7EQ-21067-75143

4 vaccinations 6 coded responses 29 check-ins 6 free-text entries 4 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 079 / NJ
Registered: 2021-01-09

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

2021-01-09
Registered in v-safe
2021-01-09
Dose 1 — Moderna
2021-01-09
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Fatigue or tiredness

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Diarrhea

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — day 7, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-01-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-30
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-06
Dose 2 — Moderna
2021-02-06
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspepsia — Feeling: Poor · Site: Pain · Fever · Fatigue or tiredness · Be unable to work

Free text: I had severe heart burn last night

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-13
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-12-16
Dose 3 — Moderna
2022-02-08
Survey response — 12 months, dose 2
MedDRA: COVID-19, Gallbladder disorder — 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, Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Gabladder issue and I had covid

MedDRA releases: 2024-11 · check-in free text available
2022-02-08
Report sent to call center — 12 months, dose 2
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 · Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-02-10
Call successful
Does not wish to fill out VAERS report
2022-10-25
Dose 4 — Moderna
2022-10-25
Survey response — day 0, dose 4
MedDRA: Dyspepsia — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Horrible heartburn

MedDRA releases: 2024-11 · check-in free text available
2022-10-25
Report sent to call center — day 0, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-26
Survey response — days 1–6 daily, dose 4
MedDRA: Dyspepsia — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Heartburn

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Report sent to call center — days 1–6 daily, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-10-26
Call successful
Participant prefers to complete VAERS report online
2022-10-27
Survey response — days 1–6 daily, dose 4
MedDRA: Headache, Office visit — Feeling: Poor · Site: Redness, Swelling · Fever · Headache, Fatigue or tiredness · Be unable to work or attend school, Get care from a doctor or other healthcare professional

Free text: Doctor visit for headache

MedDRA releases: 2024-11 · check-in free text available
2022-10-27
Report sent to call center — days 1–6 daily, dose 4
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-27
Call successful
Participant prefers to complete VAERS report online
2022-10-28
Call successful
Participant prefers to complete VAERS report online
2022-11-17
Survey response — day 21, dose 4
MedDRA: Malaise, SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend school

Free text: I tested positive for covid and have syptoms

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-09	Moderna
2	2021-02-06	Moderna
3	2021-12-16	Moderna	No
4	2022-10-25	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-02-08	Successful 2022-02-10	Does not wish to fill out VAERS report
2022-10-25	Successful 2022-10-26	Participant prefers to complete VAERS report online
2022-10-26	Successful 2022-10-27	Participant prefers to complete VAERS report online
2022-10-27	Successful 2022-10-28	Participant prefers to complete VAERS report online

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-08

Systemic reaction (other): I had severe heart burn last night

Release 11 — 12 months, dose 2

2022-02-08

Symptoms: Gabladder issue and I had covid

Release 12 — day 0, dose 4

2022-10-25

Systemic reaction (other): Horrible heartburn

Release 12 — days 1–6 daily, dose 4

2022-10-26

Systemic reaction (other): Heartburn

2022-10-27

Healthcare visit (other): Doctor visit for headache

Release 12 — day 21, dose 4

2022-11-17

Symptoms: I tested positive for covid and have syptoms

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	Headache	·	·	✓
HCVO	Office visit	·	·	✓
SD	COVID-19	·	·	✓
SD	Gallbladder disorder	·	·	✓
SD	Malaise	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SRO	Dyspepsia	✓	✓	✓

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