YB8-96870-56611

4 vaccinations 16 coded responses 41 check-ins 16 free-text entries 4 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 612 / IL
Registered: 2021-03-07

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

2021-03-07
Registered in v-safe
2021-03-07
Dose 1 — Moderna
2021-03-07
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2021-03-14
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-02
Dose 2 — Moderna
2021-04-02
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-06
Survey response — days 1–6 daily, dose 2
MedDRA: Epistaxis — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Multiple nosebleeds that last a long time

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Epistaxis — Feeling: Poor · Site: Pain, Redness, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Several significant nosebleeds today; some dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Epistaxis — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Several big nosebleeds today again; some dizziness again

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 7, dose 2
MedDRA: Dizziness, Epistaxis — Feeling: Poor · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Pretty significant nosebleeds yet again; still dizzy too

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-30
Survey response — day 28, dose 2
MedDRA: Chills, Cough, Dyspnoea, Headache, Nausea, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Vomiting — Feeling: Poor · Be unable to work, 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: Cough, sore throat, fever, headache, chills, congestion, nausea and vomiting , hard to breathe when talking for too long.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — day 28, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-07
Survey response — day 35, dose 2
MedDRA: Cough, Dyspnoea, Fatigue, Headache, Myalgia — Feeling: Poor · Be unable to work, 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: Persistent cough, headache, fatigue, muscle aches, and some difficulty talking for awhile or walking too far b/c short of breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
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)
2021-05-14
Survey response — day 42, dose 2
MedDRA: Epistaxis, Fatigue, Headache — 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: Headache, nosebleeds occasionally, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-14
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)
2021-07-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-01
Survey response — 6 months, dose 2
MedDRA: Exposure to communicable disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Rabies exposure

MedDRA releases: 2024-11 · check-in free text available
2021-10-01
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Emergency room or emergency department visit · 1 call case(s)
2021-10-06
Call successful
Does not wish to fill out VAERS report
2021-10-30
Dose 3 — Moderna
Co-administered: Flu
2021-10-30
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Epistaxis — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Significant nosebleeds

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Epistaxis — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Significant nosebleeds

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Epistaxis — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Nosebleeds

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Epistaxis — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Nosebleeds

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — day 7, dose 3
MedDRA: Epistaxis — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Nosebleeds

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Survey response — day 14, dose 3
MedDRA: Dizziness, Epistaxis, Fatigue, Headache — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Major headaches, significant nosebleeds, some dizziness, lots of fatigue that wont go away

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Survey response — day 21, dose 3
MedDRA: Ear pain, Epistaxis, Headache — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headaches, ear arches, nosebleeds that last long time

MedDRA releases: 2024-11 · check-in free text available
2021-11-27
Survey response — day 28, dose 3
MedDRA: Epistaxis, Headache, Nausea — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headaches continuing, nosebleeds, new nausea

MedDRA releases: 2024-11 · check-in free text available
2021-12-04
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-11
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-02
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-01
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-21
Dose 4 — Moderna
Co-administered: Flu
2022-10-30
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-07	Moderna
2	2021-04-02	Moderna
3	2021-10-30	Moderna	Flu
4	2022-10-21	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-04-30	Successful	Does not wish to fill out VAERS report
2021-05-07	Successful	Does not wish to fill out VAERS report
2021-05-14	Successful	Does not wish to fill out VAERS report
2021-10-01	Successful 2021-10-06	Does not wish to fill out VAERS report

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-06

Systemic reaction (other): Multiple nosebleeds that last a long time

2021-04-07

Systemic reaction (other): Several significant nosebleeds today; some dizziness

2021-04-08

Systemic reaction (other): Several big nosebleeds today again; some dizziness again

Release 7 — day 7, dose 2

2021-04-09

Systemic reaction (other): Pretty significant nosebleeds yet again; still dizzy too

Release 8 — day 28, dose 2

2021-04-30

Symptoms: Cough, sore throat, fever, headache, chills, congestion, nausea and vomiting , hard to breathe when talking for too long.

Release 8 — day 35, dose 2

2021-05-07

Symptoms: Persistent cough, headache, fatigue, muscle aches, and some difficulty talking for awhile or walking too far b/c short of breath.

Release 8 — day 42, dose 2

2021-05-14

Symptoms: Headache, nosebleeds occasionally, fatigue

Release 9 — 6 months, dose 2

2021-10-01

Symptoms: Rabies exposure

Release 10 — days 1–6 daily, dose 3

2021-11-02

Systemic reaction (other): Significant nosebleeds

2021-11-03

Systemic reaction (other): Significant nosebleeds

2021-11-04

Systemic reaction (other): Nosebleeds

2021-11-05

Systemic reaction (other): Nosebleeds

Release 10 — day 7, dose 3

2021-11-06

Systemic reaction (other): Nosebleeds

Release 10 — day 14, dose 3

2021-11-14

Symptoms: Major headaches, significant nosebleeds, some dizziness, lots of fatigue that wont go away

Release 10 — day 21, dose 3

2021-11-22

Symptoms: Headaches, ear arches, nosebleeds that last long time

Release 10 — day 28, dose 3

2021-11-27

Symptoms: Headaches continuing, nosebleeds, new nausea

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	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Ear pain	·	·	✓
SD	Epistaxis	✓	✓	✓
SD	Exposure to communicable disease	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Epistaxis	✓	✓	✓

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