N3L-59746-15067

2 vaccinations 8 coded responses 22 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 922 / CA
Registered: 2021-08-26

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

2021-08-25
Dose 1 — Moderna
2021-08-26
Registered in v-safe
2021-08-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-08-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-08-28
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease, Pregnancy — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I might have had a miscarriage today... though I have endometriosis, so I don't think it was caused by shot? Just letting you know.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-29
Survey response — days 1–6 daily, dose 1
MedDRA: Abortion spontaneous, Endometriosis — Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school

Free text: Endometriosis/Period/miscarriage might be the cause

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-30
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-08-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school

Adult check-in
2021-09-03
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting

Adult check-in
2021-09-08
Survey response — day 14, dose 1
MedDRA: Unevaluable event — Feeling: Fair

Free text: Possible bladder infection

MedDRA releases: 2024-11 · check-in free text available
2021-09-15
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-09-22
Dose 2 — Moderna
2021-09-22
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-09-23
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Poor · Site: Pain · Muscle or body aches, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: *I believe these symptoms are related to my period... but thought I should let you know and report them

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
Survey response — days 1–6 daily, dose 2
MedDRA: Endometriosis — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Also on my period with severe endometriosis, so that might be the case also.

MedDRA releases: 2024-11 · check-in free text available
2021-09-27
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
2021-09-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-09-29
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-06
Survey response — day 14, dose 2
MedDRA: Bladder discomfort, Urinary tract discomfort — Feeling: Good

Free text: Bladder and urinary discomfort

MedDRA releases: 2024-11 · check-in free text available
2021-10-13
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-10-20
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-10-29
Survey response — day 35, dose 2
MedDRA: Breast ulceration, Skin ulcer — Feeling: Fair

Free text: A sore on my left breast (possible infection), and a sore on panty line (possible infected ingrown hair).

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

Adult check-in
2021-12-26
Survey response — 3 months, dose 2
MedDRA: Herpes zoster, Rash, Sciatica — Feeling: Fair · Be unable to work or attend school, 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: Sciatica pain & Shingles rash

MedDRA releases: 2024-11 · check-in free text available
2021-12-26
Report sent to call center — 3 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-27
Call 1 — Left Voicemail
2022-03-23
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-08-25	Moderna	No
2	2021-09-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-12-26	Unsuccessful

Free text

Release 9 — days 1–6 daily, dose 1

2021-08-28

Systemic reaction (other): I might have had a miscarriage today... though I have endometriosis, so I don't think it was caused by shot? Just letting you know.

2021-08-29

Systemic reaction (other): Endometriosis/Period/miscarriage might be the cause

Release 9 — day 14, dose 1

2021-09-08

Symptoms: Possible bladder infection

Release 9 — days 1–6 daily, dose 2

2021-09-23

Systemic reaction (other): *I believe these symptoms are related to my period... but thought I should let you know and report them

2021-09-24

Systemic reaction (other): Also on my period with severe endometriosis, so that might be the case also.

Release 10 — day 14, dose 2

2021-10-06

Symptoms: Bladder and urinary discomfort

Release 10 — day 35, dose 2

2021-10-29

Symptoms: A sore on my left breast (possible infection), and a sore on panty line (possible infected ingrown hair).

Release 10 — 3 months, dose 2

2021-12-26

Symptoms: Sciatica pain & Shingles rash

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	Bladder discomfort	·	·	✓
SD	Breast ulceration	·	·	✓
SD	Herpes zoster	·	·	✓
SD	Rash	·	·	✓
SD	Sciatica	·	·	✓
SD	Skin ulcer	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Urinary tract discomfort	·	·	✓
SRO	Abortion spontaneous	✓	·	✓
SRO	Adverse reaction	·	·	✓
SRO	Endometriosis	✓	·	✓
SRO	Pre-existing disease	✓	·	✓
SRO	Pregnancy	✓	·	✓

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