ZKD-22661-74742

3 vaccinations 10 coded responses 35 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 448 / OH
Registered: 2020-12-29

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

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Survey response — day 0, dose 1
MedDRA: Headache, Stress — Feeling: Good · Headache

Free text: I had a headache before the vaccine, took Tylenol. Got better but now back again after vaccine. Might be stressed out more than everything.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Chills, Fatigue or tiredness, Nausea

Adult check-in
2020-12-31
Survey response — days 1–6 daily, dose 1
MedDRA: Heart rate increased, Palpitations — Feeling: Good · Site: Pain

Free text: The first day, about 6 hours after my shot, I took a nap and was woke up by a rapid pounding heart rate. It lasted about 1 min. Forgot to include that in initial report.

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

Free text: Woke up a bit nauseous but went away as day went on

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Nasal congestion, Upper-airway cough syndrome — Feeling: Good

Free text: Stuffy drippy nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-06
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-12
Survey response — day 14, dose 1
MedDRA: Headache — Feeling: Good

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-26
Dose 2 — Moderna
2021-01-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None · Be unable to do your normal daily activities

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-10
Dose 3 — Moderna
2022-01-11
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-01-12
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Nasal congestion, Rhinorrhoea — Feeling: Poor · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Stuffy drippy nose. Cough

MedDRA releases: 2024-11 · check-in free text available
2022-01-13
Survey response — days 1–6 daily, dose 3
MedDRA: Respiratory tract congestion — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Stuffy

MedDRA releases: 2024-11 · check-in free text available
2022-01-14
Survey response — days 1–6 daily, dose 3
MedDRA: Respiratory tract congestion — Feeling: Fair · Fever · Headache, Fatigue or tiredness · 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: Stuffy

MedDRA releases: 2024-11 · check-in free text available
2022-01-14
Report sent to call center — days 1–6 daily, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-15
Survey response — days 1–6 daily, dose 3
MedDRA: Cough, Respiratory tract congestion — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Stuffy cough

MedDRA releases: 2024-11 · check-in free text available
2022-01-16
Survey response — days 1–6 daily, dose 3
MedDRA: Respiratory tract congestion — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Stuffy

MedDRA releases: 2024-11 · check-in free text available
2022-01-18
Call 1 — Left Voicemail
2022-01-19
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-01-24
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-02-02
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-02-21
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna
3	2022-01-10	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-01-06	priority 2/3
2022-01-14	Unsuccessful

Free text

Release 1 — day 0, dose 1

2020-12-29

Systemic reaction (other): I had a headache before the vaccine, took Tylenol. Got better but now back again after vaccine. Might be stressed out more than everything.

Release 1 — days 1–6 daily, dose 1

2020-12-31

Systemic reaction (other): The first day, about 6 hours after my shot, I took a nap and was woke up by a rapid pounding heart rate. It lasted about 1 min. Forgot to include that in initial report.

2021-01-01

Systemic reaction (other): Woke up a bit nauseous but went away as day went on

2021-01-02

Systemic reaction (other): Stuffy drippy nose

Release 1 — day 14, dose 1

2021-01-12

Symptoms: Headache

Release 10 — days 1–6 daily, dose 3

2022-01-12

Systemic reaction (other): Stuffy drippy nose. Cough

2022-01-13

Systemic reaction (other): Stuffy

2022-01-14

Systemic reaction (other): Stuffy

2022-01-15

Systemic reaction (other): Stuffy cough

2022-01-16

Systemic reaction (other): Stuffy

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	Headache	✓	✓	✓
SRO	Cough	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Heart rate increased	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Palpitations	✓	✓	✓
SRO	Respiratory tract congestion	·	·	✓
SRO	Rhinorrhoea	○	○	✓
SRO	Stress	✓	✓	✓
SRO	Upper-airway cough syndrome	✓	✓	✓

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