X77-15739-80732

2 vaccinations 5 coded responses 25 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 441 / OH
Registered: 2021-01-15

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

2021-01-15
Registered in v-safe
2021-01-15
Dose 1 — Moderna
2021-01-15
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Nausea, Diarrhea

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches

Adult check-in
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort — Feeling: Fair · Headache

Free text: Chest discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-24
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-11
Dose 2 — Moderna
2021-02-11
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — day 7, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Survey response — day 35, dose 2
MedDRA: Cough, Myalgia, Nausea, Oropharyngeal pain — Feeling: Poor · Be unable to work, 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: Chest pain, sore throat, cough, nausea and muscle aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-27
Survey response — day 42, dose 2
MedDRA: Diarrhoea, Nausea, Vomiting — Feeling: Good · Be unable to work

Free text: Nausea, vomiting and diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Survey response — 3 months, dose 2
MedDRA: Diarrhoea, Nausea, Pain, Vomiting — Feeling: Good · Be unable to work, 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: Nausea, vomiting, diarrhea, body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-13
Survey response — 12 months, dose 2
MedDRA: 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 · Emergency room or emergency department visit

Free text: Yes COVID

MedDRA releases: 2024-11 · check-in free text available
2022-02-13
Report sent to call center — 12 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

Emergency room or emergency department visit · 1 call case(s)
2022-02-16
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-11	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-03-18	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-05-15	Successful	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-02-13	Successful 2022-02-16	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-19

Systemic reaction (other): Chest discomfort

Release 5 — day 35, dose 2

2021-03-18

Symptoms: Chest pain, sore throat, cough, nausea and muscle aches

Release 6 — day 42, dose 2

2021-03-27

Symptoms: Nausea, vomiting and diarrhea

Release 8 — 3 months, dose 2

2021-05-15

Symptoms: Nausea, vomiting, diarrhea, body aches

Release 11 — 12 months, dose 2

2022-02-13

Symptoms: Yes COVID

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	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓

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