W6J-15750-03652

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

Sex: Female
Age at first dose: 31-35
ZIP prefix: 070 / NJ
Registered: 2021-04-06

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

2021-04-06
Registered in v-safe
2021-04-06
Dose 1 — Moderna
2021-04-06
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · None

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-04-13
Health check-in — day 7, dose 1
Feeling: Fair · Chills

Adult check-in
2021-04-20
Survey response — day 14, dose 1
MedDRA: Injection site reaction, Rash erythematous, Rash pruritic — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: An oval shaped, red, bumpy, itchy skin rash approximately the size of my hand, beginning at the injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-27
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-05-04
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-05-06
Dose 2 — Moderna
2021-05-06
Survey response — day 0, dose 2
MedDRA: Muscular weakness — Feeling: Fair · Nausea

Free text: Weakness in legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — days 1–6 daily, dose 2
MedDRA: Eye swelling, Lip swelling, Swollen tongue — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, 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: Swollen eyelids tongue, and lips about 12 hours after injection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness · Fatigue or tiredness

Adult check-in
2021-05-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache

Adult check-in
2021-05-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-05-12
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Chills, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-28
Health check-in — day 21, dose 2
Feeling: Good

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

Adult check-in
2021-06-11
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-02-26
Call successful
Participant prefers to complete VAERS report online
2022-05-06
Survey response — 12 months, dose 2
MedDRA: Heart rate increased — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Accelerated heart rate.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-05-09
Call 1 — Could Not Reach Participant
2022-05-12
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Moderna
2	2021-05-06	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-04-20	Successful	Participant prefers to complete VAERS report online
2021-05-07	Successful 2022-02-26	Participant prefers to complete VAERS report online
2022-05-06	Unsuccessful

Free text

Release 7 — day 14, dose 1

2021-04-20

Symptoms: An oval shaped, red, bumpy, itchy skin rash approximately the size of my hand, beginning at the injection site.

Release 8 — day 0, dose 2

2021-05-06

Systemic reaction (other): Weakness in legs

Release 8 — days 1–6 daily, dose 2

2021-05-07

Systemic reaction (other): Swollen eyelids tongue, and lips about 12 hours after injection.

Release 11 — 12 months, dose 2

2022-05-06

Symptoms: Accelerated heart rate.

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	Heart rate increased	·	·	✓
SD	Injection site reaction	✓	✓	✓
SD	Rash erythematous	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SRO	Eye swelling	✓	✓	✓
SRO	Lip swelling	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓
SRO	Swollen tongue	✓	✓	✓

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