QVT-30712-38852

1 vaccination 8 coded responses 10 check-ins 8 free-text entries 5 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 486 / MI
Registered: 2021-07-19

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-07-15
Dose 1 — Moderna
2021-07-19
Registered in v-safe
2021-07-19
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Decreased appetite, Dizziness, Fatigue, Feeling abnormal, Hunger, Impaired driving ability — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): No taste , poor appetite .am hungry but when I eat I can only take a few bites then I feel dizzy , weird Everytime I eat · Healthcare visit (other): Went to hospital it's packed an went to my doctor office and they never answered the phone while I waited outside to see if it was safe to go inside with my symptoms an went home I can't drive I'm fatigued and exhausted

MedDRA releases: 2024-11 · check-in free text available
2021-07-19
Report sent to call center — days 1–6 daily, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-07-21
Survey response — days 1–6 daily, dose 1
MedDRA: Cough — Feeling: Fair · Be unable to work or attend school

Free text: Bad cough

MedDRA releases: 2024-11 · check-in free text available
2021-07-24
Survey response — day 7, dose 1
MedDRA: Cough — Feeling: Fair · Headache · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Coughing

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-24
Report sent to call center — day 7, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-26
Call successful
Participant prefers to complete VAERS report online
2021-07-29
Survey response — day 14, dose 1
MedDRA: Neck pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Pains coming and going on my left side of my neck.same side as injection arm.is still ongoing been going on for a day and a half .

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-08
Survey response — day 21, dose 1
MedDRA: Ageusia, Cough, Fatigue, Feeling hot, Oropharyngeal pain, Swelling face — Feeling: Poor · Be unable to do your normal daily activities

Free text: Cough.sore throat . fatigue.swelling of my face.warm body.loss of taste .

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-12
Survey response — day 28, dose 1
MedDRA: Ageusia, Cough, Oropharyngeal pain, Respiratory tract infection viral, Swelling face — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Viral respiratory infection, swollen face,cough,sore throat ,loss of taste

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-12
Report sent to call center — day 28, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-17
Call 1 — Left Voicemail
2021-08-19
Survey response — day 35, dose 1
MedDRA: Cough — 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 · Emergency room or emergency department visit

Free text: Cough

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-19
Report sent to call center — day 35, dose 1
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-08-23
Call 1 — Left Voicemail
2021-08-28
Health check-in — day 42, dose 1
Feeling: Good

Adult check-in
2021-10-16
Survey response — 3 months, dose 1
MedDRA: Abortion spontaneous, Complication of pregnancy, Pre-existing disease — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Pregnant problems.plus had a miscarriage and it was worse then 2 miscarriages I had in the past.

MedDRA releases: 2024-11 · check-in free text available
2021-10-16
Report sent to call center — 3 months, dose 1
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 · Emergency room or emergency department visit · 1 call case(s)
2021-10-18
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-15	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-19	Successful	Participant prefers to complete VAERS report online
2021-07-24	Successful 2021-07-26	Participant prefers to complete VAERS report online
2021-08-12	Unsuccessful
2021-08-19	Unsuccessful
2021-10-16	Unsuccessful

Free text

Release 9 — days 1–6 daily, dose 1

2021-07-19

Systemic reaction (other): No taste , poor appetite .am hungry but when I eat I can only take a few bites then I feel dizzy , weird Everytime I eat

Healthcare visit (other): Went to hospital it's packed an went to my doctor office and they never answered the phone while I waited outside to see if it was safe to go inside with my symptoms an went home I can't drive I'm fatigued and exhausted

2021-07-21

Systemic reaction (other): Bad cough

Release 9 — day 7, dose 1

2021-07-24

Systemic reaction (other): Coughing

Release 9 — day 14, dose 1

2021-07-29

Symptoms: Pains coming and going on my left side of my neck.same side as injection arm.is still ongoing been going on for a day and a half .

Release 9 — day 21, dose 1

2021-08-08

Symptoms: Cough.sore throat . fatigue.swelling of my face.warm body.loss of taste .

Release 9 — day 28, dose 1

2021-08-12

Symptoms: Viral respiratory infection, swollen face,cough,sore throat ,loss of taste

Release 9 — day 35, dose 1

2021-08-19

Symptoms: Cough

Release 10 — 3 months, dose 1

2021-10-16

Symptoms: Pregnant problems.plus had a miscarriage and it was worse then 2 miscarriages I had in the past.

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	Fatigue	·	·	✓
HCVO	Impaired driving ability	·	·	✓
SD	Abortion spontaneous	·	·	✓
SD	Ageusia	✓	·	✓
SD	Complication of pregnancy	·	·	✓
SD	Cough	✓	·	✓
SD	Fatigue	✓	·	✓
SD	Feeling hot	✓	·	✓
SD	Neck pain	✓	·	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract infection viral	✓	·	✓
SD	Swelling face	✓	·	✓
SRO	Ageusia	·	·	✓
SRO	Cough	✓	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Feeling abnormal	·	·	✓
SRO	Hunger	·	·	✓

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