24R-21054-15801

5 vaccinations 6 coded responses 27 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 606 / IL
Registered: 2021-03-08

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

2021-03-08
Registered in v-safe
2021-03-08
Dose 1 — Moderna
2021-03-08
Survey response — day 0, dose 1
MedDRA: No adverse event — Feeling: Good · Fever · Fatigue or tiredness

Free text: no

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2021-03-15
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-22
Survey response — day 14, dose 1
MedDRA: Headache, Pain — Feeling: Fair

Free text: headaches and body aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-05
Dose 2 — Moderna
2021-04-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-05
Survey response — 3 months, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: I think the circulation in my extremities hands and feet has gotten worse. Could that be a side effect from the Moderna vaccine?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-12-01
Dose 3 — Moderna
2022-03-31
Dose 4 — Moderna
2022-04-07
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-10-18
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-10-20
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-10-21
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-10-22
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-10-23
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-24
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-11-03
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-08
Survey response — day 21, dose 5
MedDRA: Influenza like illness, Nasopharyngitis — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I have developed a head cold/flu like sumptoms the last few days

MedDRA releases: 2024-11 · check-in free text available
2022-11-15
Survey response — day 28, dose 5
MedDRA: Headache, Nasopharyngitis, Pain, SARS-CoV-2 test positive — Feeling: Poor · 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

Free text: Tested positive for Covid Feel like I have the worst head cold, headache and overall body pain

MedDRA releases: 2024-11 · check-in free text available
2022-11-15
Report sent to call center — day 28, dose 5
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 · 1 call case(s)
2022-11-16
Call 1 — Left Voicemail
2022-11-22
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-29
Survey response — day 42, dose 5
MedDRA: COVID-19, Chills, Headache, Malaise — Feeling: Fair · Be unable to work or attend school

Free text: I became quite ill after Thanksgiving. It may have been food poisoning. However, I seemed to have had a relapse of my Covid symptoms: chills and headache. .

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna
2	2021-04-05	Moderna
3	2021-12-01	Moderna	No
4	2022-03-31	Moderna	No
5	2022-10-18	Pfizer-BioNTech	Flu

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-08

Systemic reaction (other): no

Release 6 — day 14, dose 1

2021-03-22

Symptoms: headaches and body aches

Release 9 — 3 months, dose 2

2021-07-05

Symptoms: I think the circulation in my extremities hands and feet has gotten worse. Could that be a side effect from the Moderna vaccine?

Release 12 — day 21, dose 5

2022-11-08

Symptoms: I have developed a head cold/flu like sumptoms the last few days

Release 12 — day 28, dose 5

2022-11-15

Symptoms: Tested positive for Covid Feel like I have the worst head cold, headache and overall body pain

Release 12 — day 42, dose 5

2022-11-29

Symptoms: I became quite ill after Thanksgiving. It may have been food poisoning. However, I seemed to have had a relapse of my Covid symptoms: chills and headache. .

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	COVID-19	·	·	✓
SD	Headache	✓	✓	✓
SD	Influenza like illness	·	·	✓
SD	Malaise	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Unevaluable event	✓	✓	✓
SRO	No adverse event	✓	✓	✓

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