2N3-26701-86144

2 vaccinations 7 coded responses 16 check-ins 7 free-text entries 5 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 071 / NJ
Registered: 2021-03-31

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

2021-03-31
Registered in v-safe
2021-03-31
Dose 1 — Moderna
2021-03-31
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fever · Headache

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to work

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches · Be unable to work

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-04-07
Survey response — day 7, dose 1
MedDRA: Headache — Feeling: Good · Headache

Free text: Headaches come & go

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Survey response — day 14, dose 1
MedDRA: Asthenia, Fatigue, Loss of personal independence in daily activities, Muscular weakness, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Since my vaccine I have been very tired and exhausted. My legs are weak. Im doing my daily chores but at a very slow pace. My energy level is very low. Ive contacted my Dr waiting on a consult. · Healthcare visit (other): Drs visit waiting on appt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-22
Survey response — day 21, dose 1
MedDRA: Fatigue, Headache, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I still feel tired and I get these slight headache they come & go quickly. · Healthcare visit (other): My own doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-28
Dose 2 — Moderna
2021-05-04
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Headache, Office visit, Pain — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Headache are short pains that come & go & extremely tired · Healthcare visit (other): My own doctor I go to his office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-12
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-26
Survey response — day 28, dose 2
MedDRA: Dyspnoea, Office visit, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Shortness of breath but this is due to covid I had it 2 times the vaccine is ok · Healthcare visit (other): My own Dr shiva

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-02
Survey response — day 35, dose 2
MedDRA: Fatigue, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Just very tired · Healthcare visit (other): Dr shiva my own physician

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-02
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-07-30
Survey response — 3 months, dose 2
MedDRA: Cough, Pyrexia, SARS-CoV-2 test — Feeling: Fair · Be unable to do your normal daily activities

Free text: I have fever & cough went for a covid test yesterday. Waiting on results.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-17
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-28
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-31	Moderna
2	2021-04-28	Moderna

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 7 — day 7, dose 1

2021-04-07

Systemic reaction (other): Headaches come & go

Release 7 — day 14, dose 1

2021-04-16

Symptoms: Since my vaccine I have been very tired and exhausted. My legs are weak. Im doing my daily chores but at a very slow pace. My energy level is very low. Ive contacted my Dr waiting on a consult.

Healthcare visit (other): Drs visit waiting on appt

Release 7 — day 21, dose 1

2021-04-22

Symptoms: I still feel tired and I get these slight headache they come & go quickly.

Healthcare visit (other): My own doctor

Release 8 — days 1–6 daily, dose 2

2021-05-04

Systemic reaction (other): Headache are short pains that come & go & extremely tired

Healthcare visit (other): My own doctor I go to his office

Release 8 — day 28, dose 2

2021-05-26

Symptoms: Shortness of breath but this is due to covid I had it 2 times the vaccine is ok

Healthcare visit (other): My own Dr shiva

Release 8 — day 35, dose 2

2021-06-02

Symptoms: Just very tired

Healthcare visit (other): Dr shiva my own physician

Release 9 — 3 months, dose 2

2021-07-30

Symptoms: I have fever & cough went for a covid test yesterday. Waiting on results.

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	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Cough	✓	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Muscular weakness	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pyrexia	✓	·	✓
SD	SARS-CoV-2 test	✓	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Pain	✓	✓	✓

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