YCJ-38189-48047

2 vaccinations 11 coded responses 21 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 483 / MI
Registered: 2021-02-15

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

2021-02-15
Registered in v-safe
2021-02-15
Dose 1 — Moderna
2021-02-16
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Decreased appetite, Heart rate increased, Respiratory tract congestion, Vision blurred — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Blurred vision, fast heart rate, chest congestion, back pain, loss appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Night sweats — Feeling: Good · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Night sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — days 1–6 daily, dose 1
MedDRA: Back pain, Insomnia, Muscle spasms — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Leg cramps, back pain, insomnia

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 · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — day 7, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-01
Survey response — day 14, dose 1
MedDRA: Dizziness — Feeling: Good

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — day 21, dose 1
MedDRA: Chest pain, Dysgeusia, Fatigue, Headache, Nausea — Feeling: Fair

Free text: Nausea, fatigue, headache, chest pain, certain foods taste a bit weird to me since Saturday night. Example grilled cheese sandwich, ice cream, ground beef

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Dose 2 — Moderna
2021-03-15
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Rash — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Noticed a skin rash on my back

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: Ocular hyperaemia, Rash — Feeling: Good · Site: Itching · Rash, not including the immediate area around the injection site

Free text: Rash on back, red eyes

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

Adult check-in
2021-03-22
Health check-in — day 7, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-05
Survey response — day 21, dose 2
MedDRA: Headache, Night sweats — Feeling: Fair

Free text: HeadacheNight sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — day 28, dose 2
MedDRA: Chest pain, Headache — Feeling: Poor

Free text: headachechest pain

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

Adult check-in
2021-04-27
Survey response — day 42, dose 2
MedDRA: Cough, Oropharyngeal pain, Sneezing — Feeling: Poor · Be unable to do your normal daily activities

Free text: sore throatsneezingdry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-14
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-13
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-03-15
Survey response — 12 months, dose 2
MedDRA: Appetite disorder, Food aversion, Gastrointestinal disorder, Infection, Menstruation irregular, Pain, Rash — 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: irregular menstruation, unexplained pains, unexplained rashes, appetite changes- food aversions, unexplained gastrointestinal issues, infections

MedDRA releases: 2024-11 · check-in free text available
2022-03-15
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-18
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-15	Moderna
2	2021-03-15	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2022-03-15	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-16

Systemic reaction (other): Blurred vision, fast heart rate, chest congestion, back pain, loss appetite

2021-02-18

Systemic reaction (other): Night sweats

2021-02-20

Systemic reaction (other): Leg cramps, back pain, insomnia

Release 4 — day 14, dose 1

2021-03-01

Symptoms: Dizziness

Release 5 — day 21, dose 1

2021-03-08

Symptoms: Nausea, fatigue, headache, chest pain, certain foods taste a bit weird to me since Saturday night. Example grilled cheese sandwich, ice cream, ground beef

Release 5 — days 1–6 daily, dose 2

2021-03-16

Systemic reaction (other): Noticed a skin rash on my back

2021-03-18

Systemic reaction (other): Rash on back, red eyes

Release 7 — day 21, dose 2

2021-04-05

Symptoms: HeadacheNight sweats

Release 7 — day 28, dose 2

2021-04-13

Symptoms: headachechest pain

Release 8 — day 42, dose 2

2021-04-27

Symptoms: sore throatsneezingdry cough

Release 11 — 12 months, dose 2

2022-03-15

Symptoms: irregular menstruation, unexplained pains, unexplained rashes, appetite changes- food aversions, unexplained gastrointestinal issues, infections

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	Appetite disorder	·	·	✓
SD	Chest pain	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dysgeusia	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Food aversion	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	✓	✓	✓
SD	Infection	·	·	✓
SD	Menstruation irregular	·	·	✓
SD	Nausea	✓	✓	✓
SD	Night sweats	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	·	·	✓
SD	Rash	·	·	✓
SD	Sneezing	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Ocular hyperaemia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Vision blurred	✓	✓	✓

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