YGV-18562-16377

2 vaccinations 11 coded responses 26 check-ins 11 free-text entries 5 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 076 / NJ
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 — day 0, dose 1
Feeling: Fair · Nausea

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness, Nausea

Adult check-in
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Peripheral coldness — Feeling: Poor · Site: Pain · Chills, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Extreme cold hands and feet.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
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)
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Palpitations — Feeling: Fair · Chills, Nausea · Be unable to work

Free text: Heart racing (may be anxiety)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Report sent to call center — days 1–6 daily, dose 1
Be unable to work

1 call case(s)
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Palpitations — Feeling: Fair · Chills, Nausea

Free text: Heart races

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate abnormal — Feeling: Fair · Site: Swelling · Fatigue or tiredness

Free text: Heart rate 170. HBP 142/90

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Office visit, Tachycardia — Feeling: Fair · Fatigue or tiredness · Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Tachycardia went to 196 bpm · Healthcare visit (other): Cardiologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-16
Survey response — day 7, dose 1
MedDRA: Tachycardia — Feeling: Fair · Fatigue or tiredness

Free text: Tachycardia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-31
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-06
Survey response — day 28, dose 1
MedDRA: Specialist consultation, Tachycardia — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Tachycardia, I am have reservations about second shot, please call me I have questions and am due Monday to get second dose. I have igg antibodies after first one. Dont know if I should get second one. · Healthcare visit (other): Pcp appointment

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-13
Health check-in — day 35, dose 1
Feeling: Fair

Adult check-in
2021-02-15
Dose 2 — Moderna
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspepsia, Flatulence — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Heartburn gas

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Heart rate decreased — Feeling: Fair · Site: Pain · Fever · Abdominal pain

Free text: Low heart rate

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-22
Health check-in — day 7, dose 2
Feeling: Fair · Abdominal pain

Adult check-in
2021-03-01
Survey response — day 14, dose 2
MedDRA: Dyspepsia, Flatulence — Feeling: Fair

Free text: Hearth burn/gas

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — day 21, dose 2
MedDRA: Dyspepsia, Flatulence, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Heart burn/ gas · Healthcare visit (other): Have an appt to see dr

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Call 1 — Left Voicemail
2021-03-15
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-22
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-29
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-16
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-28
Call 1 — Left Voicemail
2022-02-17
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-09	Moderna
2	2021-02-15	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-11	Unsuccessful
2021-01-12	Unsuccessful
2021-01-15	Unsuccessful
2021-02-06	Unsuccessful
2021-03-10	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-11

Systemic reaction (other): Extreme cold hands and feet.

2021-01-12

Systemic reaction (other): Heart racing (may be anxiety)

2021-01-13

Systemic reaction (other): Heart races

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): Heart rate 170. HBP 142/90

2021-01-15

Systemic reaction (other): Tachycardia went to 196 bpm

Healthcare visit (other): Cardiologist

Release 2 — day 7, dose 1

2021-01-16

Systemic reaction (other): Tachycardia

Release 3 — day 28, dose 1

2021-02-06

Symptoms: Tachycardia, I am have reservations about second shot, please call me I have questions and am due Monday to get second dose. I have igg antibodies after first one. Dont know if I should get second one.

Healthcare visit (other): Pcp appointment

Release 4 — days 1–6 daily, dose 2

2021-02-17

Systemic reaction (other): Heartburn gas

2021-02-18

Systemic reaction (other): Low heart rate

Release 4 — day 14, dose 2

2021-03-01

Symptoms: Hearth burn/gas

Release 5 — day 21, dose 2

2021-03-10

Symptoms: Heart burn/ gas

Healthcare visit (other): Have an appt to see dr

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
HCVO	Office visit	✓	✓	✓
HCVO	Specialist consultation	✓	✓	✓
SD	Dyspepsia	✓	✓	✓
SD	Flatulence	✓	✓	✓
SD	Tachycardia	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Heart rate abnormal	✓	✓	✓
SRO	Heart rate decreased	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Peripheral coldness	✓	✓	✓
SRO	Tachycardia	✓	✓	✓

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