ZDW-21927-62184

3 vaccinations 2 coded responses 39 check-ins 2 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 140 / NY
Registered: 2021-02-24

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

2021-02-24
Registered in v-safe
2021-02-25
Dose 1 — Moderna
2021-02-25
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

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

Adult check-in
2021-03-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-25
Dose 2 — Moderna
2021-03-25
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-04-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-23
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-30
Dose 3 — Moderna
2021-11-30
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-07
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-14
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-21
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-04
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-11
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-01
Survey response — 3 months, dose 3
MedDRA: Oropharyngeal pain, Respiratory tract congestion, SARS-CoV-2 test positive, Unevaluable event — 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 · Telehealth, virtual health, or email health consultation

Free text: Began COVID symptoms 2/14/22 tested positive 2/16/22. Sore throat, temp, cough congestion.

MedDRA releases: 2024-11 · check-in free text available
2022-03-01
Report sent to call center — 3 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-03-03
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-31
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Moderna
2	2021-03-25	Moderna
3	2021-11-30	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2022-03-01	Successful 2022-03-03	Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-27

Systemic reaction (other): Dizzy

Release 11 — 3 months, dose 3

2022-03-01

Symptoms: Began COVID symptoms 2/14/22 tested positive 2/16/22. Sore throat, temp, cough congestion.

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	Oropharyngeal pain	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Dizziness	✓	✓	✓

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