6T8-65263-11929

3 vaccinations 11 coded responses 30 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 31-35
ZIP prefix: 128 / NY
Registered: 2021-09-21

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

2021-09-20
Dose 1 — Moderna
2021-09-21
Registered in v-safe
2021-09-21
Survey response — days 1–6 daily, dose 1
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Loss of appetite

MedDRA releases: 2024-11 · check-in free text available
2021-09-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-09-23
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia, Oropharyngeal pain — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Sore throat, metallic taste

MedDRA releases: 2024-11 · check-in free text available
2021-09-24
Survey response — days 1–6 daily, dose 1
MedDRA: Dysgeusia — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Metallic taste in mouth

MedDRA releases: 2024-11 · check-in free text available
2021-09-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-09-26
Survey response — days 1–6 daily, dose 1
MedDRA: Blepharospasm — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Twitchy eyelid

MedDRA releases: 2024-11 · check-in free text available
2021-09-27
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-10-05
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-10-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-10-18
Dose 2 — Moderna
2021-10-18
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-10-18
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-10-19
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-10-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-22
Survey response — days 1–6 daily, dose 2
MedDRA: Sinus congestion — Feeling: Fair · Site: Pain · Fever · Headache

Free text: Sinus congestion

MedDRA releases: 2024-11 · check-in free text available
2021-10-23
Survey response — days 1–6 daily, dose 2
MedDRA: Ear infection, Sinusitis — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness, Diarrhea

Free text: Sinus infection, ear infection

MedDRA releases: 2024-11 · check-in free text available
2021-10-24
Survey response — days 1–6 daily, dose 2
MedDRA: Sinusitis — Feeling: Fair · Fatigue or tiredness

Free text: Sinus infection

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Survey response — day 7, dose 2
MedDRA: Sinusitis — Feeling: Fair · Fatigue or tiredness

Free text: Sinus infection

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-11-08
Survey response — day 21, dose 2
MedDRA: Headache, Paranasal sinus discomfort, Sinus pain, Upper-airway cough syndrome — Feeling: Fair · Be unable to do your normal daily activities

Free text: Post nasal drip, headache, sinus pressure/pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2022-01-17
Survey response — 3 months, dose 2
MedDRA: SARS-CoV-2 test positive — Feeling: Fair · Be unable to work or attend school

Free text: Tested positive for COVID

MedDRA releases: 2024-11 · check-in free text available
2022-04-19
Survey response — 6 months, dose 2
MedDRA: COVID-19, Heart rate increased, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Needed to see cardiologist for fast heart rate right before having COVID

MedDRA releases: 2024-11 · check-in free text available
2022-04-19
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-20
Call 1 — Left Voicemail
2022-05-11
Dose 3 — Moderna
2022-05-12
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-13
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-14
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-16
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Headache, Joint pains, Fatigue or tiredness, Abdominal pain

Adult check-in
2022-05-17
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-18
Health check-in — day 7, dose 3
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-28
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-20	Moderna	No
2	2021-10-18	Moderna	No
3	2022-05-11	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-04-19	Unsuccessful

Free text

Release 9 — days 1–6 daily, dose 1

2021-09-21

Systemic reaction (other): Loss of appetite

2021-09-23

Systemic reaction (other): Sore throat, metallic taste

2021-09-24

Systemic reaction (other): Metallic taste in mouth

2021-09-26

Systemic reaction (other): Twitchy eyelid

Release 10 — days 1–6 daily, dose 2

2021-10-22

Systemic reaction (other): Sinus congestion

2021-10-23

Systemic reaction (other): Sinus infection, ear infection

2021-10-24

Systemic reaction (other): Sinus infection

Release 10 — day 7, dose 2

2021-10-25

Systemic reaction (other): Sinus infection

Release 10 — day 21, dose 2

2021-11-08

Symptoms: Post nasal drip, headache, sinus pressure/pain

Release 10 — 3 months, dose 2

2022-01-17

Symptoms: Tested positive for COVID

Release 11 — 6 months, dose 2

2022-04-19

Symptoms: Needed to see cardiologist for fast heart rate right before having COVID

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	COVID-19	·	·	✓
SD	Headache	·	·	✓
SD	Heart rate increased	·	·	✓
SD	Office visit	·	·	✓
SD	Paranasal sinus discomfort	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sinus pain	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SRO	Blepharospasm	·	·	✓
SRO	Decreased appetite	·	·	✓
SRO	Dysgeusia	·	·	✓
SRO	Ear infection	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Sinus congestion	·	·	✓
SRO	Sinusitis	·	·	✓

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