KSY-13059-32514

4 vaccinations 4 coded responses 46 check-ins 4 free-text entries 1 call case

Sex: Female
Age at first dose: 26-30
ZIP prefix: 481 / MI
Registered: 2021-03-01

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

Registered dependents

8H2-50471-34017 Child or adolescent in my care · Female · 2022-07-01

Timeline

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

2021-03-01
Registered in v-safe
2021-03-01
Dose 1 — Moderna
2021-03-01
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

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

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · 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 · None

Adult check-in
2021-03-09
Health check-in — day 7, dose 1
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-03-15
Survey response — day 14, dose 1
MedDRA: Immunisation reaction, Injection site erythema, Injection site swelling, Rash, Rash erythematous — Feeling: Good

Free text: COVID arm slight red rash on vaccination arm. Lower down than the injection site redness and swelling that I had a week ago (one week after injection).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-29
Dose 2 — Moderna
2021-03-29
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-31
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

Adult check-in
2021-04-05
Health check-in — day 7, dose 2
Feeling: Good · None

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

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

Adult check-in
2021-04-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
Co-administered: Flu
2021-10-24
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Free text: Swollen lymph nodes in injection arm armpit

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-11-06
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-28
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
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
2022-04-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-16
Dose 4 — Moderna
2022-09-16
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-17
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness

Adult check-in
2022-09-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2022-09-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-25
Health check-in — day 7, dose 4
Feeling: Fair · None

Adult check-in
2022-09-30
Survey response — day 14, dose 4
MedDRA: Abortion spontaneous — Feeling: Good · 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: Miscarriage at 7 weeks, 1 week post vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-09-30
Report sent to call center — day 14, dose 4
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)
2022-10-03
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-01	Moderna
2	2021-03-29	Moderna
3	2021-10-22	Moderna	Flu
4	2022-09-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-09-30	Unsuccessful

Free text

Release 5 — day 14, dose 1

2021-03-15

Symptoms: COVID arm slight red rash on vaccination arm. Lower down than the injection site redness and swelling that I had a week ago (one week after injection).

Release 6 — days 1–6 daily, dose 2

2021-03-31

Systemic reaction (other): Dizziness

Release 10 — days 1–6 daily, dose 3

2021-10-24

Systemic reaction (other): Swollen lymph nodes in injection arm armpit

Release 12 — day 14, dose 4

2022-09-30

Symptoms: Miscarriage at 7 weeks, 1 week post vaccine

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	Immunisation reaction	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓

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