VCF-30071-76503

4 vaccinations 7 coded responses 25 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 234 / VA
Registered: 2021-03-26

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

2021-03-24
Dose 1 — Moderna
2021-03-26
Registered in v-safe
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-03-31
Health check-in — day 7, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-04-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-14
Survey response — day 21, dose 1
MedDRA: Pityriasis rosea — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Pityriasis Rosea - on opposite arm of vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-21
Dose 2 — Moderna
2021-04-21
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-22
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
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-04-25
Survey response — days 1–6 daily, dose 2
MedDRA: Pityriasis rosea — Feeling: Good · Site: Pain, Redness

Free text: pityriasis rosea - has continued after first shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Pityriasis rosea — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: pityriasis rosea - not resolved yet

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — day 7, dose 2
MedDRA: Pityriasis rosea — Feeling: Good

Free text: pityriasis rosea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — day 35, dose 2
MedDRA: Cough, Upper-airway cough syndrome — Feeling: Fair

Free text: Cough, post nasal drip

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

Adult check-in
2021-07-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-20
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-20
Dose 3 — Moderna
2022-02-19
Call 1 — Left Voicemail
2022-05-21
Survey response — 6 months, dose 3
MedDRA: COVID-19 — Feeling: Good · 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: Covid-19- April 28th

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Report sent to call center — 6 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)
2022-05-23
Call successful
Participant prefers to complete VAERS report online
2022-05-23
Call successful
Participant prefers to complete VAERS report online
2022-09-26
Dose 4 — Moderna
Co-administered: Flu
2022-11-20
Survey response — 12 months, dose 3
MedDRA: COVID-19, Delivery — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Developed Gestational Diabetes during pregnancy, immediately following covid diagnosis in April. I gave birth in August.

MedDRA releases: 2024-11 · check-in free text available
2022-11-20
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-21
Call 1 — Left Voicemail
2022-12-28
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-27
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna
2	2021-04-21	Moderna
3	2021-11-20	Moderna	No
4	2022-09-26	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-04-14	Successful 2022-05-23	Participant prefers to complete VAERS report online
2022-05-21	Successful 2022-05-23	Participant prefers to complete VAERS report online
2022-11-20	Unsuccessful

Free text

Release 7 — day 21, dose 1

2021-04-14

Symptoms: Pityriasis Rosea - on opposite arm of vaccination

Release 7 — days 1–6 daily, dose 2

2021-04-25

Systemic reaction (other): pityriasis rosea - has continued after first shot

Release 8 — days 1–6 daily, dose 2

2021-04-27

Systemic reaction (other): pityriasis rosea - not resolved yet

Release 8 — day 7, dose 2

2021-04-30

Systemic reaction (other): pityriasis rosea

Release 8 — day 35, dose 2

2021-05-28

Symptoms: Cough, post nasal drip

Release 11 — 6 months, dose 3

2022-05-21

Symptoms: Covid-19- April 28th

Release 12 — 12 months, dose 3

2022-11-20

Symptoms: Developed Gestational Diabetes during pregnancy, immediately following covid diagnosis in April. I gave birth in August.

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	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Delivery	·	·	✓
SD	Pityriasis rosea	✓	✓	✓
SD	Upper-airway cough syndrome	✓	✓	✓
SRO	Pityriasis rosea	✓	✓	✓

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