ZBF-22855-74056

5 vaccinations 6 coded responses 51 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 105 / NY
Registered: 2021-01-03

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

2021-01-03
Registered in v-safe
2021-01-03
Dose 1 — Moderna
2021-01-03
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-10
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-31
Dose 2 — Moderna
2021-01-31
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Dry cough

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-07
Health check-in — day 7, dose 2
Feeling: Good · None

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

Adult check-in
2021-02-21
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-28
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-08
Dose 3 — Moderna
Co-administered: Flu
2021-10-25
Survey response — day 14, dose 3
MedDRA: Chills, Diarrhoea, Dizziness, Fatigue, Headache, Hyperhidrosis, Temperature intolerance — Feeling: Good

Free text: Chills, headache, fatigue x about 40 hours, starting about 6 hours after vaccine #3. Then dizziness, feeling faint 4 days after the vaccine, sweaty, intolerant to heat & diarrhea x about 1.5 hours.

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-05
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-12
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-09
Survey response — 3 months, dose 3
MedDRA: Chills, Cough, Headache, Office visit, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Sore throat, runny nose, headache, cough, chills · Healthcare visit (other): Followup to urgent care with PCP

MedDRA releases: 2024-11 · check-in free text available
2022-01-09
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-08
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-05-15
Dose 4 — Moderna
Co-administered: Shingles
2022-05-18
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-19
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-21
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-22
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-29
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-05
Survey response — day 21, dose 4
MedDRA: Fatigue, Headache, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Headaxhe, fatigue, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-06-05
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-06
Call 1 — Requested Callback
2022-06-07
Call 2 — Left Voicemail
2022-06-07
Callback requested for
10:00AM ET
2022-06-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-19
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-26
Survey response — day 42, dose 4
MedDRA: Asthenia, Dizziness, Loss of consciousness, Nausea — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: I was in the heat for hours without drinking & felt dizzy, weak, faint, & nauseated. I did pass out for a second or two but I'm okay now.

MedDRA releases: 2024-11 · check-in free text available
2022-06-26
Report sent to call center — day 42, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-06-27
Call 1 — Left Voicemail
2022-06-27
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-08-14
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-07
Dose 5 — Moderna
Co-administered: Flu
2022-10-20
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-21
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-28
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-04
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-11
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-20
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-06
Survey response — 3 months, dose 5
MedDRA: Chalazion, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-01-06
Report sent to call center — 3 months, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2023-01-09
Call 1 — Left Voicemail
2023-04-07
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-03	Moderna
2	2021-01-31	Moderna
3	2021-10-08	Moderna	Flu
4	2022-05-15	Moderna	Shingles
5	2022-10-07	Moderna	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-01-09	Successful 2022-01-11	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-05	Successful 2022-06-07	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-26	Successful 2022-06-27	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-06	Unsuccessful

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-01

Systemic reaction (other): Dry cough

Release 10 — day 14, dose 3

2021-10-25

Symptoms: Chills, headache, fatigue x about 40 hours, starting about 6 hours after vaccine #3. Then dizziness, feeling faint 4 days after the vaccine, sweaty, intolerant to heat & diarrhea x about 1.5 hours.

Release 10 — 3 months, dose 3

2022-01-09

Symptoms: Sore throat, runny nose, headache, cough, chills

Healthcare visit (other): Followup to urgent care with PCP

Release 11 — day 21, dose 4

2022-06-05

Symptoms: Headaxhe, fatigue, sore throat

Release 12 — day 42, dose 4

2022-06-26

Symptoms: I was in the heat for hours without drinking & felt dizzy, weak, faint, & nauseated. I did pass out for a second or two but I'm okay now.

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	·	·	✓
SD	Asthenia	·	·	✓
SD	Chalazion	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Loss of consciousness	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Temperature intolerance	·	·	✓
SRO	Cough	✓	✓	✓

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