ZNK-11791-42857

5 vaccinations 10 coded responses 42 check-ins 10 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 088 / NJ
Registered: 2021-01-11

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

2021-01-11
Registered in v-safe
2021-01-11
Dose 1 — Moderna
2021-01-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Survey response — days 1–6 daily, dose 1
MedDRA: Rhinorrhoea — Feeling: Good · Site: Pain · Chills, Headache

Free text: Mild Sniffles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-08
Dose 2 — Moderna
2021-02-08
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: Just got it at 115pm. It's 3p.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-08
Survey response — day 28, dose 2
MedDRA: Laryngitis — Feeling: Good

Free text: Laryngitis since approx 2/26/21.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — day 35, dose 2
MedDRA: Laryngitis, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have laryngitis. · Healthcare visit (other): Going to an ENT today because it's been since 2/26/21.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-21
Call 2 — Could Not Reach Participant
2021-12-23
Dose 3 — Moderna
2021-12-27
Call 3 — Could Not Reach Participant
2022-02-08
Survey response — day 42, dose 3
MedDRA: Tinnitus — Feeling: Good

Free text: My ears ring more.

MedDRA releases: 2024-11 · check-in free text available
2022-02-08
Survey response — 12 months, dose 2
MedDRA: Tinnitus — Feeling: Good

Free text: My ears ring more.

MedDRA releases: 2024-11 · check-in free text available
2022-03-24
Health check-in — 3 months, dose 3
Feeling: Fair

Adult check-in
2022-06-16
Dose 4 — Moderna
2022-06-23
Survey response — 6 months, dose 3
MedDRA: Balance disorder, Malaise, SARS-CoV-2 test negative, Tinnitus — Feeling: Good · 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, Outpatient clinic or urgent care clinic visit

Free text: Ears ring more, balance is off sometimes. Was sick for a week in March and again in April, both not Covid19.

MedDRA releases: 2024-11 · check-in free text available
2022-06-23
Report sent to call center — 6 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-24
Call 1 — Left Voicemail
2022-06-24
Call 1 — Left Voicemail
2022-06-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-14
Dose 5 — Moderna
2022-10-15
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-16
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-10-17
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-18
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fever · Headache, Fatigue or tiredness

Adult check-in
2022-10-19
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-20
Survey response — days 1–6 daily, dose 5
MedDRA: Oropharyngeal pain, Rhinorrhoea — Feeling: Good

Free text: Mild runny nose, beginnings of a sore throat.

MedDRA releases: 2024-11 · check-in free text available
2022-10-21
Survey response — day 7, dose 5
MedDRA: Unevaluable event — Feeling: Good

Free text: Mild nasal

MedDRA releases: 2024-11 · check-in free text available
2022-10-28
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-04
Survey response — day 21, dose 5
MedDRA: Headache, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative, Upper respiratory tract infection — 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: Upper respiratory infection: runny nose, sore throat, low grade fever, headache. Thought I had Covid19 but, PCR was negative.

MedDRA releases: 2024-11 · check-in free text available
2022-11-04
Report sent to call center — day 21, dose 5
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)
2022-11-07
Call 1 — Left Voicemail
2022-11-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-11
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-18
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-25
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-13
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-14
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-11	Moderna
2	2021-02-08	Moderna
3	2021-12-23	Moderna	No
4	2022-06-16	Moderna	No
5	2022-10-14	Moderna	No

Call center

Reported	Outcome	VAERS-related outcome
2021-03-15	Successful 2022-06-24	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-23	Successful 2022-06-24	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-04	Successful 2022-11-07	Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-12

Systemic reaction (other): Mild Sniffles

Release 3 — day 0, dose 2

2021-02-08

Systemic reaction (other): Just got it at 115pm. It's 3p.

Release 5 — day 28, dose 2

2021-03-08

Symptoms: Laryngitis since approx 2/26/21.

Release 5 — day 35, dose 2

2021-03-15

Symptoms: I have laryngitis.

Healthcare visit (other): Going to an ENT today because it's been since 2/26/21.

Release 11 — day 42, dose 3

2022-02-08

Symptoms: My ears ring more.

Release 11 — 12 months, dose 2

2022-02-08

Symptoms: My ears ring more.

Release 12 — 6 months, dose 3

2022-06-23

Symptoms: Ears ring more, balance is off sometimes. Was sick for a week in March and again in April, both not Covid19.

Release 12 — days 1–6 daily, dose 5

2022-10-20

Systemic reaction (other): Mild runny nose, beginnings of a sore throat.

Release 12 — day 7, dose 5

2022-10-21

Systemic reaction (other): Mild nasal

Release 12 — day 21, dose 5

2022-11-04

Symptoms: Upper respiratory infection: runny nose, sore throat, low grade fever, headache. Thought I had Covid19 but, PCR was 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
HCVO	Unevaluable event	✓	✓	✓
SD	Balance disorder	·	·	✓
SD	Headache	·	·	✓
SD	Laryngitis	✓	✓	✓
SD	Malaise	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Tinnitus	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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