P4N-80818-43906

2 vaccinations 8 coded responses 28 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 600 / IL
Registered: 2021-01-23

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

2021-01-23
Registered in v-safe
2021-01-23
Dose 1 — Moderna
2021-01-23
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Survey response — day 14, dose 1
MedDRA: Fatigue, Feeling cold, Headache, Injection site erythema, Injection site swelling, Lymphadenopathy, Pain — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Red welt in area of injection site, swollen lymph nodes, fatigue, headache, slight body aches, slight chilled feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — day 21, dose 1
MedDRA: Injection site pruritus, Lymphadenopathy — Feeling: Good

Free text: A different lymph node in the armpit was swollen for a few days. The other symptoms resolved but I have an occasional slight itch in the area of the injection still.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-28
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-03-05
Dose 2 — Moderna
2021-03-05
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Migraine — Feeling: Fair · Site: Pain, Redness, Itching · Be unable to work, Be unable to do your normal daily activities

Free text: Migraine (may or may not be related to vaccine)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Survey response — day 7, dose 2
MedDRA: Headache, Pre-existing disease — Feeling: Fair · Headache

Free text: Headache may not be related to vaccine, as I have chronic migraines

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-09
Survey response — day 35, dose 2
MedDRA: Diarrhoea — Feeling: Good

Free text: Had 3 days of unexplained loose stools.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Survey response — 3 months, dose 2
MedDRA: Abortion spontaneous, Office visit, Pregnancy, Unevaluable event — Feeling: Good · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Unexpected pregnancy and subsequent miscarriage · Healthcare visit (other): Lab visits, ultrasounds at hospital, visit in drs office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-08
Call 1 — Left Voicemail
2021-09-03
Survey response — 6 months, dose 2
MedDRA: Alopecia — Feeling: Fair

Free text: Hair loss/thinning

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-03-05
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-23	Moderna
2	2021-03-05	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-06-04	Unsuccessful

Free text

Release 3 — day 14, dose 1

2021-02-06

Symptoms: Red welt in area of injection site, swollen lymph nodes, fatigue, headache, slight body aches, slight chilled feeling

Release 4 — day 21, dose 1

2021-02-13

Symptoms: A different lymph node in the armpit was swollen for a few days. The other symptoms resolved but I have an occasional slight itch in the area of the injection still.

Release 5 — days 1–6 daily, dose 2

2021-03-08

Systemic reaction (other): Brain fog

2021-03-10

Systemic reaction (other): Migraine (may or may not be related to vaccine)

Release 5 — day 7, dose 2

2021-03-12

Systemic reaction (other): Headache may not be related to vaccine, as I have chronic migraines

Release 7 — day 35, dose 2

2021-04-09

Symptoms: Had 3 days of unexplained loose stools.

Release 8 — 3 months, dose 2

2021-06-04

Symptoms: Unexpected pregnancy and subsequent miscarriage

Healthcare visit (other): Lab visits, ultrasounds at hospital, visit in drs office

Release 9 — 6 months, dose 2

2021-09-03

Symptoms: Hair loss/thinning

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	✓	·	✓
HCVO	Unevaluable event	○	✓	○
SD	Abortion spontaneous	✓	·	✓
SD	Alopecia	✓	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling cold	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pregnancy	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Migraine	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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