22X-33257-18354

3 vaccinations 6 coded responses 36 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 761 / TX
Registered: 2021-01-06

Relationship: Self
Race: Multiracial
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-06
Registered in v-safe
2021-01-06
Dose 1 — Moderna
2021-01-06
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-15
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-01-20
Survey response — day 14, dose 1
MedDRA: Gastrooesophageal reflux disease, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Gerd issues acting up. Acid reflux. Dont think it is related, but unsure. · Healthcare visit (other): Just got checked out by my primary care during a regular physical.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-20
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-29
Survey response — day 21, dose 1
MedDRA: Gallbladder disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Not related to COVID vaccine. Gall bladder issues.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-03
Dose 2 — Moderna
2021-02-03
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Pain — Feeling: Good · Site: Pain · Abdominal pain

Free text: I am on antibiotics for a cut, so the pain could be from antibiotics.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 2
Feeling: Good

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

Adult check-in
2021-03-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-17
Survey response — day 42, dose 2
MedDRA: Abdominal discomfort, Gastrooesophageal reflux disease — Feeling: Good

Free text: Acid reflux/stomach upset. It does seems to occur/return more often after Covid shots.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Call 1 — Left Voicemail
2021-05-05
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-04
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-14
Dose 3 — Moderna
2021-12-14
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-18
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-12-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Abdominal pain

Adult check-in
2021-12-20
Survey response — days 1–6 daily, dose 3
MedDRA: Unevaluable event — Feeling: Good · Abdominal pain

Free text: Could be period or Gerd related.

MedDRA releases: 2024-11 · check-in free text available
2021-12-23
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness, Abdominal pain

Adult check-in
2021-12-28
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-04
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-13
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-20
Survey response — day 35, dose 3
MedDRA: Ear pain, Ear pruritus, Fatigue, Headache, Nausea, Oropharyngeal pain, Paranasal sinus discomfort, Tonsillar erythema, Tonsillar hypertrophy, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Not sure if I have a sinus infection or something else. Tonsils swollen and red. Sore throat. Sinus pressure. Headache. 1 day of Nausea. Fatigue. Ears itch and hurt. · Healthcare visit (other): Going today, to regular physician.

MedDRA releases: 2024-11 · check-in free text available
2022-01-20
Report sent to call center — day 35, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-21
Call successful
Does not wish to fill out VAERS report
2022-01-25
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-14
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-14
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-06	Moderna
2	2021-02-03	Moderna
3	2021-12-14	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-20

Symptoms: Gerd issues acting up. Acid reflux. Dont think it is related, but unsure.

Healthcare visit (other): Just got checked out by my primary care during a regular physical.

Release 3 — day 21, dose 1

2021-01-29

Symptoms: Not related to COVID vaccine. Gall bladder issues.

Release 3 — days 1–6 daily, dose 2

2021-02-08

Systemic reaction (other): I am on antibiotics for a cut, so the pain could be from antibiotics.

Release 5 — day 42, dose 2

2021-03-17

Symptoms: Acid reflux/stomach upset. It does seems to occur/return more often after Covid shots.

Release 10 — days 1–6 daily, dose 3

2021-12-20

Systemic reaction (other): Could be period or Gerd related.

Release 10 — day 35, dose 3

2022-01-20

Symptoms: Not sure if I have a sinus infection or something else. Tonsils swollen and red. Sore throat. Sinus pressure. Headache. 1 day of Nausea. Fatigue. Ears itch and hurt.

Healthcare visit (other): Going today, to regular physician.

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	Unevaluable event	·	·	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Ear pain	·	·	✓
SD	Ear pruritus	·	·	✓
SD	Fatigue	·	·	✓
SD	Gallbladder disorder	✓	✓	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Headache	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	Tonsillar erythema	·	·	✓
SD	Tonsillar hypertrophy	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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