KR3-28573-19496

3 vaccinations 11 coded responses 38 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 928 / CA
Registered: 2021-02-11

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

Timeline

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

2021-02-11
Registered in v-safe
2021-02-13
Dose 1 — Moderna
2021-02-13
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-27
Survey response — day 14, dose 1
MedDRA: Erythema, Feeling hot, Pruritus, Rash — Feeling: Good

Free text: Delayed rash on arm at injection site that spread down my arm. Rash was red, itchy, and hot. Rash first occurred about 5 or 6 days after injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-13
Dose 2 — Moderna
2021-03-13
Survey response — day 0, dose 2
MedDRA: No adverse event — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Fair · Site: Pain, Redness, Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site pruritus, Injection site rash — Feeling: Fair · Site: Redness, Itching

Free text: Rash, redness, and itching spreading from below injection site down to elbow

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site rash — Feeling: Fair · Site: Redness, Swelling, Itching

Free text: Rash spreading down from injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-12
Survey response — 3 months, dose 2
MedDRA: Menstrual disorder — Feeling: Good

Free text: My menstrual cycle was off. It came twice in one month a month after my second shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-05
Dose 3 — Pfizer-BioNTech
2022-03-08
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Vasodilatation — Feeling: Poor · Site: Pain, Itching · Rash, not including the immediate area around the injection site · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Pain in the armpit on the same side as the injection site. Vein swelling on the chest.

MedDRA releases: 2024-11 · check-in free text available
2022-03-08
Report sent to call center — days 1–6 daily, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-09
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Rash, not including the immediate area around the injection site

Free text: Armpit pain

MedDRA releases: 2024-11 · check-in free text available
2022-03-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Rash, not including the immediate area around the injection site

Adult check-in
2022-03-10
Call 1 — Left Voicemail
2022-03-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-03-13
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-03-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-03-26
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-04-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-04-09
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-04-16
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-06-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-09-03
Survey response — 6 months, dose 3
MedDRA: Abortion spontaneous — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Molar pregnancy loss

MedDRA releases: 2024-11 · check-in free text available
2022-09-03
Report sent to call center — 6 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 · Hospitalization · 1 call case(s)
2022-09-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-05
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Moderna
2	2021-03-13	Moderna
3	2022-03-05	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2022-03-08	Successful 2022-09-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-03	Successful 2022-09-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 4 — day 14, dose 1

2021-02-27

Symptoms: Delayed rash on arm at injection site that spread down my arm. Rash was red, itchy, and hot. Rash first occurred about 5 or 6 days after injection.

Release 5 — day 0, dose 2

2021-03-13

Systemic reaction (other): No

Release 5 — days 1–6 daily, dose 2

2021-03-14

Systemic reaction (other): No

2021-03-15

Systemic reaction (other): No

2021-03-16

Systemic reaction (other): Rash, redness, and itching spreading from below injection site down to elbow

2021-03-17

Systemic reaction (other): Rash spreading down from injection

2021-03-18

Systemic reaction (other): No

Release 9 — 3 months, dose 2

2021-06-12

Symptoms: My menstrual cycle was off. It came twice in one month a month after my second shot.

Release 11 — days 1–6 daily, dose 3

2022-03-08

Systemic reaction (other): Pain in the armpit on the same side as the injection site. Vein swelling on the chest.

2022-03-09

Systemic reaction (other): Armpit pain

Release 12 — 6 months, dose 3

2022-09-03

Symptoms: Molar pregnancy loss

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	Erythema	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Menstrual disorder	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SRO	Axillary pain	·	·	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pruritus	✓	✓	✓
SRO	Injection site rash	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Vasodilatation	·	·	✓

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