2V4-12404-49179

2 vaccinations 7 coded responses 17 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 129 / NY
Registered: 2021-01-11

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
Registered in v-safe
2021-01-11
Dose 1 — Moderna
2021-01-11
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Survey response — days 1–6 daily, dose 1
MedDRA: Respiratory tract congestion, Rhinorrhoea, Sneezing — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness

Free text: Congestion, sneezing, runny nose

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 · Site: Pain · None

Adult check-in
2021-01-15
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea, Diarrhea

Free text: Dizzy. I dont think its related to vaccination

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-25
Survey response — day 14, dose 1
MedDRA: Respiratory tract congestion, Sneezing — Feeling: Fair

Free text: Congested and sneezing

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

Adult check-in
2021-02-08
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-22
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-23
Survey response — day 14, dose 2
MedDRA: Diarrhoea — Feeling: Fair

Free text: Diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-09
Survey response — day 28, dose 2
MedDRA: Office visit, Pain — Feeling: Good · Be unable to work, Get care from a doctor or other healthcare professional

Free text: Symptoms: Sharp stabbing pain in left side. Had resolved itself, but returned 72 hours ago · Healthcare visit (other): Regular physician in office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Report sent to call center — day 28, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-16
Survey response — day 35, dose 2
MedDRA: Computerised tomogram abnormal, Flank pain, Hepatic steatosis, Herpes zoster, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I still have pain in my side. My MD ordered a CT scan w/contrast. Liver is fatty, but gall bladder, pancreas, kidneys all clean. She is thinking shingles, but I have no rash. Pain is not constant. Comes and goes with no clear pattern. · Healthcare visit (other): Saw my regular provider in person

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-23
Survey response — day 42, dose 2
MedDRA: Flank pain, Office visit — Feeling: Fair · Be unable to work, Get care from a doctor or other healthcare professional

Free text: Symptoms: The pain in my side will not go away. It is a searing, sharp burning pain. It comes in without warning, and then leaves with no residual effects · Healthcare visit (other): Regular face to face with my family provider

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-23
Report sent to call center — day 42, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-12-22
Call 1 — Left Voicemail
2022-02-09
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-11	Moderna
2	2021-02-09	Moderna

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-13

Systemic reaction (other): Congestion, sneezing, runny nose

Release 2 — days 1–6 daily, dose 1

2021-01-15

Systemic reaction (other): Dizzy. I dont think its related to vaccination

Release 2 — day 14, dose 1

2021-01-25

Symptoms: Congested and sneezing

Release 4 — day 14, dose 2

2021-02-23

Symptoms: Diarrhea

Release 5 — day 28, dose 2

2021-03-09

Symptoms: Sharp stabbing pain in left side. Had resolved itself, but returned 72 hours ago

Healthcare visit (other): Regular physician in office visit

Release 5 — day 35, dose 2

2021-03-16

Symptoms: I still have pain in my side. My MD ordered a CT scan w/contrast. Liver is fatty, but gall bladder, pancreas, kidneys all clean. She is thinking shingles, but I have no rash. Pain is not constant. Comes and goes with no clear pattern.

Healthcare visit (other): Saw my regular provider in person

Release 6 — day 42, dose 2

2021-03-23

Symptoms: The pain in my side will not go away. It is a searing, sharp burning pain. It comes in without warning, and then leaves with no residual effects

Healthcare visit (other): Regular face to face with my family provider

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	Computerised tomogram abnormal	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Flank pain	✓	✓	✓
SD	Hepatic steatosis	✓	✓	✓
SD	Herpes zoster	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sneezing	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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