58C-33761-14260

3 vaccinations 9 coded responses 33 check-ins 9 free-text entries 5 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 920 / CA
Registered: 2020-12-28

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

2020-12-28
Registered in v-safe
2020-12-28
Dose 1 — Moderna
2020-12-28
Health check-in — day 0, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2020-12-29
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal distension — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Significant abdominal bloating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-29
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2020-12-30
Survey response — days 1–6 daily, dose 1
MedDRA: Body temperature decreased — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Free text: Low body temperature - down to 96, normal body temp is 97.7

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling cold — Feeling: Good · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Feel cold

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-31
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-01-04
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-13
Survey response — day 14, dose 1
MedDRA: Asthma, Fatigue, Heart rate increased, Pre-existing disease, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Be unable to work, 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: Congestion, runny nose, elevated heart rate, fatigue, asthma flare up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 14, dose 1
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-18
Dose 2 — Pfizer-BioNTech
2021-01-18
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-01-23
Call successful
Participant prefers to complete VAERS report online
2021-01-27
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-08
Survey response — day 21, dose 2
MedDRA: Chest discomfort — Feeling: Fair

Free text: Chest tightness-probably related to my asthma

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Survey response — day 28, dose 2
MedDRA: Abdominal symptom, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Abdominal symptoms - likely related to IBS and unrelated to the vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-19
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-05
Dose 3 — Pfizer-BioNTech
2021-10-05
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-10-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-10-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-10-09
Survey response — days 1–6 daily, dose 3
MedDRA: Rhinorrhoea — Feeling: Fair · Fatigue or tiredness

Free text: Runny nose

MedDRA releases: 2024-11 · check-in free text available
2021-10-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-10-12
Health check-in — day 7, dose 3
Feeling: Good · Joint pains

Adult check-in
2021-10-19
Survey response — day 14, dose 3
MedDRA: Headache — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Frequent headaches

MedDRA releases: 2024-11 · check-in free text available
2021-10-19
Report sent to call center — day 14, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-21
Call 1 — Could Not Reach Participant
2021-10-25
Call 2 — Could Not Reach Participant
2021-10-26
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-02
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-09
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-16
Health check-in — day 42, dose 3
Feeling: Good

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

Adult check-in
2022-04-05
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-05
Survey response — 12 months, dose 3
MedDRA: Nasopharyngitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Had a few colds

MedDRA releases: 2024-11 · check-in free text available
2022-10-05
Report sent to call center — 12 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-06
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	2020-12-28	Moderna
2	2021-01-18	Pfizer-BioNTech
3	2021-10-05	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2020-12-29	Successful	Participant prefers to complete VAERS report online
2020-12-31	Successful	Participant prefers to complete VAERS report online
2021-01-13	Successful 2021-01-23	Participant prefers to complete VAERS report online
2021-10-19	Successful 2022-10-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-05	Successful 2022-10-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 1 — days 1–6 daily, dose 1

2020-12-29

Systemic reaction (other): Significant abdominal bloating

2020-12-30

Systemic reaction (other): Low body temperature - down to 96, normal body temp is 97.7

2020-12-31

Systemic reaction (other): Feel cold

Release 1 — day 14, dose 1

2021-01-13

Symptoms: Congestion, runny nose, elevated heart rate, fatigue, asthma flare up

Release 3 — day 21, dose 2

2021-02-08

Symptoms: Chest tightness-probably related to my asthma

Release 4 — day 28, dose 2

2021-02-15

Symptoms: Abdominal symptoms - likely related to IBS and unrelated to the vaccine

Release 10 — days 1–6 daily, dose 3

2021-10-09

Systemic reaction (other): Runny nose

Release 10 — day 14, dose 3

2021-10-19

Symptoms: Frequent headaches

Release 12 — 12 months, dose 3

2022-10-05

Symptoms: Had a few colds

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 symptom	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Heart rate increased	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SRO	Abdominal distension	✓	✓	✓
SRO	Body temperature decreased	✓	✓	✓
SRO	Feeling cold	✓	✓	✓
SRO	Rhinorrhoea	·	·	✓

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