22R-11462-96126

2 vaccinations 11 coded responses 20 check-ins 11 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 907 / CA
Registered: 2021-01-18

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

Timeline

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

2021-01-15
Dose 1 — Moderna
2021-01-18
Registered in v-safe
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-01-24
Survey response — day 7, dose 1
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Redness, Swelling, Itching · Muscle or body aches

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — day 14, dose 1
MedDRA: Abdominal pain upper, Diarrhoea, Injection site pruritus, Injection site vesicles — Feeling: Fair · Be unable to do your normal daily activities

Free text: Stomach cramps and diarrhea.Still have some blister like bumps at the injection site that itch but not as much as before.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-08
Dose 2 — Moderna
2021-02-08
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Itching · Headache, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-09
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Free text: Loss of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Diarrhea

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Itching · Headache, Joint pains, Muscle or body aches

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — days 1–6 daily, dose 2
MedDRA: Irritability, Oropharyngeal pain — Feeling: Good · Site: Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore throat, irritated

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Survey response — days 1–6 daily, dose 2
MedDRA: Oropharyngeal pain — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-15
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

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: Influenza — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: I felt like I had the flu.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — day 35, dose 2
MedDRA: Influenza — Feeling: Fair · Be unable to do your normal daily activities

Free text: I feel like I have the flu.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — day 42, dose 2
MedDRA: Productive cough — Feeling: Fair

Free text: Constant productive cough.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-11
Survey response — 6 months, dose 2
MedDRA: Asthenia, Blister, Dyspnoea exertional, Office visit, Rash — 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: Symptoms: Skin rashes and blisters. Lack of energy and short of breath on exertion. Not sure if this is related to the vaccine. Had a physical last week and having a follow up appointment in 2 weeks. · Healthcare visit (other): Physical

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-11
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-19
Call 1 — Could Not Reach Participant
2021-08-24
Call 2 — Left Voicemail
2022-02-09
Health check-in — 12 months, dose 2
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-15	Moderna
2	2021-02-08	Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 2 — day 7, dose 1

2021-01-24

Systemic reaction (other): Sore throat

Release 3 — day 14, dose 1

2021-01-29

Symptoms: Stomach cramps and diarrhea.Still have some blister like bumps at the injection site that itch but not as much as before.

Release 3 — days 1–6 daily, dose 2

2021-02-09

Systemic reaction (other): Loss of appetite

2021-02-10

Systemic reaction (other): Sore throat

Release 4 — days 1–6 daily, dose 2

2021-02-12

Systemic reaction (other): Sore throat

2021-02-13

Systemic reaction (other): Sore throat, irritated

2021-02-14

Systemic reaction (other): Sore throat

Release 5 — day 28, dose 2

2021-03-08

Symptoms: I felt like I had the flu.

Release 5 — day 35, dose 2

2021-03-15

Symptoms: I feel like I have the flu.

Release 6 — day 42, dose 2

2021-03-22

Symptoms: Constant productive cough.

Release 9 — 6 months, dose 2

2021-08-11

Symptoms: Skin rashes and blisters. Lack of energy and short of breath on exertion. Not sure if this is related to the vaccine. Had a physical last week and having a follow up appointment in 2 weeks.

Healthcare visit (other): Physical

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 upper	✓	✓	✓
SD	Asthenia	✓	·	✓
SD	Blister	✓	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspnoea exertional	✓	·	✓
SD	Influenza	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site vesicles	✓	✓	✓
SD	Office visit	✓	·	✓
SD	Productive cough	✓	✓	✓
SD	Rash	✓	·	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓

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