7HG-31637-11925

4 vaccinations 10 coded responses 29 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 600 / IL
Registered: 2021-03-02

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

NG4-31689-44547 Child or adolescent in my care · Female · 2022-06-26

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-28
Dose 1 — Moderna
2021-03-02
Registered in v-safe
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Neck pain — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Neck ache and periodic dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — day 7, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-21
Survey response — day 21, dose 1
MedDRA: Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-03
Dose 2 — Moderna
2021-04-11
Survey response — day 7, dose 2
MedDRA: Swelling face, Tongue pruritus — Feeling: Fair · Diarrhea

Free text: Facial swelling and tongue itching

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — day 14, dose 2
MedDRA: Bronchitis, Fatigue, Nasopharyngitis — Feeling: Poor · 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: Bronchitis after a cold, extreme fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Report sent to call center — day 14, dose 2
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)
2021-04-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-01
Survey response — day 28, dose 2
MedDRA: Office visit, Tongue pruritus — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Extremely Itchy tongue · Healthcare visit (other): Asked at regularly scheduled dentist appointment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-08
Survey response — day 35, dose 2
MedDRA: Stomatitis — Feeling: Good

Free text: Mouth irritations

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-03
Survey response — 3 months, dose 2
MedDRA: Ear infection — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Ear infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-03
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-07
Call 1 — Could Not Reach Participant
2021-10-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-19
Dose 3 — Moderna
2022-04-05
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-06-26
Dose 4 — Moderna
2022-06-27
Survey response — days 1–6 daily, dose 4
MedDRA: Injection site induration, Injection site mass — Feeling: Good · Site: Pain, Swelling, Itching

Free text: Hard lump at injection site

MedDRA releases: 2024-11 · check-in free text available
2022-06-29
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2022-06-30
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-07-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-07-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-07-05
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-07-12
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-07-17
Survey response — day 21, dose 4
MedDRA: COVID-19, Nasal congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Stuffy nose, covid positive

MedDRA releases: 2024-11 · check-in free text available
2022-07-26
Survey response — day 28, dose 4
MedDRA: Nasal congestion, SARS-CoV-2 test positive — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Stuffy nose, tested positive for covid

MedDRA releases: 2024-11 · check-in free text available
2022-08-01
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-07
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-25
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-28	Moderna
2	2021-04-03	Moderna
3	2021-11-19	Moderna	No
4	2022-06-26	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-04-17	Unsuccessful
2021-05-01	Unsuccessful
2021-07-03	Unsuccessful

Free text

Release 4 — days 1–6 daily, dose 1

2021-03-02

Systemic reaction (other): Neck ache and periodic dizziness

Release 6 — day 21, dose 1

2021-03-21

Symptoms: Fatigue

Release 7 — day 7, dose 2

2021-04-11

Systemic reaction (other): Facial swelling and tongue itching

Release 7 — day 14, dose 2

2021-04-17

Symptoms: Bronchitis after a cold, extreme fatigue

Release 8 — day 28, dose 2

2021-05-01

Symptoms: Extremely Itchy tongue

Healthcare visit (other): Asked at regularly scheduled dentist appointment

Release 8 — day 35, dose 2

2021-05-08

Symptoms: Mouth irritations

Release 9 — 3 months, dose 2

2021-07-03

Symptoms: Ear infection

Release 12 — days 1–6 daily, dose 4

2022-06-27

Systemic reaction (other): Hard lump at injection site

Release 12 — day 21, dose 4

2022-07-17

Symptoms: Stuffy nose, covid positive

Release 12 — day 28, dose 4

2022-07-26

Symptoms: Stuffy nose, tested positive for 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
HCVO	Office visit	✓	✓	✓
SD	Bronchitis	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Ear infection	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Nasal congestion	·	·	✓
SD	Nasopharyngitis	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Stomatitis	✓	✓	✓
SD	Tongue pruritus	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Injection site induration	·	·	✓
SRO	Injection site mass	·	·	✓
SRO	Neck pain	✓	✓	✓
SRO	Swelling face	✓	✓	✓
SRO	Tongue pruritus	✓	✓	✓

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