Z82-13277-88805

3 vaccinations 10 coded responses 40 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 980 / WA
Registered: 2020-12-23

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

2020-12-23
Registered in v-safe
2020-12-23
Dose 1 — Moderna
2020-12-23
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2020-12-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Fatigue or tiredness

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2020-12-30
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Muscle or body aches · Be unable to work

Adult check-in
2020-12-30
Report sent to call center — day 7, dose 1
Be unable to work

1 call case(s)
2021-01-06
Survey response — day 14, dose 1
MedDRA: Injection site erythema, Injection site pruritus, Injection site swelling, Urticaria — Feeling: Good

Free text: Injection site developed a red raised welt about 3 inch diameter and became itchy. Resolved on its own after a couple days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-20
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-21
Dose 2 — Moderna
2021-01-21
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-22
Survey response — days 1–6 daily, dose 2
MedDRA: Photosensitivity reaction — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Photosensitivity

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-25
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Office visit, Urinary tract infection, Vertigo — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Systemic reaction (other): Mild Dizziness/vertigo, UTI · Healthcare visit (other): Urgent care visit for UTI

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-26
Survey response — days 1–6 daily, dose 2
MedDRA: Kidney infection — Feeling: Fair · Diarrhea · Be unable to work

Free text: On antibiotics for kidney infection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-11
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-22
Survey response — 3 months, dose 2
MedDRA: Vertigo — Feeling: Good

Free text: Small episodes of vertigo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Call successful
Participant prefers to complete VAERS report online
2021-07-22
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-16
Dose 3 — Moderna
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-11-18
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · Joint pains

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-23
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-07
Survey response — day 21, dose 3
MedDRA: Heavy menstrual bleeding, Intermenstrual bleeding, Polymenorrhoea — Feeling: Good

Free text: Spotting between periods (more often and heavier than normal)

MedDRA releases: 2024-11 · check-in free text available
2021-12-14
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-21
Survey response — day 35, dose 3
MedDRA: Heavy menstrual bleeding — Feeling: Good

Free text: Very heavy periods

MedDRA releases: 2024-11 · check-in free text available
2021-12-28
Survey response — day 42, dose 3
MedDRA: Heavy menstrual bleeding, Intermenstrual bleeding — Feeling: Good

Free text: Heavy periods, spotting

MedDRA releases: 2024-11 · check-in free text available
2022-02-15
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-17
Survey response — 6 months, dose 3
MedDRA: COVID-19, Cough, Fatigue — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Covid-19 infection, easily fatigued, lingering cough.

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Survey response — 12 months, dose 3
MedDRA: Alopecia, Brain fog, Dyspnoea exertional, Fatigue, Increased tendency to bruise, Post-acute COVID-19 syndrome — Feeling: Good · Be unable to do your normal daily activities

Free text: Long COVID: dyspnea with minimal exertion, easily fatigued, brain fog, easily bruised, hair loss

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-23	Moderna
2	2021-01-21	Moderna
3	2021-11-16	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2020-12-30	priority 2/3
2021-01-25	Successful 2021-05-27	Participant prefers to complete VAERS report online

Free text

Release 1 — day 14, dose 1

2021-01-06

Symptoms: Injection site developed a red raised welt about 3 inch diameter and became itchy. Resolved on its own after a couple days.

Release 2 — days 1–6 daily, dose 2

2021-01-22

Systemic reaction (other): Photosensitivity

2021-01-25

Systemic reaction (other): Mild Dizziness/vertigo, UTI

Healthcare visit (other): Urgent care visit for UTI

2021-01-26

Systemic reaction (other): On antibiotics for kidney infection.

Release 7 — 3 months, dose 2

2021-04-22

Symptoms: Small episodes of vertigo

Release 10 — day 21, dose 3

2021-12-07

Symptoms: Spotting between periods (more often and heavier than normal)

Release 10 — day 35, dose 3

2021-12-21

Symptoms: Very heavy periods

Release 10 — day 42, dose 3

2021-12-28

Symptoms: Heavy periods, spotting

Release 11 — 6 months, dose 3

2022-05-17

Symptoms: Covid-19 infection, easily fatigued, lingering cough.

Release 12 — 12 months, dose 3

2022-11-18

Symptoms: Long COVID: dyspnea with minimal exertion, easily fatigued, brain fog, easily bruised, hair loss

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	Office visit	✓	✓	✓
HCVO	Urinary tract infection	✓	✓	✓
SD	Alopecia	·	·	✓
SD	Brain fog	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Dyspnoea exertional	·	·	✓
SD	Fatigue	·	·	✓
SD	Heavy menstrual bleeding	·	·	✓
SD	Increased tendency to bruise	·	·	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site swelling	✓	✓	✓
SD	Intermenstrual bleeding	·	·	✓
SD	Polymenorrhoea	·	·	✓
SD	Post-acute COVID-19 syndrome	·	·	✓
SD	Urticaria	✓	✓	✓
SD	Vertigo	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Kidney infection	✓	✓	✓
SRO	Photosensitivity reaction	✓	✓	✓
SRO	Urinary tract infection	✓	✓	✓
SRO	Vertigo	✓	✓	✓

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