VH8-31297-42746

3 vaccinations 8 coded responses 16 check-ins 8 free-text entries 4 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 921 / CA
Registered: 2021-01-04

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2020-12-31
Dose 1 — Moderna
2021-01-04
Registered in v-safe
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-05
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-06
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-07
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-07
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-14
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-22
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-28
Dose 2 — Moderna
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity, Rash — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work

Free text: Huge rash on my arm with sore

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Hyperhidrosis — Feeling: Poor · 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: Sweat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Survey response — day 7, dose 2
MedDRA: Vaccination site rash — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Huge bump in my arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-29
Survey response — 6 months, dose 2
MedDRA: Abortion spontaneous, Chills, Oropharyngeal pain, Pyrexia — Feeling: Poor · 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

Free text: Fever chills sore throat lost baby

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-29
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-02
Call 1 — Could Not Reach Participant
2021-08-05
Call 2 — Left Voicemail
2021-11-24
Dose 3 — Moderna
Co-administered: Flu
2022-01-30
Survey response — 12 months, dose 2
MedDRA: Abortion spontaneous, Uterine operation — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I had 2 miscarriages, one uterine curettage surgery

MedDRA releases: 2024-11 · check-in free text available
2022-02-25
Survey response — 3 months, dose 3
MedDRA: Abortion spontaneous, Emergency care, Pain, Pyrexia — Feeling: Fair · Be unable to work or attend school

Free text: Went to the ER again around 02/11/22 , fever pain and another lost baby

MedDRA releases: 2024-11 · check-in free text available
2022-05-25
Survey response — 6 months, dose 3
MedDRA: Adverse reaction, Emergency care — Feeling: Fair · Be unable to do your normal daily activities

Free text: I went to the ER with too many different things.. let me know I can sent medical records to you.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-28	Moderna
3	2021-11-24	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-01-05	priority 2/3
2021-01-06	priority 2/3
2021-01-07	priority 2/3
2021-07-29	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-05

Systemic reaction (other): Dizziness

Release 3 — days 1–6 daily, dose 2

2021-02-01

Systemic reaction (other): Huge rash on my arm with sore

2021-02-02

Systemic reaction (other): Sweat

Release 3 — day 7, dose 2

2021-02-04

Systemic reaction (other): Huge bump in my arm

Release 9 — 6 months, dose 2

2021-07-29

Symptoms: Fever chills sore throat lost baby

Release 11 — 12 months, dose 2

2022-01-30

Symptoms: I had 2 miscarriages, one uterine curettage surgery

Release 11 — 3 months, dose 3

2022-02-25

Symptoms: Went to the ER again around 02/11/22 , fever pain and another lost baby

Release 11 — 6 months, dose 3

2022-05-25

Symptoms: I went to the ER with too many different things.. let me know I can sent medical records to you.

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	Adverse reaction	·	·	✓
SD	Chills	✓	·	✓
SD	Emergency care	·	·	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	✓	·	✓
SD	Uterine operation	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Vaccination site rash	✓	✓	✓

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