VM6-15795-00869

4 vaccinations 5 coded responses 40 check-ins 4 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 800 / CO
Registered: 2021-03-18

Relationship: Self
Race: White
Ethnicity: N/A

Timeline

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

2021-03-18
Registered in v-safe
2021-03-18
Dose 1 — Janssen/Johnson & Johnson
2021-03-18
Health check-in — day 0, dose 1
Feeling: Fair · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work

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

Adult check-in
2021-03-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-25
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-08
Survey response — day 21, single dose
MedDRA: Pyrexia — Feeling: Fair

Free text: Fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 28, single dose
MedDRA: Fatigue, Nausea — Feeling: Fair

Free text: Fatigue, nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Health check-in — day 35, single dose
Feeling: Good

Adult check-in
2021-05-01
Health check-in — day 42, single dose
Feeling: Good

Adult check-in
2021-06-17
Health check-in — 3 months, dose 1
Feeling: Good

Adult check-in
2021-09-16
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-10-28
Dose 2 — Moderna
Co-administered: Flu
2021-10-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-11-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-12-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2022-01-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-04-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-05-06
Dose 3 — Moderna
2022-05-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2022-05-08
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Nausea, Vomiting

Adult check-in
2022-05-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-05-10
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-05-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache

Adult check-in
2022-05-13
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2022-05-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-05-27
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-06-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-06-12
Survey response — day 35, dose 3
MedDRA: Dizziness, Vertigo — Feeling: Fair

Free text: Vertigo/dizziness

MedDRA releases: 2024-11 · check-in free text available
2022-06-17
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-08-07
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-11-11
Survey response — 6 months, dose 3
MedDRA: Adverse reaction, COVID-19 — 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 · Telehealth, virtual health, or email health consultation

Free text: Covid positive. Symptom began 09/30/2022

MedDRA releases: 2024-11 · check-in free text available
2022-11-11
Report sent to call center — 6 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

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-11-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-12-17
Dose 4 — Moderna
2023-03-18
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2023-06-17
Survey response — 6 months, dose 4
MedDRA: Vertigo — Feeling: Good

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Janssen/Johnson & Johnson
2	2021-10-28	Moderna	Flu
3	2022-05-06	Moderna	No
4	2022-12-17	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-11-11	Successful 2022-11-14	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 7 — day 21, single dose

2021-04-08

Symptoms: Fever

Release 7 — day 28, single dose

2021-04-15

Symptoms: Fatigue, nausea

Release 12 — day 35, dose 3

2022-06-12

Symptoms: Vertigo/dizziness

Release 12 — 6 months, dose 3

2022-11-11

Symptoms: Covid positive. Symptom began 09/30/2022

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	Adverse reaction	·	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Vertigo	·	·	✓

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