M36-26189-09461

2 vaccinations 9 coded responses 26 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 334 / FL
Registered: 2021-01-08

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

2021-01-08
Registered in v-safe
2021-01-08
Dose 1 — Moderna
2021-01-08
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Muscle or body aches

Free text: Sore arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site infection, Injection site inflammation, Injection site pruritus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Got an infection at the shot site. Became red, inflamed and itchy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-05
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-06
Dose 2 — Moderna
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-13
Survey response — day 7, dose 2
MedDRA: Uterine spasm — Feeling: Good · Site: Itching · Fatigue or tiredness

Free text: Cramping in uterus area since injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — day 14, dose 2
MedDRA: Menstruation irregular — Feeling: Good

Free text: Irregular menstrual cycle

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-13
Survey response — day 35, dose 2
MedDRA: Menstruation irregular — Feeling: Good

Free text: Irregular menstrual cycle.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-01
Call 1 — Left Voicemail
2021-05-08
Survey response — 3 months, dose 2
MedDRA: Abnormal menstrual clots, Menstruation irregular — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Irregularities with menstrual cycle since vaccine. Random bleeding with large clots.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-07
Survey response — 6 months, dose 2
MedDRA: Anovulatory cycle, Medical counselling, Vaginal haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Didnt ovulate for 5 months. Obgyn stated it was most likely due to vaccine. Large blood clots outside of menstrual cycle

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-07
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-12
Call 1 — Left Voicemail
2022-02-06
Survey response — 12 months, dose 2
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

Free text: Miscarriage

MedDRA releases: 2024-11 · check-in free text available
2022-02-06
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-07
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-06	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-22	Successful	Does not wish to fill out VAERS report
2021-05-08	Successful	Does not wish to fill out VAERS report
2021-08-07	Successful	Does not wish to fill out VAERS report
2022-02-06	Successful 2022-02-07	Does not wish to fill out VAERS report

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): Sore arm

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): Dizziness

Release 2 — day 14, dose 1

2021-01-22

Symptoms: Got an infection at the shot site. Became red, inflamed and itchy.

Release 4 — day 7, dose 2

2021-02-13

Systemic reaction (other): Cramping in uterus area since injection

Release 4 — day 14, dose 2

2021-02-20

Symptoms: Irregular menstrual cycle

Release 5 — day 35, dose 2

2021-03-13

Symptoms: Irregular menstrual cycle.

Release 8 — 3 months, dose 2

2021-05-08

Symptoms: Irregularities with menstrual cycle since vaccine. Random bleeding with large clots.

Release 9 — 6 months, dose 2

2021-08-07

Symptoms: Didnt ovulate for 5 months. Obgyn stated it was most likely due to vaccine. Large blood clots outside of menstrual cycle

Release 11 — 12 months, dose 2

2022-02-06

Symptoms: Miscarriage

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	Abnormal menstrual clots	✓	✓	✓
SD	Abortion spontaneous	·	·	✓
SD	Anovulatory cycle	✓	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site infection	✓	✓	✓
SD	Injection site inflammation	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Medical counselling	✓	·	✓
SD	Menstruation irregular	✓	✓	✓
SD	Vaginal haemorrhage	✓	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Uterine spasm	✓	✓	✓

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