Z4C-16058-33601

4 vaccinations 12 coded responses 24 check-ins 10 free-text entries 6 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 291 / SC
Registered: 2021-02-17

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

2021-02-10
Dose 1 — Moderna
2021-02-17
Registered in v-safe
2021-02-17
Survey response — day 7, dose 1
MedDRA: Lymphadenopathy — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Swollen cervical lymph nodes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — day 14, dose 1
MedDRA: Medical counselling, Sinusitis — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Sinus infection · Healthcare visit (other): Discussed with Primary care as to whether any symptoms related to vaccine but other than sore arm it was determined that I was getting sick about the time I received vaccine. Started Antibiotics

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-03
Survey response — day 21, dose 1
MedDRA: Diarrhoea, Vomiting — Feeling: Poor · Be unable to do your normal daily activities

Free text: Vomiting and diarrhea, temp 99

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Dose 2 — Moderna
2021-03-10
Survey response — day 0, dose 2
MedDRA: Cold sweat — Feeling: Good · Site: Pain

Free text: Clammy skin

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-12
Survey response — days 1–6 daily, dose 2
MedDRA: Cold sweat, Feeling abnormal — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Clammy skin, just not feeling good overall

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-16
Survey response — days 1–6 daily, dose 2
MedDRA: Cold sweat — Feeling: Fair · Fever · Headache

Free text: Clammy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 7, dose 2
MedDRA: Malaise — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Overall not feeling well

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-09
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-23
Call 3 — Could Not Reach Participant
2021-09-08
Survey response — 6 months, dose 2
MedDRA: Abdominal discomfort, Cough, Headache, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Little cough, upset stomach headaches · Healthcare visit (other): Primary care

MedDRA releases: 2024-11 · check-in free text available
2021-09-08
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-10
Call 3 — Could Not Reach Participant
2021-11-10
Dose 3 — Moderna
2022-03-10
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-10-26
Dose 4 — Moderna
2022-11-17
Survey response — day 21, dose 4
MedDRA: Influenza like illness, Influenza virus test negative, Office visit — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Flu like symptoms but negative test · Healthcare visit (other): Reg md

MedDRA releases: 2024-11 · check-in free text available
2022-11-17
Report sent to call center — day 21, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-18
Call 3 — Could Not Reach Participant
2022-11-23
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-30
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-07
Survey response — day 42, dose 4
MedDRA: Headache, Medical counselling, Nasal congestion — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Nasal congestion, headaches, this condition comes back as soon as ATB, and steroids are out of my system · Healthcare visit (other): Called MD

MedDRA releases: 2024-11 · check-in free text available
2022-12-07
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-12-08
Call X — Left Voicemail
2022-12-08
Call X — Left Voicemail
2022-12-08
Call X — Left Voicemail
2022-12-08
Call 3 — Left Voicemail
2023-01-25
Survey response — 3 months, dose 4
MedDRA: COVID-19, Chills, Headache, Nausea, Neck pain, Office visit, Pain, Viral infection — Feeling: Fair · Be unable to work or attend school, 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: 2024-11
2023-01-25
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-26
Call 1 — Left Voicemail
2023-01-26
Call 1 — Left Voicemail
2023-01-26
Call 1 — Left Voicemail
2023-01-26
Call 1 — Left Voicemail
2023-01-26
Call 1 — Left Voicemail
2023-04-26
Survey response — 6 months, dose 4
MedDRA: Emergency care, Malaise, Pain, Post-acute COVID-19 syndrome, Upper respiratory tract infection — Feeling: Fair · Be unable to work or attend school, 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: 2024-11
2023-04-26
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-27
Call 2 — Left Voicemail
2023-04-27
Call 2 — Left Voicemail
2023-04-27
Call 2 — Left Voicemail
2023-04-27
Call 2 — Left Voicemail
2023-04-27
Call 2 — Left Voicemail
2023-04-27
Call 1 — Left Voicemail
2023-04-27
Callback requested for

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-10	Moderna
2	2021-03-10	Moderna
3	2021-11-10	Moderna	No
4	2022-10-26	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-02-24	Unsuccessful
2021-09-08	Unsuccessful
2022-11-17	Unsuccessful
2022-12-07	Unsuccessful
2023-01-25	Unsuccessful
2023-04-26	Unsuccessful

Free text

Release 4 — day 7, dose 1

2021-02-17

Systemic reaction (other): Swollen cervical lymph nodes

Release 4 — day 14, dose 1

2021-02-24

Symptoms: Sinus infection

Healthcare visit (other): Discussed with Primary care as to whether any symptoms related to vaccine but other than sore arm it was determined that I was getting sick about the time I received vaccine. Started Antibiotics

Release 5 — day 21, dose 1

2021-03-03

Symptoms: Vomiting and diarrhea, temp 99

Release 5 — day 0, dose 2

2021-03-10

Systemic reaction (other): Clammy skin

Release 5 — days 1–6 daily, dose 2

2021-03-12

Systemic reaction (other): Clammy skin, just not feeling good overall

2021-03-16

Systemic reaction (other): Clammy

Release 5 — day 7, dose 2

2021-03-17

Systemic reaction (other): Overall not feeling well

Release 9 — 6 months, dose 2

2021-09-08

Symptoms: Little cough, upset stomach headaches

Healthcare visit (other): Primary care

Release 12 — day 21, dose 4

2022-11-17

Symptoms: Flu like symptoms but negative test

Healthcare visit (other): Reg md

Release 12 — day 42, dose 4

2022-12-07

Symptoms: Nasal congestion, headaches, this condition comes back as soon as ATB, and steroids are out of my system

Healthcare visit (other): Called MD

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	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
SD	Abdominal discomfort	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Emergency care	·	·	✓
SD	Headache	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Influenza virus test negative	·	·	✓
SD	Malaise	·	·	✓
SD	Nasal congestion	·	·	✓
SD	Nausea	·	·	✓
SD	Neck pain	·	·	✓
SD	Office visit	·	·	✓
SD	Pain	·	·	✓
SD	Post-acute COVID-19 syndrome	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Viral infection	·	·	✓
SD	Vomiting	✓	✓	✓
SRO	Cold sweat	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Malaise	✓	✓	✓

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