23Q-57312-14116

4 vaccinations 11 coded responses 21 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 816 / CO
Registered: 2021-01-02

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

2020-12-22
Dose 1 — Moderna
2021-01-02
Registered in v-safe
2021-01-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-22
Dose 2 — Moderna
2021-01-23
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion, Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Nasal congestion, runny nose & congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — days 1–6 daily, dose 2
MedDRA: Nasal congestion, Rhinalgia — Feeling: Good

Free text: Nasal congestion, inside my nose has been painful

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — day 7, dose 2
MedDRA: Nasal congestion — Feeling: Good · Headache, Abdominal pain

Free text: Nasal congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-12
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-24
Survey response — 3 months, dose 2
MedDRA: Abdominal discomfort, Abdominal pain upper, Chills, Diarrhoea, Pain — Feeling: Good · Be unable to do your normal daily activities

Free text: I got food poisoning last night from a work lunch. Experienced extreme GI distress w/diarreha, stomach cramps, body chills, pain lasted hours until out of my system. This is most likely not assoc w/COVID.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-26
Survey response — 6 months, dose 2
MedDRA: Sinusitis — Feeling: Good

Free text: Sinus infection

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-24
Dose 3 — Moderna
2021-10-23
Survey response — day 28, dose 3
MedDRA: Chest pain, Dry skin, Headache, Nasal dryness, Sinus disorder, Skin fissures — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Had sinus issues, dry/cracked skin in/on my nose; some headaches in last two-three months; some occasional pain in chest area.

MedDRA releases: 2024-11 · check-in free text available
2021-10-23
Report sent to call center — day 28, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-10-26
Call successful
Not applicable - Accidental Reporting
2021-11-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-26
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-31
Survey response — 6 months, dose 3
MedDRA: Dizziness, Ear disorder, Sinus pain, Vertigo — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Ear issue, sinus pain caused dizziness, vertigo in past month.

MedDRA releases: 2024-11 · check-in free text available
2022-03-31
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-04
Call 1 — Could Not Reach Participant
2022-04-05
Call successful
Does not wish to fill out VAERS report
2022-05-06
Dose 4 — Moderna
2022-05-15
Survey response — day 7, dose 4
MedDRA: Axillary pain — Feeling: Good · Site: Pain

Free text: Soreness in Left armpit after injection Left arm

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Survey response — day 14, dose 4
MedDRA: Diarrhoea — Feeling: Good

Free text: Diarreha - however may be attributed to Jif peanut butter recall.

MedDRA releases: 2024-11 · check-in free text available
2022-05-30
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-05
Survey response — day 28, dose 4
MedDRA: Diarrhoea — Feeling: Fair

Free text: Diarreha only, not sure what has caused it.

MedDRA releases: 2024-11 · check-in free text available
2022-06-19
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-05
Survey response — 3 months, dose 4
MedDRA: Arthralgia, COVID-19, Dyspnoea, Headache, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I contracted COVID from a relative at a family event in July. Tested positive on 20July2022 with moderate to severe symptoms. Acute sore throat, fever, headache, chest condestion, runny nose, joint pain, shortness of breath.

MedDRA releases: 2024-11 · check-in free text available
2022-08-05
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-08-08
Call 1 — Left Voicemail
2022-08-08
Call 2 — Left Voicemail
2022-08-08
Call 1 — Left Voicemail
2022-08-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-22	Moderna
2	2021-01-22	Moderna
3	2021-09-24	Moderna	No
4	2022-05-06	Moderna	No

Call center

3 call center cases

3 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 2

2021-01-23

Systemic reaction (other): Nasal congestion, runny nose & congestion

2021-01-26

Systemic reaction (other): Nasal congestion, inside my nose has been painful

Release 3 — day 7, dose 2

2021-01-30

Systemic reaction (other): Nasal congestion

Release 7 — 3 months, dose 2

2021-04-24

Symptoms: I got food poisoning last night from a work lunch. Experienced extreme GI distress w/diarreha, stomach cramps, body chills, pain lasted hours until out of my system. This is most likely not assoc w/COVID.

Release 9 — 6 months, dose 2

2021-07-26

Symptoms: Sinus infection

Release 10 — day 28, dose 3

2021-10-23

Symptoms: Had sinus issues, dry/cracked skin in/on my nose; some headaches in last two-three months; some occasional pain in chest area.

Release 11 — 6 months, dose 3

2022-03-31

Symptoms: Ear issue, sinus pain caused dizziness, vertigo in past month.

Release 11 — day 7, dose 4

2022-05-15

Systemic reaction (other): Soreness in Left armpit after injection Left arm

Release 11 — day 14, dose 4

2022-05-21

Symptoms: Diarreha - however may be attributed to Jif peanut butter recall.

Release 11 — day 28, dose 4

2022-06-05

Symptoms: Diarreha only, not sure what has caused it.

Release 12 — 3 months, dose 4

2022-08-05

Symptoms: I contracted COVID from a relative at a family event in July. Tested positive on 20July2022 with moderate to severe symptoms. Acute sore throat, fever, headache, chest condestion, runny nose, joint pain, shortness of breath.

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 discomfort	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Chest pain	·	·	✓
SD	Chills	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Dry skin	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Ear disorder	·	·	✓
SD	Headache	·	·	✓
SD	Nasal dryness	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sinus disorder	·	·	✓
SD	Sinus pain	·	·	✓
SD	Sinusitis	✓	·	✓
SD	Skin fissures	·	·	✓
SD	Vertigo	·	·	✓
SRO	Axillary pain	·	·	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Rhinalgia	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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