YRQ-29429-07969

4 vaccinations 11 coded responses 50 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 085 / NJ
Registered: 2021-03-05

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

Registered dependents

HGN-79981-87508 Child or adolescent in my care · Female · 2021-11-24

Timeline

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

2021-03-04
Dose 1 — Moderna
2021-03-05
Registered in v-safe
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-03-11
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-18
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-25
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-01
Dose 2 — Moderna
2021-04-01
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · None

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Muscle or body aches, Fatigue or tiredness

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

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

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-08
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-15
Survey response — day 14, dose 2
MedDRA: Back pain, Diarrhoea, Fatigue, Headache — Feeling: Fair

Free text: Headaches, fatigue, backaches, loose stool.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-29
Survey response — day 28, dose 2
MedDRA: Gastrointestinal disorder — Feeling: Good · Be unable to do your normal daily activities

Free text: Bowel issues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-01
Survey response — 3 months, dose 2
MedDRA: Menstruation irregular — Feeling: Fair

Free text: Irregular period for three months.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-30
Survey response — 6 months, dose 2
MedDRA: Depression, Libido decreased, Menstruation irregular — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Depression, lower libido, inconsistent menstrual periods

MedDRA releases: 2024-11 · check-in free text available
2021-09-30
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-09
Dose 3 — Moderna
2021-12-09
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-10
Survey response — days 1–6 daily, dose 3
MedDRA: Pain, Pain in extremity — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Random sharp pains in arms, legs and torso

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Call 2 — Left Voicemail
2021-12-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-12-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-12-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Itching · Fatigue or tiredness

Adult check-in
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-12-16
Health check-in — day 7, dose 3
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-12-23
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-01-06
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-01-13
Survey response — day 35, dose 3
MedDRA: Chest discomfort, Cough, Fatigue, Headache, Nasopharyngitis, Respiratory tract congestion, Sneezing — Feeling: Fair

Free text: Cold symptoms including heaviness on the chest, sneezing, congestion, mild cough, headache and fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-10
Health check-in — 3 months, dose 3
Feeling: Poor

Adult check-in
2022-06-09
Survey response — 6 months, dose 3
MedDRA: Bowel movement irregularity, Brain fog, Cyst, Fatigue, Headache — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I need to get a colonoscopy tomorrow for issues with bowel movements. I've grown a cyst in my lip. I'm constantly fatigued, headachy and have brain fog often.

MedDRA releases: 2024-11 · check-in free text available
2022-06-09
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)
2022-06-10
Call 2 — Left Voicemail
2022-11-04
Dose 4 — Pfizer-BioNTech
Co-administered: Flu
2022-11-04
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · None

Adult check-in
2022-11-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness · Fatigue or tiredness

Adult check-in
2022-11-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness

Adult check-in
2022-11-07
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness

Adult check-in
2022-11-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Itching · Fatigue or tiredness

Adult check-in
2022-11-11
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-11-18
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-11-25
Survey response — day 21, dose 4
MedDRA: Cough, Oropharyngeal pain, Productive cough, Respiratory tract congestion, Sneezing — Feeling: Fair

Free text: Sore throat, congestion, phlegm, sneezing and coughing.

MedDRA releases: 2024-11 · check-in free text available
2022-12-02
Survey response — day 28, dose 4
MedDRA: Dizziness, Nasopharyngitis — Feeling: Poor

Free text: Had a cold that has now resulted in dizziness.

MedDRA releases: 2024-11 · check-in free text available
2022-12-11
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-12-16
Survey response — day 42, dose 4
MedDRA: Dizziness, Feeling abnormal — Feeling: Fair

Free text: Dizziness and fuzzy head

MedDRA releases: 2024-11 · check-in free text available
2023-02-03
Survey response — 3 months, dose 4
MedDRA: Breast pain, Pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-02-03
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-02-06
Call 1 — Left Voicemail
2023-02-06
Call 1 — Left Voicemail
2023-02-06
Call 1 — Left Voicemail
2023-05-07
Health check-in — 6 months, dose 4
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-01	Moderna
3	2021-12-09	Moderna	No
4	2022-11-04	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-09-30	Unsuccessful
2022-06-09	Unsuccessful
2023-02-03	Unsuccessful

Free text

Release 7 — day 14, dose 2

2021-04-15

Symptoms: Headaches, fatigue, backaches, loose stool.

Release 8 — day 28, dose 2

2021-04-29

Symptoms: Bowel issues.

Release 9 — 3 months, dose 2

2021-07-01

Symptoms: Irregular period for three months.

Release 9 — 6 months, dose 2

2021-09-30

Symptoms: Depression, lower libido, inconsistent menstrual periods

Release 10 — days 1–6 daily, dose 3

2021-12-10

Systemic reaction (other): Random sharp pains in arms, legs and torso

Release 10 — day 35, dose 3

2022-01-13

Symptoms: Cold symptoms including heaviness on the chest, sneezing, congestion, mild cough, headache and fatigue.

Release 12 — 6 months, dose 3

2022-06-09

Symptoms: I need to get a colonoscopy tomorrow for issues with bowel movements. I've grown a cyst in my lip. I'm constantly fatigued, headachy and have brain fog often.

Release 12 — day 21, dose 4

2022-11-25

Symptoms: Sore throat, congestion, phlegm, sneezing and coughing.

Release 12 — day 28, dose 4

2022-12-02

Symptoms: Had a cold that has now resulted in dizziness.

Release 12 — day 42, dose 4

2022-12-16

Symptoms: Dizziness and fuzzy head

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	Back pain	✓	✓	✓
SD	Bowel movement irregularity	·	·	✓
SD	Brain fog	·	·	✓
SD	Breast pain	·	·	✓
SD	Chest discomfort	·	·	✓
SD	Cough	·	·	✓
SD	Cyst	·	·	✓
SD	Depression	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	·	·	✓
SD	Gastrointestinal disorder	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Libido decreased	·	·	✓
SD	Menstruation irregular	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Productive cough	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sneezing	·	·	✓
SRO	Pain	·	·	✓
SRO	Pain in extremity	·	·	✓

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