2QB-11031-47401

3 vaccinations 12 coded responses 30 check-ins 12 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 774 / TX
Registered: 2021-01-12

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

2021-01-11
Dose 1 — Moderna
2021-01-12
Registered in v-safe
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Swelling · Headache, Fatigue or tiredness

Free text: Did have low grade temp 99.2 last night but not since

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-18
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-25
Survey response — day 14, dose 1
MedDRA: Condition aggravated — Feeling: Fair · Be unable to do your normal daily activities

Free text: Shortness of breath, laryngitis, achy, tired. But these are similar to mr flareups with asthma.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — day 21, dose 1
MedDRA: Dyspnoea, Hypersensitivity — Feeling: Good

Free text: Still a bit of shortness of breath but really feel this is more due to allergies.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Dose 2 — Moderna
2021-02-08
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Pyrexia — Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Had fever 101 overnight but not since

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Survey response — day 7, dose 2
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Rash on left neck. Not sure if related.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Survey response — day 14, dose 2
MedDRA: Pre-existing disease, Rash — Feeling: Good

Free text: Rash on left side has flared up.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-08
Survey response — day 28, dose 2
MedDRA: Diarrhoea, Rash — Feeling: Good · Be unable to do your normal daily activities

Free text: Diarrhea x 2 daysRash worsened but better now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-10
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-09
Survey response — 6 months, dose 2
MedDRA: Fatigue, Headache, Nausea, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Headache, fatigue, nausea, achy

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-22
Dose 3 — Moderna
2021-10-25
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-10-27
Survey response — day 35, dose 3
MedDRA: Laryngitis, Pre-existing disease, Respiratory tract congestion — Feeling: Fair

Free text: Just allergies and chest congestion, laryngitis

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — day 42, dose 3
MedDRA: Respiratory tract congestion — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Still dealing with chest congestion

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Report sent to call center — day 42, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-03-23
Survey response — 6 months, dose 3
MedDRA: Asthma, Nasopharyngitis, Pre-existing disease, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Cold like symptoms settled in chest with asthma flare up · Healthcare visit (other): Steroids and zpak

MedDRA releases: 2024-11 · check-in free text available
2022-03-23
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 · 1 call case(s)
2022-03-24
Call 1 — Left Voicemail
2022-03-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-03-24
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-09-22
Survey response — 12 months, dose 3
MedDRA: Fungal skin infection, Rash — Feeling: Good · 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: Rash under both breasts probably fungal. On treatment, not Covid related

MedDRA releases: 2024-11 · check-in free text available
2022-09-22
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-09-23
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-11	Moderna
2	2021-02-08	Moderna
3	2021-09-22	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-13

Systemic reaction (other): Did have low grade temp 99.2 last night but not since

Release 2 — day 14, dose 1

2021-01-25

Symptoms: Shortness of breath, laryngitis, achy, tired. But these are similar to mr flareups with asthma.

Release 3 — day 21, dose 1

2021-02-01

Symptoms: Still a bit of shortness of breath but really feel this is more due to allergies.

Release 3 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Had fever 101 overnight but not since

Release 4 — day 7, dose 2

2021-02-15

Systemic reaction (other): Rash on left neck. Not sure if related.

Release 4 — day 14, dose 2

2021-02-22

Symptoms: Rash on left side has flared up.

Release 5 — day 28, dose 2

2021-03-08

Symptoms: Diarrhea x 2 daysRash worsened but better now.

Release 9 — 6 months, dose 2

2021-08-09

Symptoms: Headache, fatigue, nausea, achy

Release 10 — day 35, dose 3

2021-10-27

Symptoms: Just allergies and chest congestion, laryngitis

Release 10 — day 42, dose 3

2021-11-03

Symptoms: Still dealing with chest congestion

Release 11 — 6 months, dose 3

2022-03-23

Symptoms: Cold like symptoms settled in chest with asthma flare up

Healthcare visit (other): Steroids and zpak

Release 12 — 12 months, dose 3

2022-09-22

Symptoms: Rash under both breasts probably fungal. On treatment, not Covid related

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	Unevaluable event	·	·	✓
SD	Asthma	·	·	✓
SD	Condition aggravated	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Fungal skin infection	·	·	✓
SD	Headache	✓	·	✓
SD	Hypersensitivity	✓	✓	✓
SD	Laryngitis	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Nausea	✓	·	✓
SD	Pain	✓	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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