ZDN-15352-51511

3 vaccinations 6 coded responses 27 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 21-25
ZIP prefix: 974 / OR
Registered: 2021-02-09

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

2021-02-09
Registered in v-safe
2021-02-09
Dose 1 — Moderna
2021-02-09
Health check-in — day 0, dose 1
Feeling: Good · Fever · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · None · Be unable to do your normal daily activities

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-12
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Light headedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Abdominal pain

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Survey response — day 21, dose 2
MedDRA: Ankylosing spondylitis, Back pain, Pre-existing disease, Rash — Feeling: Good

Free text: Have ankylosing spondylitis and am having a flare of rashes in hair and face and aches in my back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 28, dose 2
MedDRA: Gastrooesophageal reflux disease, Rash — Feeling: Fair

Free text: Severe acid reflux in stomach and rashes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-11
Survey response — 3 months, dose 2
MedDRA: Erythema, Nodule, Peripheral swelling — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Swelling or arms and redness. Knots in back and legs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-11
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-22
Call 1 — Left Voicemail
2021-09-10
Survey response — 6 months, dose 2
MedDRA: Abdominal pain, Alopecia, Butterfly rash, Dyspepsia, Rash — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, Hospitalization

Free text: Hair falling out, facial butterfly rash, extreme heartburn that doesnt go away with medical issued heartburn medication, and belly pains.

MedDRA releases: 2024-11 · check-in free text available
2021-09-10
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-16
Call 1 — Left Voicemail
2022-01-20
Dose 3 — Moderna
2022-02-14
Survey response — day 21, dose 3
MedDRA: Body temperature abnormal, Gastrointestinal disorder, Hyperhidrosis, Migraine, Night sweats, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Currently seeing my PCP for night-sweats, sweating during the day and inability to control my temperature that I've been having for the last 9 months. Along with horrible migraines and GI issues. I have a colonoscopy/upper endoscopy for the GI issue

MedDRA releases: 2024-11 · check-in free text available
2022-02-14
Report sent to call center — day 21, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-02-15
Call 1 — Left Voicemail
2022-02-17
Health check-in — day 28, dose 3
Feeling: Fair

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

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-09	Moderna
2	2021-03-12	Moderna
3	2022-01-20	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-06-11	Unsuccessful
2021-09-10	Unsuccessful
2022-02-14	Unsuccessful

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): Light headedness

Release 6 — day 21, dose 2

2021-04-02

Symptoms: Have ankylosing spondylitis and am having a flare of rashes in hair and face and aches in my back.

Release 7 — day 28, dose 2

2021-04-09

Symptoms: Severe acid reflux in stomach and rashes.

Release 9 — 3 months, dose 2

2021-06-11

Symptoms: Swelling or arms and redness. Knots in back and legs

Release 9 — 6 months, dose 2

2021-09-10

Symptoms: Hair falling out, facial butterfly rash, extreme heartburn that doesnt go away with medical issued heartburn medication, and belly pains.

Release 11 — day 21, dose 3

2022-02-14

Symptoms: Currently seeing my PCP for night-sweats, sweating during the day and inability to control my temperature that I've been having for the last 9 months. Along with horrible migraines and GI issues. I have a colonoscopy/upper endoscopy for the GI issue cut off by CDC

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	Abdominal pain	·	·	✓
SD	Alopecia	·	·	✓
SD	Ankylosing spondylitis	✓	✓	✓
SD	Back pain	✓	✓	✓
SD	Body temperature abnormal	·	·	✓
SD	Butterfly rash	·	·	✓
SD	Dyspepsia	·	·	✓
SD	Erythema	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Hyperhidrosis	·	·	✓
SD	Migraine	·	·	✓
SD	Night sweats	·	·	✓
SD	Nodule	✓	✓	✓
SD	Office visit	·	·	✓
SD	Peripheral swelling	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	✓	✓	✓
SRO	Dizziness	✓	✓	✓

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