2Y8-19559-10461

3 vaccinations 12 coded responses 30 check-ins 12 free-text entries 5 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 436 / OH
Registered: 2021-01-14

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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Moderna
2021-01-14
Survey response — day 0, dose 1
MedDRA: Dizziness, Muscular weakness — Feeling: Good · Site: Pain

Free text: Slightly light headed, hands were slightly clumsy but only for about 2hrs, okay now

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Survey response — day 7, dose 1
MedDRA: Dizziness — Feeling: Fair · Diarrhea

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — day 14, dose 1
MedDRA: Abdominal discomfort — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Upset stomach

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-04
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-18
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-04
Survey response — day 21, dose 2
MedDRA: Abdominal pain upper, Diarrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Stomach pain, diarhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-13
Survey response — 3 months, dose 2
MedDRA: Headache, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Headache for over one month · Healthcare visit (other): 2 Office visits

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-04
Call 1 — Left Voicemail
2021-06-21
Call successful
Participant prefers to complete VAERS report online
2021-08-14
Survey response — 6 months, dose 2
MedDRA: Cystitis interstitial — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Interstitial cystitis

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-14
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-18
Call 1 — Left Voicemail
2021-10-26
Dose 3 — Moderna
2021-10-26
Survey response — day 0, dose 3
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches

Free text: IC flare

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair

Free text: Interstitial cystitis flare

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Survey response — day 14, dose 3
MedDRA: Cough — Feeling: Fair

Free text: A persistent, deep cough without fever or achiness for the last four or five days.

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Survey response — day 21, dose 3
MedDRA: Condition aggravated, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Interstitial cystitis flare · Healthcare visit (other): Office visit

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-17
Call 1 — Left Voicemail
2021-11-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-09
Survey response — day 42, dose 3
MedDRA: Back pain, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Back pain · Healthcare visit (other): Office visit chiropractic

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-10
Call 1 — Left Voicemail
2022-01-25
Survey response — 3 months, dose 3
MedDRA: Abdominal discomfort, Gastrooesophageal reflux disease — Feeling: Fair

Free text: Stomach discomfort, reflux issues

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna
3	2021-10-26	Moderna	No

Call center

5 call center cases

2 successful · 3 unsuccessful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-14

Systemic reaction (other): Slightly light headed, hands were slightly clumsy but only for about 2hrs, okay now

Release 2 — day 7, dose 1

2021-01-23

Systemic reaction (other): Dizziness

Release 3 — day 14, dose 1

2021-01-30

Symptoms: Upset stomach

Release 5 — day 21, dose 2

2021-03-04

Symptoms: Stomach pain, diarhea

Release 8 — 3 months, dose 2

2021-05-13

Symptoms: Headache for over one month

Healthcare visit (other): 2 Office visits

Release 9 — 6 months, dose 2

2021-08-14

Symptoms: Interstitial cystitis

Release 10 — day 0, dose 3

2021-10-26

Systemic reaction (other): IC flare

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): Interstitial cystitis flare

Release 10 — day 14, dose 3

2021-11-09

Symptoms: A persistent, deep cough without fever or achiness for the last four or five days.

Release 10 — day 21, dose 3

2021-11-16

Symptoms: Interstitial cystitis flare

Healthcare visit (other): Office visit

Release 10 — day 42, dose 3

2021-12-09

Symptoms: Back pain

Healthcare visit (other): Office visit chiropractic

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Stomach discomfort, reflux issues

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	✓	✓	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Back pain	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Cough	·	·	✓
SD	Cystitis interstitial	✓	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Headache	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SRO	Condition aggravated	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓
SRO	Pre-existing disease	·	·	✓

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