V2N-31386-17993

2 vaccinations 5 coded responses 22 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 301 / GA
Registered: 2021-06-10

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-06-10
Registered in v-safe
2021-06-10
Dose 1 — Moderna
2021-06-10
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2021-06-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-06-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-06-16
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Fever · Headache, Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-06-17
Health check-in — day 7, dose 1
Feeling: Poor · Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-06-24
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-07-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-07-08
Dose 2 — Moderna
2021-07-08
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache

Adult check-in
2021-07-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-07-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches

Adult check-in
2021-07-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-07-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-07-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Muscle or body aches

Adult check-in
2021-07-15
Health check-in — day 7, dose 2
Feeling: Fair · Headache

Adult check-in
2021-07-22
Survey response — day 14, dose 2
MedDRA: Lethargy, Musculoskeletal stiffness, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscle pain and stiffness. Lethargy.

MedDRA releases: 2024-11 · check-in free text available
2021-07-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-08-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-08-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-08-21
Survey response — day 42, dose 2
MedDRA: Headache — Feeling: Poor · Be unable to do your normal daily activities

Free text: Headache

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-08
Survey response — 3 months, dose 2
MedDRA: Cough, Dyspnoea, Nasal congestion, Respiratory tract congestion, Sneezing — 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

Free text: Chest and nasal congestion. Coughing and sneezing. Shortness of breath.

MedDRA releases: 2024-11 · check-in free text available
2021-10-08
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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-06
Call 1 — Left Voicemail
2022-01-06
Survey response — 6 months, dose 2
MedDRA: Bronchitis, COVID-19 pneumonia — Feeling: Poor · 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: Covid pneumonia and bronchitis

MedDRA releases: 2024-11 · check-in free text available
2022-01-06
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)
2022-01-07
Call 1 — Left Voicemail
2022-07-08
Survey response — 12 months, dose 2
MedDRA: Asthma, Bronchitis — 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, Outpatient clinic or urgent care clinic visit

Free text: Asthma and bronchitis issues ongoing

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Report sent to call center — 12 months, dose 2
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 · 1 call case(s)
2022-07-12
Call successful
Does not wish to fill out VAERS report
2022-07-12
Call successful
Does not wish to fill out VAERS report
2022-07-12
Call successful
Does not wish to fill out VAERS report

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-10	Moderna
2	2021-07-08	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-10-08	Successful 2022-07-12	Does not wish to fill out VAERS report
2022-01-06	Successful 2022-07-12	Does not wish to fill out VAERS report
2022-07-08	Successful 2022-07-12	Does not wish to fill out VAERS report

Free text

Release 9 — day 14, dose 2

2021-07-22

Symptoms: Muscle pain and stiffness. Lethargy.

Release 9 — day 42, dose 2

2021-08-21

Symptoms: Headache

Release 10 — 3 months, dose 2

2021-10-08

Symptoms: Chest and nasal congestion. Coughing and sneezing. Shortness of breath.

Release 10 — 6 months, dose 2

2022-01-06

Symptoms: Covid pneumonia and bronchitis

Release 12 — 12 months, dose 2

2022-07-08

Symptoms: Asthma and bronchitis issues ongoing

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	Asthma	·	·	✓
SD	Bronchitis	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19 pneumonia	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Headache	✓	·	✓
SD	Lethargy	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Myalgia	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sneezing	·	·	✓

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