VSD-31916-16024

4 vaccinations 7 coded responses 30 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 801 / CO
Registered: 2021-03-08

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

Registered dependents

QFV-30101-94015 Child or adolescent in my care · Female · 2022-09-07

Timeline

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

2021-03-03
Dose 1 — Moderna
2021-03-08
Registered in v-safe
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Suppressed lactation, Supraventricular tachycardia — Feeling: Good

Free text: SVT episode about 48 hours after the shot. Also I am lactating mom and had reduced breast milk production for 3 days after shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Survey response — day 7, dose 1
MedDRA: Lymphadenopathy — Feeling: Good

Free text: I have had a swollen lymph node in my armpit of the injection arm since the day after the shot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 14, dose 1
MedDRA: Condition aggravated, Pre-existing disease, Supraventricular tachycardia — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Had another minor episode of SVT.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-31
Dose 2 — Moderna
2021-03-31
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Suppressed lactation — 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

Free text: 25% reduction in breast milk supply (I am lactating)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Oedema peripheral, Suppressed lactation — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: Swollen underarm on side where got shot; breast milk reduction by about 10%

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Maternal exposure during breast feeding, Suppressed lactation — Feeling: Good · Site: Pain

Free text: Still have about 10-20% breast milk reduction.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-09
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-14
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-03
Dose 3 — Moderna
2021-12-17
Call 1 — Could Not Reach Participant
2021-12-22
Call 2 — Left Voicemail
2022-04-02
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-06-03
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-24
Dose 4 — Pfizer-BioNTech
2022-09-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-10-08
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-15
Survey response — day 21, dose 4
MedDRA: COVID-19 — 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: COVID

MedDRA releases: 2024-11 · check-in free text available
2022-10-15
Report sent to call center — day 21, dose 4
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)
2022-10-17
Call successful
Reported to VAERS during previous contact from GDIT
2022-10-17
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-24
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-29
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-05
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-03-25
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2021-12-03	Moderna	No
4	2022-09-24	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-17	Successful 2022-10-17	Reported to VAERS during previous contact from GDIT
2022-10-15	Successful 2022-10-17	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-08

Systemic reaction (other): SVT episode about 48 hours after the shot. Also I am lactating mom and had reduced breast milk production for 3 days after shot.

Release 5 — day 7, dose 1

2021-03-10

Systemic reaction (other): I have had a swollen lymph node in my armpit of the injection arm since the day after the shot.

Release 5 — day 14, dose 1

2021-03-17

Symptoms: Had another minor episode of SVT.

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): 25% reduction in breast milk supply (I am lactating)

2021-04-02

Systemic reaction (other): Swollen underarm on side where got shot; breast milk reduction by about 10%

2021-04-05

Systemic reaction (other): Still have about 10-20% breast milk reduction.

Release 12 — day 21, dose 4

2022-10-15

Symptoms: COVID

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	Condition aggravated	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Supraventricular tachycardia	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Maternal exposure during breast feeding	✓	✓	✓
SRO	Oedema peripheral	✓	✓	✓
SRO	Suppressed lactation	✓	✓	✓
SRO	Supraventricular tachycardia	✓	✓	✓

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