27X-18231-00178

2 vaccinations 6 coded responses 26 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 622 / IL
Registered: 2021-07-07

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-07-07
Registered in v-safe
2021-07-07
Dose 1 — Moderna
2021-07-07
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fever · Joint pains, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-07-08
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Joint pains, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work or attend school

Adult check-in
2021-07-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-07-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Nausea

Adult check-in
2021-07-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-07-12
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Discomfort, Dyspepsia, Fatigue — Feeling: Good · Fatigue or tiredness

Free text: Early in the morning i was feeling pressure on my chest like a heartburn feeling. It was uncomfortable for a few hours but the feeling went away. Other than that just continue feeding fatigue but not as bad as the firsts days.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-07-14
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-07-21
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-07-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-08-04
Dose 2 — Moderna
2021-08-04
Survey response — day 0, dose 2
MedDRA: Hyperhidrosis — Feeling: Fair · Site: Pain · Fever · Headache, Fatigue or tiredness, Nausea

Free text: Sweating

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Nausea

Adult check-in
2021-08-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-08-07
Survey response — days 1–6 daily, dose 2
MedDRA: Epistaxis — Feeling: Good

Free text: Nose bleeds

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-08-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-08-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Nausea

Adult check-in
2021-08-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-08-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-08-25
Survey response — day 21, dose 2
MedDRA: Chills, Fatigue, Nausea, Pain — Feeling: Fair

Free text: Nausea, body ache, chills, a few hours early in the day. Now just feel nausea and tiredness .

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-01
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-09-09
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-09-15
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-11-03
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-02-04
Survey response — 6 months, dose 2
MedDRA: Asthenia, Diarrhoea, SARS-CoV-2 test negative, Vomiting — Feeling: Fair · Be unable to work or attend school

Free text: Two weeks ago :Diarrhea, vomiting, weakness. Im better now. Teo of family members tested positive to Covid but i tested negative twice.

MedDRA releases: 2024-11 · check-in free text available
2022-08-04
Survey response — 12 months, dose 2
MedDRA: Asthenia, Brain fog, Hypoaesthesia, Sensory loss — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Foggy Brain, weakness, lost of sense in left arm small and ring finger. Numbness sensation on left arm.

MedDRA releases: 2024-11 · check-in free text available
2022-08-04
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-08-05
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-07-07	Moderna	No
2	2021-08-04	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 1

2021-07-12

Systemic reaction (other): Early in the morning i was feeling pressure on my chest like a heartburn feeling. It was uncomfortable for a few hours but the feeling went away. Other than that just continue feeding fatigue but not as bad as the firsts days.

Release 9 — day 0, dose 2

2021-08-04

Systemic reaction (other): Sweating

Release 9 — days 1–6 daily, dose 2

2021-08-07

Systemic reaction (other): Nose bleeds

Release 9 — day 21, dose 2

2021-08-25

Symptoms: Nausea, body ache, chills, a few hours early in the day. Now just feel nausea and tiredness .

Release 11 — 6 months, dose 2

2022-02-04

Symptoms: Two weeks ago :Diarrhea, vomiting, weakness. Im better now. Teo of family members tested positive to Covid but i tested negative twice.

Release 12 — 12 months, dose 2

2022-08-04

Symptoms: Foggy Brain, weakness, lost of sense in left arm small and ring finger. Numbness sensation on left arm.

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	Asthenia	·	·	✓
SD	Brain fog	·	·	✓
SD	Chills	✓	·	✓
SD	Diarrhoea	·	·	✓
SD	Fatigue	✓	·	✓
SD	Hypoaesthesia	·	·	✓
SD	Nausea	✓	·	✓
SD	Pain	✓	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Sensory loss	·	·	✓
SD	Vomiting	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Discomfort	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Epistaxis	✓	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Hyperhidrosis	✓	·	✓

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