ZEF-50394-13269

2 vaccinations 9 coded responses 26 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 302 / GA
Registered: 2021-01-20

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

2021-01-20
Registered in v-safe
2021-01-20
Dose 1 — Moderna
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Adult check-in
2021-01-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Nausea — Feeling: Good · Nausea · Be unable to do your normal daily activities

Free text: Nausea maybe due to something else, but happened suddenly with no other obvious reason. Lasted 2-3 hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-03
Survey response — day 14, dose 1
MedDRA: Gastrooesophageal reflux disease — Feeling: Good

Free text: Acid reflux

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 21, dose 1
MedDRA: Anxiety — Feeling: Good

Free text: Anxiety attacks

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 28, dose 1
MedDRA: Chills, Rhinorrhoea, Throat irritation — Feeling: Fair

Free text: Runny nose, scratchy throat, chills

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Dose 2 — Moderna
2021-02-19
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Good

Free text: Feel dizzy, but functioning fine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Can't sleep

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Dizziness, Neck pain — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizzy, pain in shoulder and neck above shot site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Abdominal pain

Adult check-in
2021-02-26
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-12
Survey response — day 21, dose 2
MedDRA: Diarrhoea, Eructation, Nausea, Oesophageal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Doubt this is related to vaccine: diarrhea, three days of nausea, and last night apparently had gas trapped in the esophagus, causing sharp pain. Walking around and belching helped, and eventually it was relieved

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 35, dose 2
Feeling: Good

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

Adult check-in
2021-05-21
Survey response — 3 months, dose 2
MedDRA: Abdominal pain, Bone pain, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Belly pain. Scans not showing cause. Also lots of bone aches and pains. · Healthcare visit (other): In person doctor's appointment: belly CT scan

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-20
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-02-19
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-29
Call successful
Participant prefers to complete VAERS report online

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-19	Moderna

Call center

Reported	Outcome	VAERS-related outcome
2021-05-21	Successful 2022-04-29	Participant prefers to complete VAERS report online

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-24

Systemic reaction (other): Nausea maybe due to something else, but happened suddenly with no other obvious reason. Lasted 2-3 hours.

Release 3 — day 14, dose 1

2021-02-03

Symptoms: Acid reflux

Release 4 — day 21, dose 1

2021-02-10

Symptoms: Anxiety attacks

Release 4 — day 28, dose 1

2021-02-17

Symptoms: Runny nose, scratchy throat, chills

Release 4 — day 0, dose 2

2021-02-19

Systemic reaction (other): Feel dizzy, but functioning fine

Release 4 — days 1–6 daily, dose 2

2021-02-20

Systemic reaction (other): Can't sleep

2021-02-21

Systemic reaction (other): Dizzy, pain in shoulder and neck above shot site

Release 5 — day 21, dose 2

2021-03-12

Symptoms: Doubt this is related to vaccine: diarrhea, three days of nausea, and last night apparently had gas trapped in the esophagus, causing sharp pain. Walking around and belching helped, and eventually it was relieved

Release 8 — 3 months, dose 2

2021-05-21

Symptoms: Belly pain. Scans not showing cause. Also lots of bone aches and pains.

Healthcare visit (other): In person doctor's appointment: belly CT scan

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	Abdominal pain	✓	✓	✓
SD	Anxiety	✓	✓	✓
SD	Bone pain	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Eructation	✓	✓	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oesophageal pain	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Throat irritation	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Neck pain	✓	✓	✓

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