Y2C-17428-53352

3 vaccinations 11 coded responses 39 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 600 / IL
Registered: 2021-02-17

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

Registered dependents

BPV-30550-26119 Child or adolescent in my care · Male · 2021-12-14

Timeline

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

2021-02-17
Registered in v-safe
2021-02-17
Dose 1 — Moderna
2021-02-17
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-02-20
Survey response — days 1–6 daily, dose 1
MedDRA: Irritability — Feeling: Good · Site: Pain, Redness · Joint pains, Fatigue or tiredness

Free text: Irritability

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-17
Dose 2 — Moderna
2021-03-17
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Free text: Severe head ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Severe dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-21
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness, Diarrhea

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Headache, Diarrhea

Adult check-in
2021-03-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Itching · Headache, Diarrhea

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 7, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-03-31
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-14
Survey response — day 28, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Survey response — day 35, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Tires

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-16
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-15
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-02
Dose 3 — Moderna
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-12-09
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-12-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-25
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-30
Survey response — day 28, dose 3
MedDRA: Headache, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair

Free text: Headache sniffles sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Survey response — day 35, dose 3
MedDRA: Headache, Oropharyngeal pain — Feeling: Fair

Free text: Sore throat headache

MedDRA releases: 2024-11 · check-in free text available
2022-01-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-03
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-02
Health check-in — 6 months, dose 3
Feeling: Poor

Adult check-in
2022-12-02
Survey response — 12 months, dose 3
MedDRA: Neck mass, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: A mass in my skin located on my neck · Healthcare visit (other): Appointment

MedDRA releases: 2024-11 · check-in free text available
2022-12-02
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-12-05
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-17	Moderna
2	2021-03-17	Moderna
3	2021-12-02	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-12-02	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-20

Systemic reaction (other): Irritability

Release 5 — days 1–6 daily, dose 2

2021-03-18

Systemic reaction (other): Severe head ache

2021-03-19

Systemic reaction (other): Severe dizziness

Release 6 — days 1–6 daily, dose 2

2021-03-20

Systemic reaction (other): Dizzy

2021-03-21

Systemic reaction (other): Dizzy

2021-03-23

Systemic reaction (other): Dizzy

Release 7 — day 28, dose 2

2021-04-14

Symptoms: Tired

Release 7 — day 35, dose 2

2021-04-21

Symptoms: Tires

Release 10 — day 28, dose 3

2021-12-30

Symptoms: Headache sniffles sore throat

Release 10 — day 35, dose 3

2022-01-08

Symptoms: Sore throat headache

Release 12 — 12 months, dose 3

2022-12-02

Symptoms: A mass in my skin located on my neck

Healthcare visit (other): Appointment

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
HCVO	Office visit	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Neck mass	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Irritability	✓	✓	✓

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