 1
Feeling: Poor · Chills · Be unable to do your normal daily activities

Adult check-in
2021-03-15
Survey response — day 14, dose 1
MedDRA: Headache — Feeling: Fair · Be unable to work

Free text: Severe headache possible allergy symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Dose 2 — Moderna
2021-03-29
Health check-in — day 0, dose 2
Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site rash — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Rash at and around injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Chills, Headache, Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

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

Adult check-in
2021-04-07
Health check-in — day 7, dose 2
Feeling: Poor · Headache, Abdominal pain · Be unable to work

Adult check-in
2021-04-12
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-19
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-29
Survey response — day 28, dose 2
MedDRA: Influenza like illness — Feeling: Fair · Be unable to work

Free text: Feel like I have the flu

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-28
Survey response — 3 months, dose 2
MedDRA: Abortion spontaneous, Fatigue, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Runny nose. Tired. Miscarriage.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-27
Survey response — 6 months, dose 2
MedDRA: Fatigue, Gastrointestinal disorder — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Fatigue, gastrointestinal issues

MedDRA releases: 2024-11 · check-in free text available
2021-09-27
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-09-29
Call 1 — Left Voicemail
2021-10-24
Dose 3 — Moderna
Co-administered: Flu
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-10-31
Health check-in — day 7, dose 3
Feeling: Fair · Fever · Headache, Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-11-07
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-14
Survey response — day 21, dose 3
MedDRA: Headache, Paranasal sinus discomfort — Feeling: Poor · Be unable to do your normal daily activities

Free text: Headache sinus pressure

MedDRA releases: 2024-11 · check-in free text available
2021-11-21
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-28
Survey response — day 35, dose 3
MedDRA: Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-12-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-23
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-04-26
Survey response — 6 months, dose 3
MedDRA: Fatigue, Nasopharyngitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue and cold like symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Survey response — 12 months, dose 3
MedDRA: Multiple sclerosis, Office visit, Pre-existing disease — 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: Symptoms: Multiple Sclerosis Flair/Relapse · Healthcare visit (other): Doctor appointments and infusions

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-10-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-03-29	Moderna
3	2021-10-24	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-09-27	Successful 2022-10-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-26	Successful 2022-10-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5 — day 14, dose 1

2021-03-15

Symptoms: Severe headache possible allergy symptoms

Release 6 — days 1–6 daily, dose 2

2021-03-30

Systemic reaction (other): Rash at and around injection site

Release 8 — day 28, dose 2

2021-04-29

Symptoms: Feel like I have the flu

Release 9 — 3 months, dose 2

2021-06-28

Symptoms: Runny nose. Tired. Miscarriage.

Release 9 — 6 months, dose 2

2021-09-27

Symptoms: Fatigue, gastrointestinal issues

Release 10 — day 21, dose 3

2021-11-14

Symptoms: Headache sinus pressure

Release 10 — day 35, dose 3

2021-11-28

Symptoms: Headache fatigue

Release 11 — 6 months, dose 3

2022-04-26

Symptoms: Fatigue and cold like symptoms

Release 12 — 12 months, dose 3

2022-10-26

Symptoms: Multiple Sclerosis Flair/Relapse

Healthcare visit (other): Doctor appointments and infusions

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	Office visit	·	·	✓
SD	Abortion spontaneous	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	✓	✓	✓
SD	Influenza like illness	✓	✓	✓
SD	Multiple sclerosis	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SRO	Injection site rash	✓	✓	✓

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