Z4E-75346-92274

2 vaccinations 11 coded responses 25 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 070 / NJ
Registered: 2021-01-08

Relationship: Self
Race: N/A
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-08
Registered in v-safe
2021-01-08
Dose 1 — Moderna
2021-01-08
Survey response — day 0, dose 1
MedDRA: Tremor — Feeling: Fair · Chills, Muscle or body aches, Fatigue or tiredness

Free text: Trembling, shakiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Palpitations, Respiratory tract congestion, Throat tightness, Tremor — Feeling: Fair · Site: Pain · Chills · Be unable to do your normal daily activities

Free text: Tightness in throat, slight chest congestion and now cough, shakiness and pounding heartbeat

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

1 call case(s)
2021-01-10
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal discomfort, Decreased appetite — Feeling: Good · Site: Pain · Nausea

Free text: Low appetite and minor stomach upset, but feel much better than yesterday over all

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain · Nausea

Free text: Transient lightheadedness.

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

Free text: Fast pulse, pounding heartbeat & insomnia

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: Abdominal discomfort, Flatulence, Frequent bowel movements — Feeling: Good

Free text: Mild lower GI discomfort, gas, frequent BMs

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-29
Survey response — day 21, dose 1
MedDRA: Cough, Sneezing — Feeling: Good

Free text: Transient cough, sneezing.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Dose 2 — Moderna
2021-02-05
Survey response — day 0, dose 2
MedDRA: Chills, Tremor — Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Shaky, teeth chattering

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms — Feeling: Fair · Site: Pain · Muscle or body aches · Be unable to work, Be unable to do your normal daily activities

Free text: Upper back muscle spasm, vaccination side

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Chills

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-19
Survey response — day 14, dose 2
MedDRA: Eczema — Feeling: Good

Free text: Reddish, eczematic rash in left armpit and groin area (same side as shots)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-07
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-06
Survey response — 6 months, dose 2
MedDRA: Cough, Pain, Respiratory tract congestion, Upper-airway cough syndrome — Feeling: Good · Be unable to do your normal daily activities

Free text: Painful post nasal drip, congestion, cough

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-02-06
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-05	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-01-09	priority 2/3
2021-01-12	priority 2/3

Free text

Release 1 — day 0, dose 1

2021-01-08

Systemic reaction (other): Trembling, shakiness

Release 1 — days 1–6 daily, dose 1

2021-01-09

Systemic reaction (other): Tightness in throat, slight chest congestion and now cough, shakiness and pounding heartbeat

2021-01-10

Systemic reaction (other): Low appetite and minor stomach upset, but feel much better than yesterday over all

2021-01-11

Systemic reaction (other): Transient lightheadedness.

2021-01-12

Systemic reaction (other): Fast pulse, pounding heartbeat & insomnia

2021-01-13

Systemic reaction (other): Mild lower GI discomfort, gas, frequent BMs

Release 3 — day 21, dose 1

2021-01-29

Symptoms: Transient cough, sneezing.

Release 3 — day 0, dose 2

2021-02-05

Systemic reaction (other): Shaky, teeth chattering

Release 3 — days 1–6 daily, dose 2

2021-02-07

Systemic reaction (other): Upper back muscle spasm, vaccination side

Release 4 — day 14, dose 2

2021-02-19

Symptoms: Reddish, eczematic rash in left armpit and groin area (same side as shots)

Release 9 — 6 months, dose 2

2021-08-06

Symptoms: Painful post nasal drip, congestion, cough

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	Eczema	✓	✓	✓
SD	Pain	✓	·	✓
SD	Respiratory tract congestion	✓	·	✓
SD	Sneezing	✓	✓	✓
SD	Upper-airway cough syndrome	✓	·	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Frequent bowel movements	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Throat tightness	✓	✓	✓
SRO	Tremor	✓	✓	✓
SRO	Upper respiratory tract congestion	○	○	○

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