26K-16261-01790

3 vaccinations 14 coded responses 39 check-ins 14 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 981 / WA
Registered: 2021-01-21

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

2021-01-21
Registered in v-safe
2021-01-21
Dose 1 — Moderna
2021-01-22
Survey response — days 1–6 daily, dose 1
MedDRA: Nausea — Feeling: Good · Fatigue or tiredness

Free text: Yesterday after the shot I felt nauseous.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Fatigue or tiredness, Nausea

Free text: I used a CBD Arnica cream at my shot sight and have had no pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness, Nausea

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea — Feeling: Good · Diarrhea

Free text: I think the diarrhea was related to my metformin

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Survey response — day 14, dose 1
MedDRA: Injection site pain — Feeling: Good

Free text: Sore arm ( the shot arm)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — day 21, dose 1
MedDRA: Diarrhoea, Fatigue, Gastrooesophageal reflux disease — Feeling: Fair

Free text: Mild Loose stool for 2 days, increased acid reflux Dont know if Its related to shot or not. Also fatigued... slept today until 10am (usually up by 8:30

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Site: Pain · Joint pains, Fatigue or tiredness

Free text: Acid reflux increased

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Decreased appetite — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Loss of appetite

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia — Feeling: Good · Headache, Joint pains, Fatigue or tiredness

Free text: Joint pain is mostly in my hands and knee and when I sleep. Not sure its related to shot. Ive had it before

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Light headedness when getting up from sitting

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

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-09
Survey response — day 42, dose 2
MedDRA: Cough, Nasal congestion — Feeling: Fair

Free text: I have a stuffy nose and a cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-28
Dose 3 — Moderna
2021-10-28
Health check-in — day 0, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea

Adult check-in
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Myalgia — Feeling: Good · Site: Pain

Free text: Neck and shoulder muscle ache on opposite side of shot arm

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Hypoaesthesia — Feeling: Good · Chills, Muscle or body aches

Free text: Numbness in fingertips

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-04
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-11
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-18
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-02
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-11
Survey response — day 42, dose 3
MedDRA: Diarrhoea — Feeling: Good

Free text: Occasional diarrhea

MedDRA releases: 2024-11 · check-in free text available
2022-01-27
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-28
Survey response — 6 months, dose 3
MedDRA: Abdominal distension, Abdominal pain upper, Asthenia, Flatulence, Headache, SARS-CoV-2 test negative — Feeling: Good · 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: I had an endoscopy and colonoscopy at the same time. And it impacted my energy and left me gassy and bloated. I have had a headache and achy stomach since. Took a home CoVid test and tested negative

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-29
Call 1 — Left Voicemail
2022-04-29
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-21	Moderna
2	2021-02-26	Moderna
3	2021-10-28	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-22

Systemic reaction (other): Yesterday after the shot I felt nauseous.

2021-01-23

Systemic reaction (other): I used a CBD Arnica cream at my shot sight and have had no pain.

2021-01-26

Systemic reaction (other): I think the diarrhea was related to my metformin

Release 3 — day 14, dose 1

2021-02-04

Symptoms: Sore arm ( the shot arm)

Release 4 — day 21, dose 1

2021-02-11

Symptoms: Mild Loose stool for 2 days, increased acid reflux Dont know if Its related to shot or not. Also fatigued... slept today until 10am (usually up by 8:30

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Acid reflux increased

2021-02-28

Systemic reaction (other): Loss of appetite

2021-03-02

Systemic reaction (other): Joint pain is mostly in my hands and knee and when I sleep. Not sure its related to shot. Ive had it before

2021-03-03

Systemic reaction (other): Light headedness when getting up from sitting

Release 7 — day 42, dose 2

2021-04-09

Symptoms: I have a stuffy nose and a cough

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): Neck and shoulder muscle ache on opposite side of shot arm

2021-11-01

Systemic reaction (other): Numbness in fingertips

Release 10 — day 42, dose 3

2021-12-11

Symptoms: Occasional diarrhea

Release 11 — 6 months, dose 3

2022-04-28

Symptoms: I had an endoscopy and colonoscopy at the same time. And it impacted my energy and left me gassy and bloated. I have had a headache and achy stomach since. Took a home CoVid test and tested 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
SD	Abdominal distension	·	·	✓
SD	Abdominal pain upper	·	·	✓
SD	Asthenia	·	·	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Flatulence	·	·	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Headache	·	·	✓
SD	Injection site pain	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SRO	Arthralgia	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Hypoaesthesia	·	·	✓
SRO	Myalgia	·	·	✓
SRO	Nausea	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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