XZ5-42670-39941

2 vaccinations 12 coded responses 22 check-ins 12 free-text entries 7 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 953 / CA
Registered: 2021-01-09

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

2021-01-09
Registered in v-safe
2021-01-09
Dose 1 — Moderna
2021-01-09
Health check-in — 0 day, dose 1
Feeling: Good · None

Adult check-in
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Injection site pain — Feeling: Good

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

Adult check-in
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Laryngitis — Feeling: Fair · Fever · Chills, Fatigue or tiredness, Nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Oropharyngeal pain — Feeling: Poor · Chills, Nausea, Vomiting · Be unable to work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-13
Report sent to call center — days 1–6 daily, dose 1
Be unable to work

1 call case(s)
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Laryngitis, Oropharyngeal pain — Feeling: Poor · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to work, Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-14
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Laryngitis, Nausea, Oropharyngeal pain, SARS-CoV-2 test, Vomiting — Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
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)
2021-01-16
Survey response — 7 day, dose 1
MedDRA: Cough, Laryngitis — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-01-24
Health check-in — 14 day, dose 1
Feeling: Fair

Adult check-in
2021-01-30
Health check-in — 21 day, dose 1
Feeling: Good

Adult check-in
2021-02-06
Dose 2 — Moderna
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Nausea

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Itching · Headache

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Headache

Adult check-in
2021-02-13
Health check-in — 7 day, dose 2
Feeling: Poor · Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Survey response — 14 day, dose 2
MedDRA: Laryngitis, Oropharyngeal pain — Feeling: Poor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-02-27
Survey response — 21 day, dose 2
MedDRA: Arthralgia, Myalgia, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-06
Survey response — 28 day, dose 2
MedDRA: Arthralgia, Chills, Cough, Diarrhoea, Dyspnoea, Oropharyngeal pain, Pain, Pyrexia, SARS-CoV-2 test, Vomiting — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-06
Report sent to call center — 28 day, 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)
2021-03-09
Call successful
Reported to VAERS voluntarily prior to GDIT contact
2021-03-14
Health check-in — 35 day, dose 2
Feeling: Fair

Adult check-in
2021-03-21
Survey response — 42 day, dose 2
MedDRA: Fatigue, Nausea, Vomiting — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-03-21
Report sent to call center — 42 day, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-08
Survey response — 3 month, dose 2
MedDRA: Haematemesis, Unevaluable event — 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, Emergency room or emergency department visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in answers available
2021-05-08
Report sent to call center — 3 month, 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)
2021-06-17
Call successful
Participant prefers to complete VAERS report online
2021-08-10
Survey response — 6 month, dose 2
MedDRA: Gait inability, Guillain-Barre syndrome, Muscular weakness, Office visit, Pre-existing disease — 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 · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2021-09,2024-11 · check-in answers available
2021-08-10
Report sent to call center — 6 month, 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)
2021-08-19
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-09	Moderna
2	2021-02-06	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-13	Successful	Participant prefers to complete VAERS report online
2021-01-14	Successful	Reported to VAERS voluntarily prior to GDIT contact
2021-01-15	Successful 2021-03-09	Reported to VAERS voluntarily prior to GDIT contact
2021-03-06	Successful	Participant prefers to complete VAERS report online
2021-03-21	Successful 2021-06-17	Participant prefers to complete VAERS report online
2021-05-08	Successful	Participant prefers to complete VAERS report online
2021-08-10	Successful 2021-08-19	Participant prefers to complete VAERS report online

Free text

Release 1

Systemic reaction (other): Very mild site tenderness; less tenderness than any injection I've ever received including vaccines, flu shot, and all other injections. I did not even feel the stick from the needle.

Systemic reaction (other): Cough and laryngitis,

Systemic reaction (other): Cough and sore throat

Release 2

Systemic reaction (other): Cough, sore throat, and laryngitis.

Healthcare visit (other): COVID-19 test 1/14/21 and ask for Zofran RX 1/15/21 for the nausea and vomiting

Systemic reaction (other): Barking seal cough similar to child's whooping cough and mild laryngitis.

Release 4

Symptoms: Sore throat and laryngitis.

Symptoms: Muscle and joint ache worsening.

Release 5

Symptoms: Spre throat, cough, breathing peoblems, chills, body aches, joint pain, mild fever, vomiting, and diarrhea.

Healthcare visit (other): Covid test taken 3/5/21

Release 6

Symptoms: Vomiting and fatigue

Healthcare visit (other): Medicine for nausea

Release 8

Symptoms: Vomiting with blood

Healthcare visit (other): Urgent EGD

Release 9

Symptoms: Gian Beret syndrome and I'm unable to walk. I also cannot use my hands much and am I on medication for high blood pressure, high pulse, and underactive thyroid; all of which are conditions I did not have before covid or the vaccine.

Healthcare visit (other): Multiple appointments with multiple doctors

Free-text releases are not linked to a specific 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
HCVO	Nausea	✓	✓	✓
HCVO	Office visit	✓	·	✓
HCVO	SARS-CoV-2 test	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
HCVO	Vomiting	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Gait inability	✓	·	✓
SD	Guillain-Barre syndrome	✓	·	✓
SD	Haematemesis	✓	✓	✓
SD	Laryngitis	✓	✓	✓
SD	Muscular weakness	✓	·	✓
SD	Myalgia	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	✓	·	✓
SD	Pyrexia	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Laryngitis	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pertussis	○	○	○

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