QZQ-55585-79793

4 vaccinations 15 coded responses 37 check-ins 14 free-text entries 5 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 971 / OR
Registered: 2021-04-05

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

2021-04-05
Registered in v-safe
2021-04-05
Dose 1 — Moderna
2021-04-05
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Wooziness, dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Feeling abnormal — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Dizziness, brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
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
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Headache, Muscle or body aches, Nausea

Adult check-in
2021-04-12
Health check-in — day 7, dose 1
Feeling: Good · Headache, Abdominal pain

Adult check-in
2021-04-19
Survey response — day 14, dose 1
MedDRA: Condition aggravated, Dizziness, Dyspnoea, Headache, Nausea, Pre-existing disease — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Worsened shortness of breath [o2 sat hit 94 before nebulizing again] increased dizziness, more frequent and severe headaches.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-05-03
Dose 2 — Moderna
2021-05-03
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-05-04
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Mental disorder, Vitreous floaters — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: 6ish hours after injection, dancing lights and 'loopy' mentality for a couple hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Tachycardia — Feeling: Fair · Fatigue or tiredness

Free text: Shory of breatg, tachycardia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Tachycardia — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Shortness of breath, tachycardia (150)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-02
Survey response — day 28, dose 2
MedDRA: Dyspnoea — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: SOB

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-11-01
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-03
Dose 3 — Moderna
2021-11-03
Health check-in — day 0, dose 3
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Food aversion — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, 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: Food aversion--everything seems awful

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-06
Survey response — days 1–6 daily, dose 3
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Shortness lf breath

MedDRA releases: 2024-11 · check-in free text available
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 7, dose 3
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-24
Survey response — day 21, dose 3
MedDRA: Pregnancy — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Pregnant [about 3.5 weeks when vaccinated] Fatigued, nauseated, etc.

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Report sent to call center — day 21, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-01
Health check-in — day 28, dose 3
Feeling: Poor

Adult check-in
2021-12-08
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-16
Survey response — day 42, dose 3
MedDRA: Abortion spontaneous — 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: Miscarried

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Report sent to call center — day 42, dose 3
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)
2021-12-18
Call 1 — Requested Callback
2021-12-18
Call 1 — Requested Callback
2021-12-18
Call successful
Does not wish to fill out VAERS report
2022-01-18
Call successful
Does not wish to fill out VAERS report
2022-11-04
Dose 4 — Moderna
Co-administered: Flu
2022-11-05
Health check-in — 12 months, dose 3
Feeling: Poor

Adult check-in
2022-11-05
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-11-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2022-11-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2022-11-13
Health check-in — day 7, dose 4
Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-20
Survey response — day 14, dose 4
MedDRA: Migraine — Feeling: Fair · Be unable to do your normal daily activities

Free text: Migraines

MedDRA releases: 2024-11 · check-in free text available
2022-11-25
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-12-02
Survey response — day 28, dose 4
MedDRA: Migraine, Pre-existing disease — 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 · Telehealth, virtual health, or email health consultation

Free text: Migraines unusually awful. Extremely

MedDRA releases: 2024-11 · check-in free text available
2022-12-02
Report sent to call center — day 28, dose 4
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 · 1 call case(s)
2022-12-05
Call 1 — Requested Callback
2022-12-06
Callback requested for
2022-12-06
Call successful
Participant prefers to complete VAERS report online
2023-02-04
Survey response — 3 months, dose 4
MedDRA: COVID-19 — 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, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-02-04
Report sent to call center — 3 months, dose 4
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-02-06
Call 1 — Could Not Reach Participant
2023-02-09
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-05	Moderna
2	2021-05-03	Moderna
3	2021-11-03	Moderna	No
4	2022-11-04	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-06-02	Successful	Does not wish to fill out VAERS report
2021-11-24	Successful 2022-01-18	Does not wish to fill out VAERS report
2021-12-16	Successful 2021-12-18	Does not wish to fill out VAERS report
2022-12-02	Successful 2022-12-06	Participant prefers to complete VAERS report online
2023-02-04	Unsuccessful

Free text

Release 6 — day 0, dose 1

2021-04-05

Systemic reaction (other): Wooziness, dizziness

Release 7 — days 1–6 daily, dose 1

2021-04-06

Systemic reaction (other): Dizziness, brain fog

2021-04-07

Systemic reaction (other): Dizziness

Release 7 — day 14, dose 1

2021-04-19

Symptoms: Worsened shortness of breath [o2 sat hit 94 before nebulizing again] increased dizziness, more frequent and severe headaches.

Release 8 — days 1–6 daily, dose 2

2021-05-04

Systemic reaction (other): 6ish hours after injection, dancing lights and 'loopy' mentality for a couple hours

2021-05-06

Systemic reaction (other): Shory of breatg, tachycardia

2021-05-08

Systemic reaction (other): Shortness of breath, tachycardia (150)

Release 8 — day 28, dose 2

2021-06-02

Symptoms: SOB

Release 10 — days 1–6 daily, dose 3

2021-11-04

Systemic reaction (other): Food aversion--everything seems awful

2021-11-06

Systemic reaction (other): Shortness lf breath

Release 10 — day 21, dose 3

2021-11-24

Symptoms: Pregnant [about 3.5 weeks when vaccinated] Fatigued, nauseated, etc.

Release 10 — day 42, dose 3

2021-12-16

Symptoms: Miscarried

Release 12 — day 14, dose 4

2022-11-20

Symptoms: Migraines

Release 12 — day 28, dose 4

2022-12-02

Symptoms: Migraines unusually awful. Extremely

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	Abortion spontaneous	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Migraine	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pregnancy	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Food aversion	·	·	✓
SRO	Mental disorder	✓	·	✓
SRO	Tachycardia	✓	✓	✓
SRO	Vitreous floaters	○	✓	○

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