Y23-15422-07760

3 vaccinations 5 coded responses 22 check-ins 5 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 197 / DE
Registered: 2020-12-23

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2020-12-23
Registered in v-safe
2020-12-23
Dose 1 — Moderna
2021-01-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-20
Dose 2 — Moderna
2021-01-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · None

Adult check-in
2021-01-27
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness · Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-21
Survey response — 6 months, dose 2
MedDRA: Ageusia, Anosmia, Cough, Pyrexia, Respiratory tract infection, SARS-CoV-2 test negative, Sinusitis — 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 · Telehealth, virtual health, or email health consultation

Free text: Respiratory infection, sinusitis, loss of smell or taste, fever, coughing. Tested negative for Covid-19 twice. Lasted 10 days.

MedDRA releases: 2024-11 · check-in free text available
2021-07-21
Report sent to call center — 6 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

1 call case(s)
2021-07-27
Call 1 — Could Not Reach Participant
2021-07-30
Call successful
Participant prefers to complete VAERS report online
2022-01-20
Survey response — 12 months, dose 2
MedDRA: Headache, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test negative, SARS-CoV-2 test positive, Sinus pain, Upper respiratory tract congestion, Vomiting — 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 · Telehealth, virtual health, or email health consultation

Free text: Week of Dec 27- Had a week of fever, vomiting, sinus and body ache but tested negative for covid Currently covid positive with fever,upper respiratory congestion, sore throat bodyache, headache

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-21
Call 1 — Left Voicemail
2022-04-01
Dose 3 — Moderna
2022-04-26
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2022-05-01
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-05-06
Survey response — day 35, dose 3
MedDRA: Dyspnoea — Feeling: Good

Free text: Some shortness of breath.

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-07-01
Survey response — 3 months, dose 3
MedDRA: Menstrual disorder, Menstruation irregular — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Increased irregularities and intensity in menstrual cycle

MedDRA releases: 2024-11 · check-in free text available
2022-10-02
Survey response — 6 months, dose 3
MedDRA: Fatigue, Nausea, Pyrexia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Intermittent fatigue, fever, nausea symptoms

MedDRA releases: 2024-11 · check-in free text available
2023-04-01
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-23	Moderna
2	2021-01-20	Moderna
3	2022-04-01	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-07-21	Successful 2021-07-30	Participant prefers to complete VAERS report online
2022-01-20	Unsuccessful

Free text

Release 9 — 6 months, dose 2

2021-07-21

Symptoms: Respiratory infection, sinusitis, loss of smell or taste, fever, coughing. Tested negative for Covid-19 twice. Lasted 10 days.

Release 10 — 12 months, dose 2

2022-01-20

Symptoms: Week of Dec 27- Had a week of fever, vomiting, sinus and body ache but tested negative for covid Currently covid positive with fever,upper respiratory congestion, sore throat bodyache, headache

Release 11 — day 35, dose 3

2022-05-06

Symptoms: Some shortness of breath.

Release 12 — 3 months, dose 3

2022-07-01

Symptoms: Increased irregularities and intensity in menstrual cycle

Release 12 — 6 months, dose 3

2022-10-02

Symptoms: Intermittent fatigue, fever, nausea symptoms

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	Ageusia	·	·	✓
SD	Anosmia	·	·	✓
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Menstrual disorder	·	·	✓
SD	Menstruation irregular	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract infection	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sinus pain	·	·	✓
SD	Sinusitis	·	·	✓
SD	Upper respiratory tract congestion	·	·	✓
SD	Vomiting	·	·	✓

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