26P-19189-83682

5 vaccinations 6 coded responses 42 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 038 / NH
Registered: 2021-03-17

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

2021-02-17
Dose 1 — Moderna
2021-03-15
Dose 2 — Moderna
2021-03-17
Registered in v-safe
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Fever · Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-20
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling, Itching · Fever · Chills, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-03-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-22
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-03-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-12
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-19
Survey response — day 35, dose 2
MedDRA: Fatigue, Headache — Feeling: Fair

Free text: Really tired; headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-14
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-13
Survey response — 6 months, dose 2
MedDRA: Dyspepsia, Gastrooesophageal reflux disease, Office visit, Ulcer — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Acid reflux and heartburn. Do not think related to vaccine. Likely an ulcer. · Healthcare visit (other): Saw primary. Have telemedicine visit later in month with Gastrology dr.

MedDRA releases: 2024-11 · check-in free text available
2021-09-13
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-16
Call 1 — Left Voicemail
2021-12-03
Dose 3 — Moderna
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Fever · Chills

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Headache, Fatigue or tiredness

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-12-08
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-12-10
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-12-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-14
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-31
Dose 4 — Moderna
2022-05-31
Survey response — day 0, dose 4
MedDRA: No adverse event — Feeling: Good

Free text: Nothing at this point. Got booster vaccination at 9am today and past reaction was at 10-12 hour after.

MedDRA releases: 2024-11 · check-in free text available
2022-06-01
Survey response — days 1–6 daily, dose 4
MedDRA: Migraine — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school

Free text: Also triggered a migraine

MedDRA releases: 2024-11 · check-in free text available
2022-06-02
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-06-03
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Swelling · Chills, Fatigue or tiredness

Adult check-in
2022-06-04
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-06-05
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache

Adult check-in
2022-06-06
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-06-07
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-14
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-21
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-28
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-05
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-12
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-30
Survey response — 3 months, dose 4
MedDRA: Nasopharyngitis, Oropharyngeal pain, Pre-existing disease, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good

Free text: Sore throat, nasal drainage; likely allergies or summer cold; took home Covid -19 test and negative results.

MedDRA releases: 2024-11 · check-in free text available
2022-11-29
Survey response — 6 months, dose 4
MedDRA: Cough, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Good

Free text: Cough, nasal drip, some congestion, but no fever and home Covid tests have been negative.

MedDRA releases: 2024-11 · check-in free text available
2022-12-16
Dose 5 — Moderna
2023-06-16
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-17	Moderna
2	2021-03-15	Moderna
3	2021-12-03	Moderna	No
4	2022-05-31	Moderna	No
5	2022-12-16	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 7 — day 35, dose 2

2021-04-19

Symptoms: Really tired; headaches

Release 9 — 6 months, dose 2

2021-09-13

Symptoms: Acid reflux and heartburn. Do not think related to vaccine. Likely an ulcer.

Healthcare visit (other): Saw primary. Have telemedicine visit later in month with Gastrology dr.

Release 11 — day 0, dose 4

2022-05-31

Systemic reaction (other): Nothing at this point. Got booster vaccination at 9am today and past reaction was at 10-12 hour after.

Release 11 — days 1–6 daily, dose 4

2022-06-01

Systemic reaction (other): Also triggered a migraine

Release 12 — 3 months, dose 4

2022-08-30

Symptoms: Sore throat, nasal drainage; likely allergies or summer cold; took home Covid -19 test and negative results.

Release 12 — 6 months, dose 4

2022-11-29

Symptoms: Cough, nasal drip, some congestion, but no fever and home Covid tests have been 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	Office visit	·	·	✓
SD	Cough	·	·	✓
SD	Dyspepsia	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Headache	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Ulcer	·	·	✓
SRO	Migraine	·	·	✓
SRO	No adverse event	·	·	✓

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