ZJ2-27264-94652

5 vaccinations 13 coded responses 63 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 41-45
ZIP prefix: 280 / NC
Registered: 2021-03-04

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

H9Q-32643-39322 Child or adolescent in my care · Male · 2021-11-06

Timeline

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

2021-03-03
Dose 1 — Moderna
2021-03-04
Registered in v-safe
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-10
Health check-in — day 7, dose 1
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-03-17
Survey response — day 14, dose 1
MedDRA: Chills, Erythema, Feeling hot, Headache, Hyperhidrosis, Malaise, Rash, Rash pruritic, Vomiting — Feeling: Poor · Be unable to do your normal daily activities

Free text: Delayed rash on arm lasted for 5-6 days. It was red, hot to the touch and itchy. Two days after it went away, yesterday, I started vomiting ALOT, had chills , sweats, and a headache. Today, the vomiting has stops but still not feeling 100%.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 21, dose 1
MedDRA: Chills, Diarrhoea, Malaise, Nausea, Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: My vomiting last week ended up turning into diarrhea with nausea for 3 days before finally going away. I was sick 6 days total with vomiting chills, nausea, and diarrhea .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Dose 2 — Moderna
2021-03-31
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Malaise, Vomiting — Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Vomiting lasted a full day starting yesterday when i was to sick to do the check-in

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Flatulence — Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Gas

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Insomnia, Mucous stools — Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Can't sleep for more than an hour or so at a time, white mucus in stool

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-07
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

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

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

Adult check-in
2021-04-28
Survey response — day 28, dose 2
MedDRA: Arthralgia, Chest pain, Injection site pain, Neuralgia — Feeling: Good

Free text: Muscle pain that comes and goes at injection sight. Joint pain and Sciatic nerve pain( not constant but comes in waves) chest pain when working out/ jogging ( never has happened before)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Survey response — day 35, dose 2
MedDRA: Vaccination site pain — Feeling: Good

Free text: Still getting random pain, sometimes sharp, sometimes dull ache,on arm (s) at vaccination site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-29
Survey response — 6 months, dose 2
MedDRA: Myalgia — Feeling: Good · Be unable to do your normal daily activities

Free text: I still have muscle pain and problems with my left arm fromsince getting the first shot.

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Dose 3 — Moderna
2021-10-29
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Itching · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-12
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-28
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-29
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-07-21
Dose 4 — Pfizer-BioNTech
2022-07-21
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · None

Adult check-in
2022-07-22
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-07-23
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2022-07-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2022-07-25
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-07-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-07-28
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-08-04
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-08-11
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-08-18
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-08-26
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-09-02
Survey response — day 42, dose 4
MedDRA: Herpes zoster, Infection, Nervous system disorder — Feeling: Good · 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: Infections from shingles...i never have shingles before the covis vaccine and ive had it twice since. Nerve issues

MedDRA releases: 2024-11 · check-in free text available
2022-09-02
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-09-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-05
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-10-05
Health check-in — day 0, dose 5
Feeling: Good · None

Adult check-in
2022-10-06
Survey response — days 1–6 daily, dose 5
MedDRA: Anal haemorrhage — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness, Nausea

Free text: Anal bleeding

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
Survey response — days 1–6 daily, dose 5
MedDRA: Chest pain, Poor quality sleep — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Chest pains, not able to sleep well

MedDRA releases: 2024-11 · check-in free text available
2022-10-08
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-09
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-12
Health check-in — day 7, dose 5
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-19
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-10-26
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-02
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-09
Survey response — day 35, dose 5
MedDRA: Chills, Diarrhoea, Exposure to SARS-CoV-2, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Fair

Free text: Chills, sore throat, diarrhea My son tested positive for Covid yesterday. I'm still negative.

MedDRA releases: 2024-11 · check-in free text available
2022-11-16
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-04
Health check-in — 3 months, dose 5
Feeling: Poor

Adult check-in
2023-04-05
Survey response — 6 months, dose 5
MedDRA: Pain in extremity, Shoulder injury related to vaccine administration — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-03	Moderna
2	2021-03-31	Moderna
3	2021-10-29	Moderna	No
4	2022-07-21	Pfizer-BioNTech	No
5	2022-10-05	Pfizer-BioNTech	Flu

Call center

Reported	Outcome	VAERS-related outcome
2022-09-02	Successful 2022-09-06	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 5 — day 14, dose 1

2021-03-17

Symptoms: Delayed rash on arm lasted for 5-6 days. It was red, hot to the touch and itchy. Two days after it went away, yesterday, I started vomiting ALOT, had chills , sweats, and a headache. Today, the vomiting has stops but still not feeling 100%.

Release 6 — day 21, dose 1

2021-03-25

Symptoms: My vomiting last week ended up turning into diarrhea with nausea for 3 days before finally going away. I was sick 6 days total with vomiting chills, nausea, and diarrhea .

Release 6 — days 1–6 daily, dose 2

2021-04-02

Systemic reaction (other): Vomiting lasted a full day starting yesterday when i was to sick to do the check-in

2021-04-03

Systemic reaction (other): Gas

2021-04-04

Systemic reaction (other): Can't sleep for more than an hour or so at a time, white mucus in stool

Release 8 — day 28, dose 2

2021-04-28

Symptoms: Muscle pain that comes and goes at injection sight. Joint pain and Sciatic nerve pain( not constant but comes in waves) chest pain when working out/ jogging ( never has happened before)

Release 8 — day 35, dose 2

2021-05-05

Symptoms: Still getting random pain, sometimes sharp, sometimes dull ache,on arm (s) at vaccination site.

Release 9 — 6 months, dose 2

2021-09-29

Symptoms: I still have muscle pain and problems with my left arm fromsince getting the first shot.

Release 12 — day 42, dose 4

2022-09-02

Symptoms: Infections from shingles...i never have shingles before the covis vaccine and ive had it twice since. Nerve issues

Release 12 — days 1–6 daily, dose 5

2022-10-06

Systemic reaction (other): Anal bleeding

2022-10-07

Systemic reaction (other): Chest pains, not able to sleep well

Release 12 — day 35, dose 5

2022-11-09

Symptoms: Chills, sore throat, diarrhea My son tested positive for Covid yesterday. I'm still negative.

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	Arthralgia	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Erythema	✓	✓	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Feeling hot	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Herpes zoster	·	·	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Infection	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Nausea	✓	✓	✓
SD	Nervous system disorder	·	·	✓
SD	Neuralgia	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Rash	✓	✓	✓
SD	Rash pruritic	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Shoulder injury related to vaccine administration	·	·	✓
SD	Vaccination site pain	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Anal haemorrhage	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Flatulence	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Mucous stools	✓	✓	✓
SRO	Poor quality sleep	·	·	✓
SRO	Vomiting	✓	✓	✓

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