S93-61620-42940

2 vaccinations 8 coded responses 24 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 128 / NY
Registered: 2021-03-31

Relationship: Self
Race: Multiracial
Ethnicity: N/A

Timeline

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

2021-03-31
Registered in v-safe
2021-03-31
Dose 1 — Moderna
2021-03-31
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · 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

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Nausea, Vomiting

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Fever · Headache, Muscle or body aches

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Fever · Headache, Nausea

Adult check-in
2021-04-07
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-14
Survey response — day 14, dose 1
MedDRA: Injection site hypoaesthesia, Injection site pain, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nausea, pain and numbness in left arm near injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 21, dose 1
MedDRA: Back pain, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigued from time to time more easily. More frequent back aces and headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Dose 2 — Moderna
2021-04-28
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Swelling · Muscle or body aches

Adult check-in
2021-04-30
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site reaction, Rash macular — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Red blotches and near around injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-02
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lack of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-05-05
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-21
Survey response — day 21, dose 2
MedDRA: Fatigue, Hot flush, Injection site erythema, Injection site hypoaesthesia, Injection site pain, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue, Nausea, hot flashes, redness at injection site and mild pain/ numbness in injection site area.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — day 28, dose 2
MedDRA: Back pain, Nausea, Respiratory tract congestion — Feeling: Poor · Be unable to work, 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: Back pain and nausea on and off again, congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Report sent to call center — day 28, 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)
2021-06-02
Survey response — day 35, dose 2
MedDRA: Fatigue, Headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Headaches, fatigue

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

Adult check-in
2021-07-28
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-04-27
Call 1 — Left Voicemail
2022-04-28
Survey response — 12 months, dose 2
MedDRA: Abortion spontaneous, Oropharyngeal pain, Pre-existing disease, Reaction to previous exposure to any vaccine — 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, Emergency room or emergency department visit, Hospitalization

Free text: Sore throat but no longer a reaction at injection site at this time. 2 miscarriages sense being vaccinated with prior infertility symptoms as well.

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-31	Moderna
2	2021-04-28	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-05-26	Unsuccessful
2022-04-28	Unsuccessful

Free text

Release 7 — day 14, dose 1

2021-04-14

Symptoms: Nausea, pain and numbness in left arm near injection site

Release 7 — day 21, dose 1

2021-04-21

Symptoms: Fatigued from time to time more easily. More frequent back aces and headaches

Release 8 — days 1–6 daily, dose 2

2021-04-30

Systemic reaction (other): Red blotches and near around injection site

2021-05-02

Systemic reaction (other): Lack of appetite

Release 8 — day 21, dose 2

2021-05-21

Symptoms: Fatigue, Nausea, hot flashes, redness at injection site and mild pain/ numbness in injection site area.

Release 8 — day 28, dose 2

2021-05-26

Symptoms: Back pain and nausea on and off again, congestion

Release 8 — day 35, dose 2

2021-06-02

Symptoms: Headaches, fatigue

Release 11 — 12 months, dose 2

2022-04-28

Symptoms: Sore throat but no longer a reaction at injection site at this time. 2 miscarriages sense being vaccinated with prior infertility symptoms as well.

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	Back pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hot flush	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site hypoaesthesia	✓	✓	✓
SD	Injection site pain	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Injection site reaction	✓	✓	✓
SRO	Rash macular	✓	✓	✓

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