MW9-16582-35054

4 vaccinations 9 coded responses 49 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 484 / MI
Registered: 2021-04-01

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

2021-04-01
Registered in v-safe
2021-04-01
Dose 1 — Moderna
2021-04-01
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-08
Health check-in — day 7, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-15
Survey response — day 14, dose 1
MedDRA: Urticaria — Feeling: Good

Free text: Groups of hives on my neck and foot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-29
Dose 2 — Moderna
2021-04-29
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-05-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-05-06
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Rash, not including the immediate area around the injection site

Adult check-in
2021-05-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-03
Survey response — day 35, dose 2
MedDRA: Rash — Feeling: Fair

Free text: I have developed another rash similar to the one I had after the vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-12
Dose 3 — Moderna
Co-administered: Flu
2021-11-12
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-13
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-14
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-11-17
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Abdominal pain

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-19
Health check-in — day 7, dose 3
Feeling: Good · Abdominal pain

Adult check-in
2021-11-26
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-17
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-12
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-13
Survey response — 6 months, dose 3
MedDRA: Office visit, Pregnancy, Subchorionic haemorrhage — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Pregnancy, and a sub chorionic hemorrhage · Healthcare visit (other): Obgyn

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-05-16
Call successful
Does not wish to fill out VAERS report
2022-06-24
Dose 4 — Moderna
2022-06-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-30
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-07-01
Survey response — day 7, dose 4
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-07-15
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-07-22
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-29
Survey response — day 35, dose 4
MedDRA: Gestational diabetes — Feeling: Good

Free text: Gestational diabetes

MedDRA releases: 2024-11 · check-in free text available
2022-08-05
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-09-23
Survey response — 3 months, dose 4
MedDRA: Hypertension — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

Free text: High blood pressure

MedDRA releases: 2024-11 · check-in free text available
2022-09-23
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2022-09-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-23
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in
2023-06-24
Survey response — 12 months, dose 4
MedDRA: Abortion spontaneous — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-01	Moderna
2	2021-04-29	Moderna
3	2021-11-12	Moderna	Flu
4	2022-06-24	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-05-13	Successful 2022-05-16	Does not wish to fill out VAERS report
2022-09-23	Successful 2022-09-26	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — day 14, dose 1

2021-04-15

Symptoms: Groups of hives on my neck and foot.

Release 8 — day 35, dose 2

2021-06-03

Symptoms: I have developed another rash similar to the one I had after the vaccine.

Release 10 — days 1–6 daily, dose 3

2021-11-14

Systemic reaction (other): Sore throat

2021-11-17

Systemic reaction (other): Sore throat

Release 11 — 6 months, dose 3

2022-05-13

Symptoms: Pregnancy, and a sub chorionic hemorrhage

Healthcare visit (other): Obgyn

Release 12 — day 7, dose 4

2022-07-01

Systemic reaction (other): Sore throat

Release 12 — day 35, dose 4

2022-07-29

Symptoms: Gestational diabetes

Release 12 — 3 months, dose 4

2022-09-23

Symptoms: High blood pressure

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	Gestational diabetes	·	·	✓
SD	Hypertension	·	·	✓
SD	Pregnancy	·	·	✓
SD	Rash	✓	✓	✓
SD	Subchorionic haemorrhage	·	·	✓
SD	Urticaria	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓

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