YR6-15483-94226

3 vaccinations 8 coded responses 33 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 935 / CA
Registered: 2021-05-04

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

2021-04-20
Dose 1 — Moderna
2021-05-04
Registered in v-safe
2021-05-04
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-13
Survey response — day 21, dose 1
MedDRA: Abdominal pain upper, Acupuncture — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Upper left side of abdomen (spleen area) became painful again after physical activity. Resolved after 48 hours and acupuncture treatment. · Healthcare visit (other): Acupuncture

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-21
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-05-25
Dose 2 — Moderna
2021-05-25
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Lightheaded

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain, Abdominal pain upper — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Abdominal pain not GI related. Localized on left side mid-rib cage in area of spleen

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain — Feeling: Good · Site: Pain, Swelling · Headache, Muscle or body aches, Abdominal pain

Free text: Abdominal pain remains localized in upper left side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-05-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-05-30
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain — Feeling: Good · Abdominal pain

Free text: Abdominal pain localized upper left side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-06-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-11-25
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-28
Dose 3 — Moderna
2022-01-28
Survey response — day 0, dose 3
MedDRA: Brain fog, Dizziness, Feeling abnormal — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Spacey, lightheaded, brain fog

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2022-01-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-01-31
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal pain upper, Musculoskeletal chest pain, Skin tightness — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Pain and tightness under lower left rib cage in area of spleen

MedDRA releases: 2024-11 · check-in free text available
2022-02-01
Survey response — days 1–6 daily, dose 3
MedDRA: Abdominal discomfort — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Tightness and pulling sensation on left side around spleen area

MedDRA releases: 2024-11 · check-in free text available
2022-02-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2022-02-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2022-02-04
Health check-in — day 7, dose 3
Feeling: Good · Muscle or body aches

Adult check-in
2022-02-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-03-04
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-03-13
Health check-in — day 42, dose 3
Feeling: Good

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

Adult check-in
2022-05-05
Call 1 — Left Voicemail
2022-07-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2023-02-03
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-20	Moderna
2	2021-05-25	Moderna
3	2022-01-28	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-05-13	Unsuccessful

Free text

Release 8 — day 21, dose 1

2021-05-13

Symptoms: Upper left side of abdomen (spleen area) became painful again after physical activity. Resolved after 48 hours and acupuncture treatment.

Healthcare visit (other): Acupuncture

Release 8 — day 0, dose 2

2021-05-25

Systemic reaction (other): Lightheaded

Release 8 — days 1–6 daily, dose 2

2021-05-26

Systemic reaction (other): Abdominal pain not GI related. Localized on left side mid-rib cage in area of spleen

2021-05-27

Systemic reaction (other): Abdominal pain remains localized in upper left side

2021-05-30

Systemic reaction (other): Abdominal pain localized upper left side

Release 11 — day 0, dose 3

2022-01-28

Systemic reaction (other): Spacey, lightheaded, brain fog

Release 11 — days 1–6 daily, dose 3

2022-01-31

Systemic reaction (other): Pain and tightness under lower left rib cage in area of spleen

2022-02-01

Systemic reaction (other): Tightness and pulling sensation on left side around spleen area

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	Acupuncture	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SRO	Abdominal discomfort	·	·	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Abdominal pain upper	✓	✓	✓
SRO	Brain fog	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Feeling abnormal	·	·	✓
SRO	Musculoskeletal chest pain	·	·	✓
SRO	Skin tightness	·	·	✓

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