R7P-31000-75572

3 vaccinations 5 coded responses 34 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 837 / ID
Registered: 2021-01-19

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

2021-01-19
Registered in v-safe
2021-01-19
Dose 1 — Moderna
2021-01-19
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Axillary pain — Feeling: Good

Free text: Armpit pain on the same side as injection. Lymph?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-15
Dose 2 — Moderna
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-08
Survey response — day 21, dose 2
MedDRA: Gastrooesophageal reflux disease, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Have had new onset GERD symptoms which I havent experienced before. Its been consistent for 2.5 weeks and 5 days after second shot. Just documenting here for more info just in case. · Healthcare visit (other): Made GI appointment.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-29
Survey response — day 42, dose 2
MedDRA: Gastrooesophageal reflux disease — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Chronic gerd

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-07
Dose 3 — Moderna
2021-11-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fatigue or tiredness

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

Adult check-in
2021-11-12
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-13
Survey response — days 1–6 daily, dose 3
MedDRA: Lymphadenopathy — Feeling: Good

Free text: Swollen armpit lymph nodes on side of injection

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-23
Survey response — day 14, dose 3
MedDRA: Pruritus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Full body itching

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
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)
2021-11-29
Call 1 — Left Voicemail
2021-11-29
Call successful
Does not wish to fill out VAERS report
2021-11-30
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-19
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-06
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-11-07
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-19	Moderna
2	2021-02-15	Moderna
3	2021-11-07	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-25

Systemic reaction (other): Armpit pain on the same side as injection. Lymph?

Release 5 — day 21, dose 2

2021-03-08

Symptoms: Have had new onset GERD symptoms which I havent experienced before. Its been consistent for 2.5 weeks and 5 days after second shot. Just documenting here for more info just in case.

Healthcare visit (other): Made GI appointment.

Release 6 — day 42, dose 2

2021-03-29

Symptoms: Chronic gerd

Release 10 — days 1–6 daily, dose 3

2021-11-13

Systemic reaction (other): Swollen armpit lymph nodes on side of injection

Release 10 — day 14, dose 3

2021-11-23

Symptoms: Full body itching

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	Unevaluable event	✓	✓	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Pruritus	·	·	✓
SRO	Axillary pain	✓	✓	✓
SRO	Lymphadenopathy	·	·	✓

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