Y5E-13988-06321

3 vaccinations 8 coded responses 40 check-ins 8 free-text entries 5 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 323 / FL
Registered: 2021-02-28

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

2021-02-28
Registered in v-safe
2021-02-28
Dose 1 — Moderna
2021-02-28
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain

Free text: I am a little Dizzy/lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fever · Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Urinary tract infection — Feeling: Fair

Free text: UTI. Possibly Pregnant.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — day 7, dose 1
Feeling: Good · None

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

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

Adult check-in
2021-03-25
Dose 2 — Moderna
2021-03-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fever · Headache

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · None

Adult check-in
2021-04-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-08
Survey response — day 14, dose 2
MedDRA: Pregnancy — Feeling: Good

Free text: Pregnancy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-18
Pregnancy registry survey
Pregnant at time of vaccination · Yes, I would like someone to contact me
2021-04-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-29
Survey response — day 35, dose 2
MedDRA: Pregnancy, Vaginal haemorrhage — Feeling: Fair · Be unable to work, 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: Vaginal bleeding while pregnant

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Survey response — day 42, dose 2
MedDRA: Abortion spontaneous — Feeling: Fair · 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: Pregnancy Loss

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-20
Call 1 — Left Voicemail
2021-06-24
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Abortion spontaneous, Office visit, Pregnancy — 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

Free text: Symptoms: Confirmed pregnant by OBGyN 8 days after 2nd dose. Further HCG blood testing to monitor pregnancy during 14 day waiting period. Fetal heartbeat detected via ultrasound 32 days after 2nd dose. Confirmed Spontaneous miscarriage 36 days after 2nd dose. · Healthcare visit (other): Multiple Office visits.

MedDRA releases: 2024-11 · check-in free text available
2021-09-23
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)
2021-09-27
Call 1 — Left Voicemail
2021-10-28
Dose 3 — Moderna
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-27
Survey response — 3 months, dose 3
MedDRA: Abortion spontaneous — 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: Pregnancy Loss

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Report sent to call center — 3 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)
2022-01-28
Call 1 — Left Voicemail
2022-04-28
Survey response — 6 months, dose 3
MedDRA: Abortion spontaneous, Antiphospholipid syndrome — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Pregnancy loss and Antiphospholipid Syndrome

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-29
Call 1 — Left Voicemail
2022-10-28
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-28	Moderna
2	2021-03-25	Moderna
3	2021-10-28	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-29	Unsuccessful
2021-05-06	Unsuccessful
2021-09-23	Unsuccessful
2022-01-27	Unsuccessful
2022-04-28	Unsuccessful

Free text

Release 4 — day 0, dose 1

2021-02-28

Systemic reaction (other): I am a little Dizzy/lightheaded

Release 5 — days 1–6 daily, dose 1

2021-03-06

Systemic reaction (other): UTI. Possibly Pregnant.

Release 7 — day 14, dose 2

2021-04-08

Symptoms: Pregnancy

Release 8 — day 35, dose 2

2021-04-29

Symptoms: Vaginal bleeding while pregnant

Release 8 — day 42, dose 2

2021-05-06

Symptoms: Pregnancy Loss

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: Confirmed pregnant by OBGyN 8 days after 2nd dose. Further HCG blood testing to monitor pregnancy during 14 day waiting period. Fetal heartbeat detected via ultrasound 32 days after 2nd dose. Confirmed Spontaneous miscarriage 36 days after 2nd dose. cut off by CDC

Healthcare visit (other): Multiple Office visits.

Release 11 — 3 months, dose 3

2022-01-27

Symptoms: Pregnancy Loss

Release 11 — 6 months, dose 3

2022-04-28

Symptoms: Pregnancy loss and Antiphospholipid Syndrome

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	Abortion spontaneous	✓	✓	✓
SD	Antiphospholipid syndrome	·	·	✓
SD	Pregnancy	✓	✓	✓
SD	Vaginal haemorrhage	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Urinary tract infection	✓	✓	✓

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