Z4H-29208-32953

4 vaccinations 6 coded responses 55 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 923 / CA
Registered: 2021-01-26

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

Registered dependents

JFC-79410-72936 Child or adolescent in my care · Male · 2021-11-05

76A-17301-25724 Child or adolescent in my care · Female · 2021-11-05

Timeline

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

2021-01-26
Registered in v-safe
2021-01-26
Dose 1 — Moderna
2021-01-26
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: These symptoms happened after my check in yesterday. I woke up this morning completely fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-23
Dose 2 — Moderna
2021-02-23
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-24
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, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-09
Survey response — day 14, dose 2
MedDRA: Vaccination site pruritus, Vaccination site rash — Feeling: Good

Free text: I still feel itchy where the rash was around the vaccine site. Every once in a while it's so extreme I HAVE to itch immediately. Very strange. No rash remains.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-25
Survey response — 3 months, dose 2
MedDRA: Heavy menstrual bleeding, Menstruation irregular — Feeling: Good

Free text: I lost my period from Jan to now. I just got it back and it was very heavy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-19
Dose 3 — Moderna
2021-11-19
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-21
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain, Swelling · Be unable to do your normal daily activities

Free text: Swollen lymph node in left armpit

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-26
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-03
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-18
Survey response — 3 months, dose 3
MedDRA: Nasopharyngitis, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I had a bad cold (negative Covid test x 5)

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Survey response — 6 months, dose 3
MedDRA: Influenza — Feeling: Fair · 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

Free text: I have the flu

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Report sent to call center — 6 months, 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 · 1 call case(s)
2022-05-23
Call 1 — Could Not Reach Participant
2022-05-26
Call successful
Not applicable - Accidental Reporting
2022-09-20
Dose 4 — Moderna
2022-09-20
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2022-09-21
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Nausea, Diarrhea, Rash, not including the immediate area around the injection site

Adult check-in
2022-09-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2022-09-23
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-09-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-09-27
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-04
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-11
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-18
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-25
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-20
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-03-21
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Moderna
2	2021-02-23	Moderna
3	2021-11-19	Moderna	No
4	2022-09-20	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-05-20	Successful 2022-05-26	Not applicable - Accidental Reporting

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-28

Systemic reaction (other): These symptoms happened after my check in yesterday. I woke up this morning completely fine.

Release 5 — day 14, dose 2

2021-03-09

Symptoms: I still feel itchy where the rash was around the vaccine site. Every once in a while it's so extreme I HAVE to itch immediately. Very strange. No rash remains.

Release 8 — 3 months, dose 2

2021-05-25

Symptoms: I lost my period from Jan to now. I just got it back and it was very heavy.

Release 10 — days 1–6 daily, dose 3

2021-11-21

Systemic reaction (other): Swollen lymph node in left armpit

Release 11 — 3 months, dose 3

2022-02-18

Symptoms: I had a bad cold (negative Covid test x 5)

Release 11 — 6 months, dose 3

2022-05-20

Symptoms: I have the flu

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	Heavy menstrual bleeding	✓	✓	✓
SD	Influenza	·	·	✓
SD	Menstruation irregular	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Vaccination site pruritus	✓	✓	✓
SD	Vaccination site rash	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓

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