ZQ9-23552-90300

4 vaccinations 7 coded responses 38 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 200 / DC
Registered: 2021-01-17

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

Timeline

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

2021-01-08
Dose 1 — Moderna
2021-01-17
Registered in v-safe
2021-01-17
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · None

Adult check-in
2021-01-22
Survey response — day 14, dose 1
MedDRA: Fatigue, Injection site pruritus, Injection site rash, Pyrexia — Feeling: Fair

Free text: Intermittent high temperature (~99.8-100.8 F), mild fatigue, vaccine injection site rash and itchiness that started about 1 week after initial vaccine. Rash has since improved.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-05
Dose 2 — Moderna
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Disturbance in attention — Feeling: Fair · Fatigue or tiredness

Free text: Unsure if related, but difficulty concentrating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-09
Survey response — 3 months, dose 2
MedDRA: Aphthous ulcer, Chest pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Intermittent chest pain, recurrent canker sores

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-06
Survey response — 6 months, dose 2
MedDRA: Chest pain — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Intermittent chest pain for 1-2 months (no abnormalities on echocardiogram) - mostly resolved

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-06
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-12
Call 1 — Left Voicemail
2022-01-08
Dose 3 — Moderna
2022-01-09
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-01-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache

Adult check-in
2022-01-11
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-13
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-14
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-01-15
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-01-22
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-29
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-05
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-02-12
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-02-19
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-04-09
Survey response — 3 months, dose 3
MedDRA: Menstruation irregular — Feeling: Good

Free text: Irregular period

MedDRA releases: 2024-11 · check-in free text available
2022-07-09
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-21
Dose 4 — Moderna
Co-administered: Flu
2022-10-03
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-05
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-12
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-27
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-02
Survey response — day 42, dose 4
MedDRA: Menstruation irregular — Feeling: Good

Free text: Irregular period

MedDRA releases: 2024-11 · check-in free text available
2022-12-21
Survey response — 3 months, dose 4
MedDRA: Chest pain — Feeling: Good

Free text: Intermittent chest pain

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna
3	2022-01-08	Moderna	No
4	2022-09-21	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-05-09	Unsuccessful
2021-08-06	Unsuccessful

Free text

Release 2 — day 14, dose 1

2021-01-22

Symptoms: Intermittent high temperature (~99.8-100.8 F), mild fatigue, vaccine injection site rash and itchiness that started about 1 week after initial vaccine. Rash has since improved.

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Unsure if related, but difficulty concentrating

Release 8 — 3 months, dose 2

2021-05-09

Symptoms: Intermittent chest pain, recurrent canker sores

Release 9 — 6 months, dose 2

2021-08-06

Symptoms: Intermittent chest pain for 1-2 months (no abnormalities on echocardiogram) - mostly resolved

Release 11 — 3 months, dose 3

2022-04-09

Symptoms: Irregular period

Release 12 — day 42, dose 4

2022-11-02

Symptoms: Irregular period

Release 12 — 3 months, dose 4

2022-12-21

Symptoms: Intermittent chest pain

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	Aphthous ulcer	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SD	Menstruation irregular	·	·	✓
SD	Pyrexia	✓	✓	✓
SRO	Disturbance in attention	✓	✓	✓

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