2T8-14765-39800

3 vaccinations 9 coded responses 24 check-ins 6 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 841 / UT
Registered: 2021-02-17

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

2021-02-16
Dose 1 — Moderna
2021-02-17
Registered in v-safe
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-18
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Yesterday...felt a little fatigued

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills

Adult check-in
2021-02-23
Health check-in — day 7, dose 1
Feeling: Fair · Muscle or body aches

Adult check-in
2021-03-02
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-09
Survey response — day 21, dose 1
MedDRA: Asthenia, Sensitivity to weather change — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lacking energy but could be weather related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Dose 2 — Moderna
2021-03-30
Survey response — day 14, dose 2
MedDRA: Asthenia, Blood pressure increased, Headache, Hypertension, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Lack of energy & headacheSpike in bp, dr asvised me to double my dose of losartan

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-06
Survey response — day 21, dose 2
MedDRA: Blood pressure abnormal, Lethargy — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lethargic, unable to control Blood pressure, even with BP medication

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-20
Survey response — day 35, dose 2
MedDRA: Blood pressure inadequately controlled, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Unable to control blood pressure. I am taking BP medication. Dr has doubled the dosage, but it still spikes out of normal. · Healthcare visit (other): Dr office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-27
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-06-15
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-14
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-01-24
Call 1 — Left Voicemail
2022-03-16
Survey response — 12 months, dose 2
MedDRA: Discomfort, Intervertebral disc displacement, Musculoskeletal chest pain, Scoliosis, Unevaluable event, Urinary tract infection — Feeling: Fair · 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: Symptoms: Urinary tract infection After 7 days of antibiotics, back to normal. 2- pain & tightness in rib cage. Had MRI. It reveals slight scoliosis & L1 vertebrae tipped.Review with Dr soon. · Healthcare visit (other): ANTIBIOTIC & MRI

MedDRA releases: 2024-11 · check-in free text available
2022-03-16
Report sent to call center — 12 months, dose 2
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)
2022-03-17
Call 1 — Left Voicemail
2022-03-17
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-12-16
Dose 3 — Pfizer-BioNTech
Co-administered: Tetanus
2023-01-02
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2023-01-06
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2023-01-13
Survey response — day 28, dose 3
MedDRA: Vaginal infection, Vulvovaginal burning sensation, Vulvovaginal pruritus — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-01-13
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-16
Call successful
Not applicable - Accidental Reporting
2023-01-21
Survey response — day 35, dose 3
MedDRA: Back disorder, Scoliosis — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-01-27
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2023-03-17
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2023-06-19
Survey response — 6 months, dose 3
MedDRA: Blood cobalt increased, Blood disorder, Complication associated with device, Condition aggravated, Malaise, Metal poisoning, Pre-existing disease, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-16	Moderna
2	2021-03-16	Moderna
3	2022-12-16	Pfizer-BioNTech	Tetanus

Call center

4 call center cases

4 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-18

Systemic reaction (other): Yesterday...felt a little fatigued

Release 5 — day 21, dose 1

2021-03-09

Symptoms: Lacking energy but could be weather related

Release 6 — day 14, dose 2

2021-03-30

Symptoms: Lack of energy & headacheSpike in bp, dr asvised me to double my dose of losartan

Release 7 — day 21, dose 2

2021-04-06

Symptoms: Lethargic, unable to control Blood pressure, even with BP medication

Release 7 — day 35, dose 2

2021-04-20

Symptoms: Unable to control blood pressure. I am taking BP medication. Dr has doubled the dosage, but it still spikes out of normal.

Healthcare visit (other): Dr office visit

Release 11 — 12 months, dose 2

2022-03-16

Symptoms: Urinary tract infection After 7 days of antibiotics, back to normal. 2- pain & tightness in rib cage. Had MRI. It reveals slight scoliosis & L1 vertebrae tipped.Review with Dr soon.

Healthcare visit (other): ANTIBIOTIC & MRI

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	Back disorder	·	·	✓
SD	Blood cobalt increased	·	·	✓
SD	Blood disorder	·	·	✓
SD	Blood pressure abnormal	✓	✓	✓
SD	Blood pressure inadequately controlled	✓	✓	✓
SD	Blood pressure increased	✓	✓	✓
SD	Complication associated with device	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Discomfort	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Intervertebral disc displacement	·	·	✓
SD	Lethargy	✓	✓	✓
SD	Malaise	·	·	✓
SD	Metal poisoning	·	·	✓
SD	Musculoskeletal chest pain	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Scoliosis	·	·	✓
SD	Sensitivity to weather change	✓	✓	✓
SD	Unevaluable event	·	·	✓
SD	Urinary tract infection	·	·	✓
SD	Vaginal infection	·	·	✓
SD	Vulvovaginal burning sensation	·	·	✓
SD	Vulvovaginal pruritus	·	·	✓
SRO	Fatigue	✓	✓	✓

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