5H7-21869-21298

5 vaccinations 9 coded responses 28 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 273 / NC
Registered: 2021-11-17

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

2021-01-21
Dose 1 — Moderna
2021-02-17
Dose 2 — Moderna
2021-11-14
Dose 3 — Moderna
2021-11-17
Registered in v-safe
2021-11-17
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Chills, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-18
Survey response — days 1–6 daily, dose 3
MedDRA: Swelling face — Feeling: Good

Free text: Slight swelling of the right side of my face, around the nose/cheek/chin area

MedDRA releases: 2024-11 · check-in free text available
2021-11-19
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-21
Health check-in — day 7, dose 3
Feeling: Good · Abdominal pain

Adult check-in
2021-11-28
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-05
Survey response — day 21, dose 3
MedDRA: Cough — Feeling: Fair

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2021-12-12
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-19
Survey response — day 35, dose 3
MedDRA: Cough, Diarrhoea, Sneezing — Feeling: Fair

Free text: Cough, sneezing, diarrhea

MedDRA releases: 2024-11 · check-in free text available
2021-12-26
Survey response — day 42, dose 3
MedDRA: Cough, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative — 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: Cough, congestion, runny nose. COVID tested negative.

MedDRA releases: 2024-11 · check-in free text available
2021-12-26
Report sent to call center — day 42, dose 3
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)
2021-12-30
Call 1 — Left Voicemail
2021-12-30
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-02-13
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-15
Dose 4 — Moderna
2022-04-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-04-20
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Headache, Fatigue or tiredness

Adult check-in
2022-04-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-22
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-04-29
Survey response — day 14, dose 4
MedDRA: Headache — Feeling: Good

Free text: I've been having headaches quite often.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-13
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-20
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-15
Survey response — 3 months, dose 4
MedDRA: Dizziness, Feeling abnormal, Gastroenteritis, Gastrooesophageal reflux disease, Nausea, Office visit, Vomiting — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Past 4 days: vomiting, Nauseated, acid reflux, lightheaded, overall feeling poorly. Dr. thinks it's gastroenteritis.

MedDRA releases: 2024-11 · check-in free text available
2022-07-15
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-09
Dose 5 — Moderna
2022-09-19
Survey response — day 7, dose 5
MedDRA: Cough — Feeling: Fair

Free text: Cough

MedDRA releases: 2024-11 · check-in free text available
2022-09-23
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-09-30
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-07
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-14
Survey response — day 35, dose 5
MedDRA: Cough, Decreased appetite, Diarrhoea, Insomnia, Nausea — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: For a week, I experienced diarrhea, coughing, nausea, appetite loss, sleeplessness. I tested negative consistently.

MedDRA releases: 2024-11 · check-in free text available
2022-12-09
Survey response — 3 months, dose 5
MedDRA: 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 tested positive for COVID on 11/7/2022.

MedDRA releases: 2024-11 · check-in free text available
2022-12-09
Report sent to call center — 3 months, dose 5
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)
2022-12-13
Call successful
Participant prefers to complete VAERS report online
2023-03-10
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna	No
2	2021-02-17	Moderna	No
3	2021-11-14	Moderna	No
4	2022-04-15	Moderna	No
5	2022-09-09	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 10 — days 1–6 daily, dose 3

2021-11-18

Systemic reaction (other): Slight swelling of the right side of my face, around the nose/cheek/chin area

Release 10 — day 21, dose 3

2021-12-05

Symptoms: Cough

Release 10 — day 35, dose 3

2021-12-19

Symptoms: Cough, sneezing, diarrhea

Release 10 — day 42, dose 3

2021-12-26

Symptoms: Cough, congestion, runny nose. COVID tested negative.

Release 11 — day 14, dose 4

2022-04-29

Symptoms: I've been having headaches quite often.

Release 12 — 3 months, dose 4

2022-07-15

Symptoms: Past 4 days: vomiting, Nauseated, acid reflux, lightheaded, overall feeling poorly. Dr. thinks it's gastroenteritis.

Release 12 — day 7, dose 5

2022-09-19

Systemic reaction (other): Cough

Release 12 — day 35, dose 5

2022-10-14

Symptoms: For a week, I experienced diarrhea, coughing, nausea, appetite loss, sleeplessness. I tested negative consistently.

Release 12 — 3 months, dose 5

2022-12-09

Symptoms: I tested positive for COVID on 11/7/2022.

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	Cough	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Feeling abnormal	·	·	✓
SD	Gastroenteritis	·	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Headache	·	·	✓
SD	Insomnia	·	·	✓
SD	Nausea	·	·	✓
SD	Office visit	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sneezing	·	·	✓
SD	Vomiting	·	·	✓
SRO	Cough	·	·	✓
SRO	Swelling face	·	·	✓

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