SRM-16467-63248

4 vaccinations 10 coded responses 50 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 280 / NC
Registered: 2020-12-28

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

Registered dependents

T9M-88244-34750 Child or adolescent in my care · Female · 2021-11-23

GPN-18376-39663 Child or adolescent in my care · Female · 2022-07-11

Timeline

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

2020-12-28
Registered in v-safe
2020-12-28
Dose 1 — Moderna
2020-12-28
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Fever · Fatigue or tiredness

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Nausea

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

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

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-25
Dose 2 — Moderna
2021-01-25
Health check-in — day 0, dose 2
Feeling: Good · Headache

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-01-28
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Fair · Site: Pain, Redness, Itching · Fever · Abdominal pain

Free text: Have had insomnia every night since i got the 2nd dose (not normal for me).

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · Diarrhea

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-01
Health check-in — day 7, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-02-08
Survey response — day 14, dose 2
MedDRA: Diarrhoea — Feeling: Good

Free text: Diarrhea continued from vaccine, worse than initially but still not severe.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-23
Survey response — day 28, dose 2
MedDRA: Chills, Pyrexia, Vomiting — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Vomiting, low grade fever, chills.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-04-26
Survey response — 3 months, dose 2
MedDRA: Chest pain, Dizziness, Fatigue, Pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Body aches, fatigue, dizziness, chest discomfort.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-26
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-25
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain, Itching · None

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-11-01
Health check-in — day 7, dose 3
Feeling: Good · Headache

Adult check-in
2021-11-08
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-15
Survey response — day 21, dose 3
MedDRA: Headache, Nausea, Oropharyngeal pain, Respiratory tract congestion — Feeling: Fair

Free text: Sore throat, nausea, congestion, headaches.

MedDRA releases: 2024-11 · check-in free text available
2021-12-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Survey response — day 42, dose 3
MedDRA: Chest pain, Constipation, Fatigue, Headache, Oropharyngeal pain, Pain, Pyrexia, Sinusitis, Upper-airway cough syndrome — Feeling: Fair · 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: Sinus infection; constipation; sore throat, body aches, chest pain, headache, feeling feverish, fatigue, postnasal drip.

MedDRA releases: 2024-11 · check-in free text available
2021-12-06
Report sent to call center — day 42, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-08
Call 1 — Left Voicemail
2022-01-25
Survey response — 3 months, dose 3
MedDRA: COVID-19, Influenza — 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 · Emergency room or emergency department visit

Free text: Flu A, COVID-19

MedDRA releases: 2024-11 · check-in free text available
2022-01-25
Report sent to call center — 3 months, 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

Emergency room or emergency department visit · 1 call case(s)
2022-01-26
Call successful
Participant prefers to complete VAERS report online
2022-04-25
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-09-26
Dose 4 — Pfizer-BioNTech
2022-09-26
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2022-09-27
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2022-10-03
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-10-10
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-10-17
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-10-25
Survey response — day 28, dose 4
MedDRA: Cough — Feeling: Good

Free text: Dry cough at night (unrelated to c19 vaccine)

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-11-07
Survey response — day 42, dose 4
MedDRA: Nausea, Sinusitis, Upper respiratory tract infection — Feeling: Good · Be unable to do your normal daily activities

Free text: Upper respiratory infection/sinusitis, nausea. Unrelated to c19 vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-12-27
Survey response — 3 months, dose 4
MedDRA: Abortion spontaneous, Sinusitis — Feeling: Good · 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: Miscarriage, sinus infection

MedDRA releases: 2024-11 · check-in free text available
2022-12-27
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-12-29
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-29
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-28	Moderna
2	2021-01-25	Moderna
3	2021-10-25	Moderna	No
4	2022-09-26	Pfizer-BioNTech	No

Call center

Reported	Outcome	VAERS-related outcome
2021-12-06	Successful	Participant prefers to complete VAERS report online
2022-01-25	Successful 2022-01-26	Participant prefers to complete VAERS report online
2022-12-27	Successful 2022-12-29	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 2 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): Have had insomnia every night since i got the 2nd dose (not normal for me).

Release 3 — day 14, dose 2

2021-02-08

Symptoms: Diarrhea continued from vaccine, worse than initially but still not severe.

Release 4 — day 28, dose 2

2021-02-23

Symptoms: Vomiting, low grade fever, chills.

Release 8 — 3 months, dose 2

2021-04-26

Symptoms: Body aches, fatigue, dizziness, chest discomfort.

Release 10 — day 21, dose 3

2021-11-15

Symptoms: Sore throat, nausea, congestion, headaches.

Release 10 — day 42, dose 3

2021-12-06

Symptoms: Sinus infection; constipation; sore throat, body aches, chest pain, headache, feeling feverish, fatigue, postnasal drip.

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Flu A, COVID-19

Release 12 — day 28, dose 4

2022-10-25

Symptoms: Dry cough at night (unrelated to c19 vaccine)

Release 12 — day 42, dose 4

2022-11-07

Symptoms: Upper respiratory infection/sinusitis, nausea. Unrelated to c19 vaccine

Release 12 — 3 months, dose 4

2022-12-27

Symptoms: Miscarriage, sinus infection

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	Abortion spontaneous	·	·	✓
SD	Chest pain	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Constipation	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	·	·	✓
SD	Influenza	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinusitis	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Upper-airway cough syndrome	·	·	✓
SD	Vomiting	✓	✓	✓
SRO	Insomnia	✓	✓	✓

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