Z48-69889-20518

3 vaccinations 7 coded responses 32 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 36-40
ZIP prefix: 810 / CO
Registered: 2021-01-05

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-01-07
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain, Lymph node pain, Oropharyngeal pain — Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Free text: Some aching in the ear and throat/gland on the same side as my injection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-12
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Survey response — day 14, dose 1
MedDRA: Abdominal pain upper, Diarrhoea, Headache — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: I experienced stomach cramping, loose stools, and persistent headache beginning 1/13- these symptoms lessened over the course of several days and were completely gone by 1/17

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — day 21, dose 1
MedDRA: Ear pain, Lymph node pain — Feeling: Fair

Free text: Developed ear and glandular aching on the same side as injection- persisted from Friday 1/22-Sunday 1/24- moderate to severe pain at times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — day 28, dose 1
MedDRA: Arthralgia, Headache, Malaise — Feeling: Fair

Free text: I generally have been feeling mildly unwell- intermittent joint aches, persistent mild headache, and overall malaise

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Dose 2 — Moderna
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain, Lymph node pain — Feeling: Good · Abdominal pain

Free text: An aching feeling in my left ear/glands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — day 7, dose 2
Feeling: Fair · Headache

Adult check-in
2021-02-20
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-02-28
Survey response — day 21, dose 2
MedDRA: Fatigue, Headache, Infectious mononucleosis, Lymph node pain — Feeling: Fair · 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: Glandular aching, fatigue, headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-07
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Abdominal pain

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-05
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-22
Call 1 — Left Voicemail
2022-01-24
Survey response — 3 months, dose 3
MedDRA: Cough, Nasal congestion — Feeling: Good · Be unable to work or attend school

Free text: Had a period of nasal congestion and cough- 2 negative rapid and 1 negative PCR test while symptoms were present

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-24
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-06	Moderna
3	2021-10-22	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-28	Unsuccessful

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-07

Systemic reaction (other): Some aching in the ear and throat/gland on the same side as my injection

Release 2 — day 14, dose 1

2021-01-19

Symptoms: I experienced stomach cramping, loose stools, and persistent headache beginning 1/13- these symptoms lessened over the course of several days and were completely gone by 1/17

Release 2 — day 21, dose 1

2021-01-26

Symptoms: Developed ear and glandular aching on the same side as injection- persisted from Friday 1/22-Sunday 1/24- moderate to severe pain at times

Release 3 — day 28, dose 1

2021-02-02

Symptoms: I generally have been feeling mildly unwell- intermittent joint aches, persistent mild headache, and overall malaise

Release 4 — days 1–6 daily, dose 2

2021-02-11

Systemic reaction (other): An aching feeling in my left ear/glands

Release 4 — day 21, dose 2

2021-02-28

Symptoms: Glandular aching, fatigue, headache

Release 11 — 3 months, dose 3

2022-01-24

Symptoms: Had a period of nasal congestion and cough- 2 negative rapid and 1 negative PCR test while symptoms were present

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	Abdominal pain upper	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Cough	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Ear pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Infectious mononucleosis	○	✓	○
SD	Lymph node pain	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Nasal congestion	·	·	✓
SRO	Ear pain	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Neck pain	○	○	○
SRO	Oropharyngeal pain	✓	✓	✓

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