XMS-12664-11279

3 vaccinations 5 coded responses 39 check-ins 5 free-text entries 1 call case

Sex: Female
Age at first dose: 26-30
ZIP prefix: 786 / TX
Registered: 2021-02-04

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

2021-02-03
Dose 1 — Moderna
2021-02-04
Registered in v-safe
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-17
Survey response — day 14, dose 1
MedDRA: Fatigue, Migraine, Pruritus — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: 9 days after injection experienced severe fatigue and migraines, as well as whole body itching for two-three days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-03
Dose 2 — Moderna
2021-03-03
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness

Adult check-in
2021-03-04
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, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

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

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — day 7, dose 2
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-01
Survey response — 6 months, dose 2
MedDRA: Cholelithiasis, Vaginal haemorrhage — Feeling: Good

Free text: Gallstones Vaginal clotting

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-09
Dose 3 — Moderna
2021-11-09
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-11-10
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-15
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-18
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-23
Survey response — day 14, dose 3
MedDRA: Fatigue — Feeling: Good

Free text: Fatigue

MedDRA releases: 2024-11 · check-in free text available
2021-11-30
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-16
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-21
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-08
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-10
Survey response — 6 months, dose 3
MedDRA: Back pain, Headache, Malaise, Neck pain, Oropharyngeal pain, Rhinorrhoea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sore throat, headache, neck and back pain, runny nose, malaise

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Survey response — 12 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 · Outpatient clinic or urgent care clinic visit

Free text: COVID mid July.

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Report sent to call center — 12 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-11-10
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-03	Moderna
3	2021-11-09	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-11-09	Unsuccessful

Free text

Release 4 — day 14, dose 1

2021-02-17

Symptoms: 9 days after injection experienced severe fatigue and migraines, as well as whole body itching for two-three days.

Release 9 — 6 months, dose 2

2021-09-01

Symptoms: Gallstones Vaginal clotting

Release 10 — day 14, dose 3

2021-11-23

Symptoms: Fatigue

Release 11 — 6 months, dose 3

2022-05-10

Symptoms: Sore throat, headache, neck and back pain, runny nose, malaise

Release 12 — 12 months, dose 3

2022-11-09

Symptoms: COVID mid July.

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	Back pain	·	·	✓
SD	Cholelithiasis	✓	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Malaise	·	·	✓
SD	Migraine	✓	✓	✓
SD	Neck pain	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rhinorrhoea	·	·	✓
SD	Vaginal haemorrhage	✓	·	✓

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