3HZ-25658-39356

4 vaccinations 6 coded responses 39 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 208 / MD
Registered: 2021-01-20

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

2021-01-20
Registered in v-safe
2021-01-20
Dose 1 — Moderna
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-17
Survey response — day 0, dose 2
MedDRA: Euphoric mood, Feeling abnormal — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Mildly dopey / out of it feeling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Doing better after 24hrs, but

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 7, dose 2
Feeling: Good · Joint pains

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

Adult check-in
2021-03-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-24
Survey response — day 35, dose 2
MedDRA: Pre-existing disease, Tinnitus — Feeling: Good

Free text: I have tinnitus. Its actually been going on and off for a few weeks after 2nd shot.. In the middle o day two of the second shot, it was very bad. Now its a mild tinnitus that comes & goes Im just letting you know, I am a licensed Audiologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Pfizer-BioNTech
2022-02-17
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-29
Dose 4 — Pfizer-BioNTech
2022-04-30
Survey response — days 1–6 daily, dose 4
MedDRA: Cardiac flutter — Feeling: Fair · 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: heart is fluttering - i do get that sometimes

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-05-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-05-04
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fever · Headache

Adult check-in
2022-05-06
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · Headache

Adult check-in
2022-05-13
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-10
Survey response — day 42, dose 4
MedDRA: SARS-CoV-2 test positive — Feeling: Fair · 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 19 - I tested positive with an antigen test on June 6, 2022.

MedDRA releases: 2024-11 · check-in free text available
2022-06-10
Report sent to call center — day 42, 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)
2022-06-14
Call 1 — Left Voicemail
2022-07-29
Survey response — 3 months, dose 4
MedDRA: Pruritus, Urticaria — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: unexplained hives for 4 days. bad itching symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-07-29
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-01
Call 1 — Left Voicemail
2022-08-01
Call successful
Participant prefers to complete VAERS report online
2022-08-01
Call successful
Participant prefers to complete VAERS report online
2022-10-28
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-29
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna
3	2021-10-29	Pfizer-BioNTech	No
4	2022-04-29	Pfizer-BioNTech	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 4 — day 0, dose 2

2021-02-17

Systemic reaction (other): Mildly dopey / out of it feeling

Release 4 — days 1–6 daily, dose 2

2021-02-18

Systemic reaction (other): Doing better after 24hrs, but

Release 6 — day 35, dose 2

2021-03-24

Symptoms: I have tinnitus. Its actually been going on and off for a few weeks after 2nd shot.. In the middle o day two of the second shot, it was very bad. Now its a mild tinnitus that comes & goes Im just letting you know, I am a licensed Audiologist

Release 11 — days 1–6 daily, dose 4

2022-04-30

Systemic reaction (other): heart is fluttering - i do get that sometimes

Release 12 — day 42, dose 4

2022-06-10

Symptoms: i contracted covid 19 - I tested positive with an antigen test on June 6, 2022.

Release 12 — 3 months, dose 4

2022-07-29

Symptoms: unexplained hives for 4 days. bad itching symptoms

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	Pre-existing disease	✓	✓	✓
SD	Pruritus	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Tinnitus	✓	✓	✓
SD	Urticaria	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Cardiac flutter	·	·	✓
SRO	Euphoric mood	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓

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