VAD-25505-59474

3 vaccinations 6 coded responses 28 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 481 / MI
Registered: 2021-01-15

Relationship: Self
Race: N/A
Ethnicity: N/A

Registered dependents

J4C-12298-61837 Child or adolescent in my care · Male · 2022-02-10

Timeline

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

2021-01-15
Registered in v-safe
2021-01-15
Dose 1 — Moderna
2021-01-15
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-16
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Free text: Headache and body aches are in part related to the start of my menstrual cycle today.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Headache, Muscle or body aches, Abdominal pain

Free text: I think an ovarian cyst ruptured

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — day 14, dose 1
MedDRA: Oropharyngeal pain, Pyrexia — Feeling: Fair

Free text: Fever, sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-10
Dose 2 — Moderna
2021-02-10
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Chills, Headache

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Fever · Chills, Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Menstruation irregular — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Abdominal pain

Free text: My period has started early again. With my first dose it was 7 days early and with my second, it is 5 days early.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Menstrual disorder — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: Extra awful menstrual cycle.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-17
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 14, dose 2
Feeling: Good

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

Adult check-in
2021-03-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-12
Dose 3 — Moderna
2022-02-10
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-02-11
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-13
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-11-12
Survey response — 12 months, dose 3
MedDRA: Dyspnoea, Pregnancy, SARS-CoV-2 test negative, SARS-CoV-2 test positive — 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

Free text: Pregnant in June. Covid positive 9/26. Negative about two weeks later. Still having shortness of breath. Pregnancy is progressing as expected.

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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-11-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-10	Moderna
3	2021-11-12	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-16	priority 2/3
2022-11-12	Successful 2022-11-14	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): Headache and body aches are in part related to the start of my menstrual cycle today.

Release 2 — day 7, dose 1

2021-01-22

Systemic reaction (other): I think an ovarian cyst ruptured

Release 3 — day 14, dose 1

2021-01-29

Symptoms: Fever, sore throat

Release 4 — days 1–6 daily, dose 2

2021-02-13

Systemic reaction (other): My period has started early again. With my first dose it was 7 days early and with my second, it is 5 days early.

2021-02-14

Systemic reaction (other): Extra awful menstrual cycle.

Release 12 — 12 months, dose 3

2022-11-12

Symptoms: Pregnant in June. Covid positive 9/26. Negative about two weeks later. Still having shortness of breath. Pregnancy is progressing as expected.

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	Dyspnoea	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Menstrual disorder	✓	✓	✓
SRO	Menstruation irregular	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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