Y6M-28171-70853

4 vaccinations 11 coded responses 41 check-ins 10 free-text entries 4 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 551 / MN
Registered: 2021-01-23

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

Registered dependents

KE8-82738-14386 Child or adolescent in my care · Female · 2022-06-28

Timeline

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

2021-01-23
Registered in v-safe
2021-01-23
Dose 1 — Moderna
2021-01-23
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Upper-airway cough syndrome — Feeling: Good

Free text: Post nasal drip

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-17
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills, Headache · Be unable to do your normal daily activities

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Nausea

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 2
Feeling: Good · Chills

Adult check-in
2021-03-03
Survey response — day 14, dose 2
MedDRA: Hypersensitivity, Pre-existing disease — Feeling: Good

Free text: Allergy flare

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-24
Survey response — day 35, dose 2
MedDRA: Hypersensitivity, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Allergies have been horrible. But probably not related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-31
Survey response — day 42, dose 2
MedDRA: Back pain, Night sweats — Feeling: Good · Be unable to do your normal daily activities

Free text: Night sweats and back pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-18
Survey response — 6 months, dose 2
MedDRA: Tonsillitis — 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: Tonsillitis

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-18
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)
2021-08-19
Call 1 — Left Voicemail
2021-08-19
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-23
Dose 3 — Moderna
2021-10-23
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · Fatigue or tiredness, Nausea

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-06
Survey response — day 14, dose 3
MedDRA: Pregnancy, Sinusitis — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sinus infection likely due to having to stop certain medication due to pregnancy

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-20
Survey response — day 28, dose 3
MedDRA: Abortion spontaneous — 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, Outpatient clinic or urgent care clinic visit

Free text: In the middle of miscarriage at 9 weeks, baby died around 8 weeks. Not likely related to vax but for stats should be noted

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Report sent to call center — day 28, 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)
2021-11-23
Call 1 — Left Voicemail
2021-11-27
Survey response — day 35, dose 3
MedDRA: Constipation — Feeling: Good · Be unable to do your normal daily activities

Free text: Constipation caused by d&c meds

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Survey response — day 42, dose 3
MedDRA: Oropharyngeal pain, Pre-existing disease — Feeling: Fair

Free text: Sore throat allergies

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-23
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-23
Survey response — 12 months, dose 3
MedDRA: Pregnancy — Feeling: Fair

Free text: Pregnancy and related complications

MedDRA releases: 2024-11 · check-in free text available
2022-11-04
Dose 4 — Moderna
2023-05-05
Survey response — 6 months, dose 4
MedDRA: Emergency care, Pregnancy — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-05-05
Report sent to call center — 6 months, dose 4
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 · Emergency room or emergency department visit · 1 call case(s)
2023-05-08
Call successful
Not applicable - Accidental Reporting
2023-05-08
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-23	Moderna
2	2021-02-17	Moderna
3	2021-10-23	Moderna	No
4	2022-11-04	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-24	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-08-18	Successful 2021-08-19	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-20	Successful 2023-05-08	Not applicable - Accidental Reporting
2023-05-05	Successful 2023-05-08	Not applicable - Accidental Reporting

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-26

Systemic reaction (other): Post nasal drip

Release 5 — day 14, dose 2

2021-03-03

Symptoms: Allergy flare

Release 6 — day 35, dose 2

2021-03-24

Symptoms: Allergies have been horrible. But probably not related

Release 6 — day 42, dose 2

2021-03-31

Symptoms: Night sweats and back pain

Release 9 — 6 months, dose 2

2021-08-18

Symptoms: Tonsillitis

Release 10 — day 14, dose 3

2021-11-06

Symptoms: Sinus infection likely due to having to stop certain medication due to pregnancy

Release 10 — day 28, dose 3

2021-11-20

Symptoms: In the middle of miscarriage at 9 weeks, baby died around 8 weeks. Not likely related to vax but for stats should be noted

Release 10 — day 35, dose 3

2021-11-27

Symptoms: Constipation caused by d&c meds

Release 10 — day 42, dose 3

2021-12-04

Symptoms: Sore throat allergies

Release 12 — 12 months, dose 3

2022-10-23

Symptoms: Pregnancy and related complications

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	Abortion spontaneous	·	·	✓
SD	Back pain	✓	✓	✓
SD	Constipation	·	·	✓
SD	Emergency care	·	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Night sweats	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pregnancy	·	·	✓
SD	Sinusitis	·	·	✓
SD	Tonsillitis	✓	·	✓
SRO	Upper-airway cough syndrome	✓	✓	✓

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