XZ8-31010-47093

4 vaccinations 11 coded responses 31 check-ins 10 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 908 / CA
Registered: 2021-01-29

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

2021-01-29
Registered in v-safe
2021-01-29
Dose 1 — Moderna
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Abdominal pain

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus, Vein disorder — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — 7 day, dose 1
Feeling: Good · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-02-12
Survey response — 14 day, dose 1
MedDRA: Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-19
Survey response — 21 day, dose 1
MedDRA: Cough, Respiratory tract congestion, Throat irritation — Feeling: Good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-26
Dose 2 — Moderna
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling · Fever · Chills, Joint pains, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — 7 day, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — 14 day, dose 2
Feeling: Good

Adult check-in
2021-03-20
Survey response — 21 day, dose 2
MedDRA: Dyspnoea, Dyspnoea exertional, Fatigue, Impaired work ability, Weight increased — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-04-03
Health check-in — 35 day, dose 2
Feeling: Good

Adult check-in
2021-04-11
Health check-in — 42 day, dose 2
Feeling: Good

Adult check-in
2021-05-28
Survey response — 3 month, dose 2
MedDRA: Nausea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-12-02
Dose 3 — Moderna
2021-12-02
Survey response — 0 day, dose 3
MedDRA: Dizziness — Feeling: Good · Muscle or body aches, Fatigue or tiredness

MedDRA releases: 2024-11 · check-in answers available
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-12-17
Survey response — 14 day, dose 3
MedDRA: Incontinence — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11 · check-in answers available
2021-12-26
Health check-in — 21 day, dose 3
Feeling: Fair

Adult check-in
2021-12-30
Health check-in — 28 day, dose 3
Feeling: Good

Adult check-in
2022-03-05
Survey response — 3 month, dose 3
MedDRA: Abnormal sensation in eye, Aphasia, Brain fog, Tongue discomfort, Vision blurred — Feeling: Fair · Be unable to work or attend school

MedDRA releases: 2024-11 · check-in answers available
2022-06-02
Survey response — 6 month, dose 3
MedDRA: Aphasia, Bradyphrenia, Confusional state, Office visit, Pre-existing disease, Tongue geographic, Unevaluable event, Vision blurred — 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, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11 · check-in answers available
2022-06-02
Report sent to call center — 6 month, 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-03
Call successful
Participant prefers to complete VAERS report online
2023-01-11
Dose 4 — Moderna
2023-01-12
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2023-01-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Abdominal pain

Adult check-in
2023-01-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Chills, Abdominal pain

Adult check-in
2023-01-15
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2023-01-27
Survey response — 14 day, dose 4
MedDRA: Dyspnoea exertional — Feeling: Good

MedDRA releases: 2024-11 · check-in answers available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-29	Moderna
2	2021-02-26	Moderna
3	2021-12-02	Moderna	No
4	2023-01-11	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-06-02	Successful 2022-06-03	Participant prefers to complete VAERS report online

Free text

Release 3

Systemic reaction (other): The veins inside of the arm that received the injection itched in my inner elbow. I have never experienced itchy veins before. It was bizarre.

Release 4

Symptoms: Sore throat yesterday & today (maybe due to excessive talking at work?) after a negative covid test yesterday.

Symptoms: Coughs, occasional scratchy throat, and a tad bit of congestion.

Systemic reaction (other): Light headedness

Release 6

Symptoms: I have been gaining weight, get winded easier, and am tired a lot earlier when walking long distances than I used to be. While it hasn't made me unable to work. It has made work more difficult.

Release 8

Symptoms: My menstruations have been more severe, and coupled with more nausea than before vaccination.

Release 10

Systemic reaction (other): Wooziness, lightheaded

Symptoms: Frequent incontinence.

Release 11

Symptoms: 2/19 my tongue burned, my left eye had the sensation of falling (didn't visually), my vision blurred, then my thinking was foggy, and I had trouble forming sentences for 20 minutes. 2/21 my left eye felt like it fell again.

Symptoms: I had an episode of confusion, slow thinking, blurred vision, and inability to say or type the words I was thinking that lasted 20 min. Diagnosed with geographic tongue, and prescribed glasses, regularly have tongue and teeth issues.

Healthcare visit (other): MRI with no results

Free-text releases are not linked to a specific 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
HCVO	Unevaluable event	·	·	✓
SD	Abnormal sensation in eye	·	·	✓
SD	Aphasia	·	·	✓
SD	Bradyphrenia	·	·	✓
SD	Brain fog	·	·	✓
SD	Confusional state	·	·	✓
SD	Cough	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Dyspnoea exertional	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Impaired work ability	✓	✓	✓
SD	Incontinence	·	·	✓
SD	Nausea	✓	✓	✓
SD	Office visit	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Throat irritation	✓	✓	✓
SD	Tongue discomfort	·	·	✓
SD	Tongue geographic	·	·	✓
SD	Vision blurred	·	·	✓
SD	Weight increased	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Vein disorder	✓	✓	✓

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