24J-26248-30696

4 vaccinations 7 coded responses 24 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 959 / CA
Registered: 2021-03-01

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

2021-02-01
Dose 1 — Moderna
2021-03-01
Registered in v-safe
2021-03-01
Dose 2 — Moderna
2021-03-01
Survey response — day 0, dose 2
MedDRA: No adverse event, Pre-existing disease — Feeling: Good · Site: Pain · Chills

Free text: I live with 5 tick borne illnesses per testing at (b)(6) CA. My Lyme doc can read the lab results : 2 types of Lyme, 1 Babesia, 2 Bartonella. I didnt take ANY of the antibiotics or supplements he has prescribed , today. I wanted my body to be free and clear of anything that could disrupt or decrease the effectiveness of the vaccine . Im doing very well with these re: feeling good.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: See previous input on my living w 5 tick borne illnesses. But these SX Ive reported are not related . Ive been seeing a Lyme MD. Feeling quite good w his meds and supplements hes prescribed.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-08
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-17
Survey response — day 14, dose 2
MedDRA: Fatigue, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Tired a few days. But its probably due to packing for our two week trip to see our son and daughter in law , and grandson in NYC., its exhausting for me, due to living w Lyme , Babesia, and Bartonella bacteria .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-17
Dose 3 — Moderna
2021-08-30
Survey response — 6 months, dose 2
MedDRA: Chills, Injection site pain, Mobility decreased, Pain, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: I had my 3rd vaccine. The day after: body aches and pain , chills. In bed much of day . Felt fine following day. All good afterwards Only pain at injection site for 5 days. Im immuno compromised with 5 tick borne illnesses.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2022-01-28
Dose 4 — Moderna
2022-02-15
Survey response — 6 months, dose 3
MedDRA: Sinusitis, Tinnitus — Feeling: Good · Be unable to do your normal daily activities

Free text: Sinusitis and tinnitus

MedDRA releases: 2024-11 · check-in free text available
2022-02-15
Survey response — day 14, dose 4
MedDRA: Sinusitis, Tinnitus — Feeling: Good · Be unable to do your normal daily activities

Free text: Sinusitis tinnitus

MedDRA releases: 2024-11 · check-in free text available
2022-02-20
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-02-25
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-03-04
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-03-11
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-04-29
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-07-29
Survey response — 6 months, dose 4
MedDRA: Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sinusitis. 14 days Augmentin eliminated it

MedDRA releases: 2024-11 · check-in free text available
2022-07-29
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-08-01
Call 1 — Left Voicemail
2022-08-01
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-30
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-01	Moderna
2	2021-03-01	Moderna
3	2021-08-17	Moderna	No
4	2022-01-28	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 4 — day 0, dose 2

2021-03-01

Systemic reaction (other): I live with 5 tick borne illnesses per testing at (b)(6) CA. My Lyme doc can read the lab results : 2 types of Lyme, 1 Babesia, 2 Bartonella. I didnt take ANY of the antibiotics or supplements he has prescribed , today. I wanted my body to be free and clear of anything that could disrupt or decrease the effectiveness of the vaccine . Im doing very well with these re: feeling good.

redacted (b)(6)

Release 4 — days 1–6 daily, dose 2

2021-03-02

Systemic reaction (other): See previous input on my living w 5 tick borne illnesses. But these SX Ive reported are not related . Ive been seeing a Lyme MD. Feeling quite good w his meds and supplements hes prescribed.

Release 5 — day 14, dose 2

2021-03-17

Symptoms: Tired a few days. But its probably due to packing for our two week trip to see our son and daughter in law , and grandson in NYC., its exhausting for me, due to living w Lyme , Babesia, and Bartonella bacteria .

Release 9 — 6 months, dose 2

2021-08-30

Symptoms: I had my 3rd vaccine. The day after: body aches and pain , chills. In bed much of day . Felt fine following day. All good afterwards Only pain at injection site for 5 days. Im immuno compromised with 5 tick borne illnesses.

Release 11 — 6 months, dose 3

2022-02-15

Symptoms: Sinusitis and tinnitus

Release 11 — day 14, dose 4

2022-02-15

Symptoms: Sinusitis tinnitus

Release 12 — 6 months, dose 4

2022-07-29

Symptoms: Sinusitis. 14 days Augmentin eliminated it

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	Chills	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Injection site pain	✓	·	✓
SD	Mobility decreased	✓	·	✓
SD	Pain	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Tinnitus	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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