22A-75162-71355

3 vaccinations 6 coded responses 25 check-ins 6 free-text entries 0 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 016 / MA
Registered: 2021-02-04

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-04
Registered in v-safe
2021-02-04
Dose 1 — Moderna
2021-02-04
Survey response — day 0, dose 1
MedDRA: Dizziness, Ear pain — Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Free text: It hurts a little, behind my ear. And, Im a little bit dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Nausea

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-04
Dose 2 — Moderna
2021-03-04
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Chills — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Severe prolonged chills.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-26
Survey response — day 21, dose 2
MedDRA: Dyspepsia, Gastrooesophageal reflux disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Significant heartburn and GERD. I have never had this before but now its almost every night. I realized it started after my first dose of the COVID vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Survey response — day 28, dose 2
MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Acid Reflux, that started after vaccination is still pretty bad. I never had this before and now I have had it for weeks.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 35, dose 2
MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Acid Reflux or GERD It seems to be a little better now. Hopefully it will just go away as suddenly as it began. I am concerned that it is because I had such a strong immune response to the second shot, and will resolve itself.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 42, dose 2
MedDRA: Gastrooesophageal reflux disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Still have acid reflux since being vaccinated, but it seems to be better that it was. At least its not constant anymore. I still cant sleep without being propped up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-08
Dose 3 — Moderna
2022-03-05
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-04	Moderna
2	2021-03-04	Moderna
3	2021-12-08	Moderna	No

Free text

Release 3 — day 0, dose 1

2021-02-04

Systemic reaction (other): It hurts a little, behind my ear. And, Im a little bit dizzy

Release 5 — days 1–6 daily, dose 2

2021-03-05

Systemic reaction (other): Severe prolonged chills.

Release 6 — day 21, dose 2

2021-03-26

Symptoms: Significant heartburn and GERD. I have never had this before but now its almost every night. I realized it started after my first dose of the COVID vaccine.

Release 6 — day 28, dose 2

2021-04-01

Symptoms: Acid Reflux, that started after vaccination is still pretty bad. I never had this before and now I have had it for weeks.

Release 7 — day 35, dose 2

2021-04-08

Symptoms: Acid Reflux or GERD It seems to be a little better now. Hopefully it will just go away as suddenly as it began. I am concerned that it is because I had such a strong immune response to the second shot, and will resolve itself.

Release 7 — day 42, dose 2

2021-04-15

Symptoms: Still have acid reflux since being vaccinated, but it seems to be better that it was. At least its not constant anymore. I still cant sleep without being propped up.

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	Dyspepsia	✓	✓	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Ear pain	✓	✓	✓

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