M9X-13523-66373

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

Sex: Female
Age at first dose: 31-35
ZIP prefix: 853 / AZ
Registered: 2020-12-28

Relationship: Self
Race: Multiracial
Ethnicity: Hispanic or Latino

Registered dependents

2GP-13386-09617 Child or adolescent in my care · Female · 2022-06-28

Timeline

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

2020-12-28
Registered in v-safe
2020-12-28
Dose 1 — Moderna
2020-12-28
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Health check-in — day 7, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-01-11
Survey response — day 14, dose 1
MedDRA: Fatigue, Headache, Rash — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Headache and fatigue. As well as a rash on both hands which is now improving.

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

1 call case(s)
2021-01-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-25
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-27
Dose 2 — Moderna
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 2
MedDRA: Dysgeusia — Feeling: Good · Site: Pain · Headache

Free text: Bitter taste in mouth.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Call successful
Participant prefers to complete VAERS report online
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

Adult check-in
2021-02-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 21, dose 2
Feeling: Good

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

Adult check-in
2021-03-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Dose 3 — Moderna
2022-01-27
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-29
Dose 4 — Moderna
2022-04-29
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-04-30
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-06
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-13
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-10
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-05
Survey response — 3 months, dose 4
MedDRA: Cough, Pyrexia, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Cough, fever, runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-08-05
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-08
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-30
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-05-01
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-28	Moderna
2	2021-01-27	Moderna
3	2021-10-26	Moderna	No
4	2022-04-29	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 1 — day 14, dose 1

2021-01-11

Symptoms: Headache and fatigue. As well as a rash on both hands which is now improving.

Release 3 — days 1–6 daily, dose 2

2021-01-29

Systemic reaction (other): Bitter taste in mouth.

Release 12 — 3 months, dose 4

2022-08-05

Symptoms: Cough, fever, runny nose

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	Cough	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Rash	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SRO	Dysgeusia	✓	✓	✓

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