TU3-28333-53452

4 vaccinations 4 coded responses 37 check-ins 3 free-text entries 3 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 441 / OH
Registered: 2021-01-07

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

F47-31773-28717 Child or adolescent in my care · Female · 2022-06-22

Q3X-29176-14879 Child or adolescent in my care · Male · 2022-06-22

3QM-17706-31216 Child or adolescent in my care · Female · 2022-06-22

Timeline

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

2021-01-07
Registered in v-safe
2021-01-07
Dose 1 — Moderna
2021-01-07
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Fair · Joint pains · Be unable to do your normal daily activities

Free text: Tail bone

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-03
Dose 2 — Moderna
2021-02-03
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

Free text: Vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-04
Survey response — 6 months, dose 2
MedDRA: Pregnancy — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Pregnancy

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-04
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-09
Call 1 — Left Voicemail
2021-08-09
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-22
Dose 3 — Moderna
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache

Adult check-in
2022-09-13
Dose 4 — Moderna
2022-09-13
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain · Headache, Nausea

Adult check-in
2022-09-16
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-17
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-22
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-09-27
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-05
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-11
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-18
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-10-25
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-13
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-16
Survey response — 6 months, dose 4
MedDRA: Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-16
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-17
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-03	Moderna
3	2021-10-22	Moderna	No
4	2022-09-13	Moderna	No

Call center

3 call center cases

1 successful · 1 unsuccessful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-11

Systemic reaction (other): Tail bone

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): Vertigo

Release 9 — 6 months, dose 2

2021-08-04

Symptoms: Pregnancy

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	Pregnancy	✓	·	✓
SD	Sinusitis	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Unevaluable event	○	○	○
SRO	Vertigo	✓	✓	✓

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