UZ5-12156-02975

3 vaccinations 14 coded responses 27 check-ins 14 free-text entries 2 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 840 / UT
Registered: 2021-03-15

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

2021-03-15
Registered in v-safe
2021-03-15
Dose 1 — Moderna
2021-03-15
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Redness, Swelling · Headache

Free text: Felt a little dizzy for about an hour after the vaccine administration

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches

Adult check-in
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Dysphonia, Oropharyngeal pain, Secretion discharge — Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches

Free text: Sore throat, raspy voice, mild cough with some mucus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Oropharyngeal pain — Feeling: Good · Site: Pain, Redness, Swelling · Headache

Free text: Sore throat, mild cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness · None

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-22
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-05
Survey response — day 21, dose 1
MedDRA: Cough, Oropharyngeal pain — Feeling: Good

Free text: Sore throat and mild cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Dose 2 — Moderna
2021-04-12
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Dyspnoea, Nasal congestion, Oropharyngeal pain, Pyrexia — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Sore throat, fever, stuffy nose, cough, difficulty breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Nasal congestion, Oropharyngeal pain — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Stuffy nose, sore throat, cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Nasal congestion, Oropharyngeal pain — Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Cough, sore throat, stuffy nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Nasal congestion, Oropharyngeal pain — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Cough, stuffy nose, sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Nasal congestion, Oropharyngeal pain — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Sore throat, stuffy nose, dry cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — day 7, dose 2
MedDRA: Cough, Nasal congestion, Oropharyngeal pain, Productive cough — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Nasal congestion, cough, sore throat, phlegm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Nasal congestion, Oropharyngeal pain, Productive cough — Feeling: Fair · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Free text: Sore throat, cough, phlegm, nasal congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — day 14, dose 2
MedDRA: Cough — Feeling: Good

Free text: Persistent cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-12
Survey response — 3 months, dose 2
MedDRA: Inflammatory bowel disease — 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: IBD symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-12
Report sent to call center — 3 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

1 call case(s)
2021-07-20
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-11
Survey response — 6 months, dose 2
MedDRA: Abdominal pain upper, Blood cholesterol increased, Nasopharyngitis — 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: I had a really bad cold. High cholesterol. Severe stomach pain (possibly IBD/IBS)

MedDRA releases: 2024-11 · check-in free text available
2021-10-11
Report sent to call center — 6 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

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2021-10-13
Call 1 — Left Voicemail
2021-11-05
Dose 3 — Pfizer-BioNTech
Co-administered: Flu
2022-04-12
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-06
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Moderna
2	2021-04-12	Moderna
3	2021-11-05	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2021-07-12	Successful 2021-07-20	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-11	Unsuccessful

Free text

Release 5 — day 0, dose 1

2021-03-15

Systemic reaction (other): Felt a little dizzy for about an hour after the vaccine administration

Release 5 — days 1–6 daily, dose 1

2021-03-17

Systemic reaction (other): Sore throat, raspy voice, mild cough with some mucus

2021-03-18

Systemic reaction (other): Sore throat, mild cough

Release 6 — day 21, dose 1

2021-04-05

Symptoms: Sore throat and mild cough

Release 7 — days 1–6 daily, dose 2

2021-04-13

Systemic reaction (other): Sore throat, fever, stuffy nose, cough, difficulty breathing

2021-04-14

Systemic reaction (other): Stuffy nose, sore throat, cough

2021-04-15

Systemic reaction (other): Cough, sore throat, stuffy nose

2021-04-16

Systemic reaction (other): Cough, stuffy nose, sore throat

2021-04-17

Systemic reaction (other): Sore throat, stuffy nose, dry cough

Release 7 — day 7, dose 2

2021-04-19

Systemic reaction (other): Nasal congestion, cough, sore throat, phlegm

Release 7 — days 1–6 daily, dose 2

2021-04-19

Systemic reaction (other): Sore throat, cough, phlegm, nasal congestion

Release 8 — day 14, dose 2

2021-04-26

Symptoms: Persistent cough

Release 9 — 3 months, dose 2

2021-07-12

Symptoms: IBD symptoms

Release 10 — 6 months, dose 2

2021-10-11

Symptoms: I had a really bad cold. High cholesterol. Severe stomach pain (possibly IBD/IBS)

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	Abdominal pain upper	·	·	✓
SD	Blood cholesterol increased	·	·	✓
SD	Cough	✓	✓	✓
SD	Inflammatory bowel disease	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dysphonia	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Productive cough	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Secretion discharge	✓	✓	✓

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