X3S-10681-92716

5 vaccinations 7 coded responses 53 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 660 / KS
Registered: 2021-04-03

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

Registered dependents

NRP-18552-08561 Child or adolescent in my care · Male · 2022-07-14

JSG-28887-16023 Child or adolescent in my care · Male · 2022-07-14

Timeline

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

2021-04-03
Registered in v-safe
2021-04-03
Dose 1 — Moderna
2021-04-03
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

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

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-04-10
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-17
Survey response — day 14, dose 1
MedDRA: Cough, Rhinorrhoea, Sneezing — Feeling: Poor

Free text: Our kiddo brought the cold home from school.SneezingRunny noseCoughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-05-01
Dose 2 — Moderna
2021-05-01
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-02
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-05-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-05-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness

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

Adult check-in
2021-05-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-05-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-05-08
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

Adult check-in
2021-05-15
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-05-22
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-05
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-30
Survey response — 6 months, dose 2
MedDRA: Nasopharyngitis — Feeling: Poor

Free text: We all have colds

MedDRA releases: 2024-11 · check-in free text available
2021-12-19
Dose 3 — Moderna
2022-05-03
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-07-16
Dose 4 — Moderna
2022-07-16
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-17
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-07-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2022-07-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-07-20
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-07-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-07-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-07-23
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-07-30
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-08-06
Survey response — day 21, dose 4
MedDRA: Pre-existing disease, Sinus disorder — Feeling: Fair

Free text: My allergies and sinuses are pretty bad today

MedDRA releases: 2024-11 · check-in free text available
2022-08-13
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-08-20
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-08-27
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-10-15
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-11-16
Dose 5 — Moderna
2022-11-16
Health check-in — day 0, dose 5
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-11-17
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2022-11-18
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2022-11-19
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-11-20
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-11-21
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-22
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-11-23
Health check-in — day 7, dose 5
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-11-30
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-12-07
Survey response — day 21, dose 5
MedDRA: Fatigue, Rhinorrhoea — Feeling: Fair

Free text: Fatigue and running nose

MedDRA releases: 2024-11 · check-in free text available
2022-12-14
Survey response — day 28, dose 5
MedDRA: Nasopharyngitis — Feeling: Poor

Free text: We all have bad colds

MedDRA releases: 2024-11 · check-in free text available
2022-12-21
Survey response — day 35, dose 5
MedDRA: Conjunctivitis, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: We have a bad sinus infection and pink eye

MedDRA releases: 2024-11 · check-in free text available
2022-12-21
Report sent to call center — day 35, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-22
Call successful
Participant prefers to complete VAERS report online
2022-12-28
Survey response — day 42, dose 5
MedDRA: Nasopharyngitis — Feeling: Fair

Free text: Have a bad cold

MedDRA releases: 2024-11 · check-in free text available
2023-02-15
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-03	Moderna
2	2021-05-01	Moderna
3	2021-12-19	Moderna	No
4	2022-07-16	Moderna	No
5	2022-11-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-12-21	Successful 2022-12-22	Participant prefers to complete VAERS report online

Free text

Release 7 — day 14, dose 1

2021-04-17

Symptoms: Our kiddo brought the cold home from school.SneezingRunny noseCoughing

Release 10 — 6 months, dose 2

2021-10-30

Symptoms: We all have colds

Release 12 — day 21, dose 4

2022-08-06

Symptoms: My allergies and sinuses are pretty bad today

Release 12 — day 21, dose 5

2022-12-07

Symptoms: Fatigue and running nose

Release 12 — day 28, dose 5

2022-12-14

Symptoms: We all have bad colds

Release 12 — day 35, dose 5

2022-12-21

Symptoms: We have a bad sinus infection and pink eye

Release 12 — day 42, dose 5

2022-12-28

Symptoms: Have a bad cold

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	Conjunctivitis	·	·	✓
SD	Cough	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Sinus disorder	·	·	✓
SD	Sinusitis	·	·	✓
SD	Sneezing	✓	✓	✓

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