34H-17866-42655

5 vaccinations 4 coded responses 33 check-ins 4 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 432 / OH
Registered: 2021-02-12

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

2021-02-12
Registered in v-safe
2021-02-12
Dose 1 — Moderna
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-02-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-21
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-12
Dose 2 — Moderna
2021-03-12
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Heart rate irregular — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Increase in irregular heartbeat, shortness of breath last night, normal when woke this morning.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-19
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-28
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-11
Health check-in — 3 months, dose 2
Feeling: Good

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

Adult check-in
2021-12-02
Dose 3 — Moderna
Co-administered: Flu
2022-03-12
Survey response — 12 months, dose 2
MedDRA: Cardiac ablation, Cardiac failure, Ejection fraction decreased, Hospitalisation, Office visit, Pre-existing disease, Supraventricular tachycardia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Hospitalized with SVT, 2/16, successful ablation 2/18. Chronic problem since 1994. Caused return of heart failure. EF 40%. 3/3 nuclear stress test showed no coronary blockage. Continuing treatment w/ heart failure doctor.

MedDRA releases: 2024-11 · check-in free text available
2022-03-12
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

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-03-15
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-08-09
Dose 4 — Moderna
2022-11-07
Dose 5 — Moderna
Co-administered: Flu
2022-11-09
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-11
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-12
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-13
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-16
Health check-in — day 7, dose 5
Feeling: Poor · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-21
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-11-28
Survey response — day 21, dose 5
MedDRA: Cough, Dysphonia, Fatigue, Nasopharyngitis, Rhinorrhoea, Sneezing, Throat irritation — Feeling: Good · Be unable to do your normal daily activities

Free text: Cold; 2wks & counting. Respiratory only: runny nose, sneezing, dry tickling cough. Clear discharge. Extreme fatigue 1st wk. Hoarseness in last 5 days. NO fever, chills, sore throat, congestion, headache, or muscle/joint pain.

MedDRA releases: 2024-11 · check-in free text available
2022-12-05
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-12-12
Survey response — day 35, dose 5
MedDRA: Cough, Laryngitis — Feeling: Fair

Free text: Laryngitis and dry cough returned.

MedDRA releases: 2024-11 · check-in free text available
2022-12-19
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-02-06
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-05-08
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-12	Moderna
2	2021-03-12	Moderna
3	2021-12-02	Moderna	Flu
4	2022-08-09	Moderna	No
5	2022-11-07	Moderna	Flu

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 2

2021-03-13

Systemic reaction (other): Increase in irregular heartbeat, shortness of breath last night, normal when woke this morning.

Release 11 — 12 months, dose 2

2022-03-12

Symptoms: Hospitalized with SVT, 2/16, successful ablation 2/18. Chronic problem since 1994. Caused return of heart failure. EF 40%. 3/3 nuclear stress test showed no coronary blockage. Continuing treatment w/ heart failure doctor.

Release 12 — day 21, dose 5

2022-11-28

Symptoms: Cold; 2wks & counting. Respiratory only: runny nose, sneezing, dry tickling cough. Clear discharge. Extreme fatigue 1st wk. Hoarseness in last 5 days. NO fever, chills, sore throat, congestion, headache, or muscle/joint pain.

Release 12 — day 35, dose 5

2022-12-12

Symptoms: Laryngitis and dry cough returned.

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	Cardiac ablation	·	·	✓
SD	Cardiac failure	·	·	✓
SD	Cough	·	·	✓
SD	Dysphonia	·	·	✓
SD	Ejection fraction decreased	·	·	✓
SD	Fatigue	·	·	✓
SD	Hospitalisation	·	·	✓
SD	Laryngitis	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sneezing	·	·	✓
SD	Supraventricular tachycardia	·	·	✓
SD	Throat irritation	·	·	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Heart rate irregular	✓	✓	✓

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