34Q-14611-29809

4 vaccinations 11 coded responses 37 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 346 / FL
Registered: 2021-04-25

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

2021-04-22
Dose 1 — Moderna
2021-04-25
Registered in v-safe
2021-04-25
Survey response — days 1–6 daily, dose 1
MedDRA: Night sweats — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness, Diarrhea

Free text: Night sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-26
Survey response — days 1–6 daily, dose 1
MedDRA: Lip blister, Oral herpes — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Diarrhea

Free text: Got a fever blister on lip.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-28
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea, Pre-existing disease, Self-medication — Feeling: Good · Site: Swelling, Itching · Diarrhea

Free text: Diarrhea is soupy liquid. Taking now over counter Lopetamide Hci twice a day. This not just from shot.. diarrheal is result from Cancer treatment. On a break since FEB 2021

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-29
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-05-06
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-05-13
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-20
Dose 2 — Moderna
2021-05-20
Health check-in — day 0, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-05-21
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-05-22
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Night sweats, Pyrexia, Tremor — Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Free text: Night sweats.. so bad wet sheets. FRIDAY night chills shaking fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-05-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · None

Adult check-in
2021-05-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-05-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-27
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-06-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-17
Survey response — day 28, dose 2
MedDRA: Dizziness, Vertigo, Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: Vertigo..for 3 days. Throwing up dizzy ..could be inner ear problem..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-01
Survey response — day 42, dose 2
MedDRA: Vertigo, Vision blurred — Feeling: Good · Be unable to do your normal daily activities

Free text: Vertigo blurry vision.. seeing eye dr. Soon.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-19
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Dose 3 — Moderna
Co-administered: Flu
2021-11-18
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-26
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-18
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-04
Survey response — 3 months, dose 3
MedDRA: Arthralgia, Cardiac disorder — Feeling: Good

Free text: Knee joint pain. Heart issuses.

MedDRA releases: 2024-11 · check-in free text available
2022-05-06
Survey response — 6 months, dose 3
MedDRA: Neuropathy peripheral, Office visit, Physiotherapy — Feeling: Good · Be unable to do your normal daily activities

Free text: Increase of neuropathy in left foot.. Seeibg a neurologist., doing PT twice a week. For 8 weeks so far.

MedDRA releases: 2024-11 · check-in free text available
2022-05-09
Dose 4 — Moderna
2022-05-19
Health check-in — day 7, dose 4
Feeling: Good · Site: Redness, Swelling · Chills, Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-05-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-30
Survey response — day 21, dose 4
MedDRA: COVID-19, Pre-existing disease, Pulmonary fibrosis, Wheezing — Feeling: Good

Free text: This week had chest xrays, cause Dr. Heard wheezing??. I feel fine. In 2020 had covid while having cancer treatments. Told in 2020 scars in bottom of lungsdue to covid. In ct scans in 2021 showed no cancer, no concern with lungs.

MedDRA releases: 2024-11 · check-in free text available
2022-06-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-13
Survey response — day 35, dose 4
MedDRA: Inflammatory marker increased, Office visit, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Extremely high inflammation blood test results taken 3/27..follow up with Drs. · Healthcare visit (other): Referal to Rheumatologist.

MedDRA releases: 2024-11 · check-in free text available
2022-06-13
Report sent to call center — day 35, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-08
Survey response — 3 months, dose 4
MedDRA: Blood test abnormal, Hepatic enzyme increased, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: High liver enzymes. Adnormal blood work. · Healthcare visit (other): Cancer Doctor

MedDRA releases: 2024-11 · check-in free text available
2022-08-08
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-08-09
Call 1 — Left Voicemail
2022-08-09
Call 1 — Left Voicemail
2023-05-09
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-22	Moderna
2	2021-05-20	Moderna
3	2021-11-05	Moderna	Flu
4	2022-05-09	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-25

Systemic reaction (other): Night sweats

Release 8 — days 1–6 daily, dose 1

2021-04-26

Systemic reaction (other): Got a fever blister on lip.

2021-04-28

Systemic reaction (other): Diarrhea is soupy liquid. Taking now over counter Lopetamide Hci twice a day. This not just from shot.. diarrheal is result from Cancer treatment. On a break since FEB 2021

Release 8 — days 1–6 daily, dose 2

2021-05-22

Systemic reaction (other): Night sweats.. so bad wet sheets. FRIDAY night chills shaking fever.

Release 9 — day 28, dose 2

2021-06-17

Symptoms: Vertigo..for 3 days. Throwing up dizzy ..could be inner ear problem..

Release 9 — day 42, dose 2

2021-07-01

Symptoms: Vertigo blurry vision.. seeing eye dr. Soon.

Release 11 — 3 months, dose 3

2022-02-04

Symptoms: Knee joint pain. Heart issuses.

Release 11 — 6 months, dose 3

2022-05-06

Symptoms: Increase of neuropathy in left foot.. Seeibg a neurologist., doing PT twice a week. For 8 weeks so far.

Release 11 — day 21, dose 4

2022-05-30

Symptoms: This week had chest xrays, cause Dr. Heard wheezing??. I feel fine. In 2020 had covid while having cancer treatments. Told in 2020 scars in bottom of lungsdue to covid. In ct scans in 2021 showed no cancer, no concern with lungs.

Release 12 — day 35, dose 4

2022-06-13

Symptoms: Extremely high inflammation blood test results taken 3/27..follow up with Drs.

Healthcare visit (other): Referal to Rheumatologist.

Release 12 — 3 months, dose 4

2022-08-08

Symptoms: High liver enzymes. Adnormal blood work.

Healthcare visit (other): Cancer Doctor

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	Arthralgia	·	·	✓
SD	Blood test abnormal	·	·	✓
SD	Cardiac disorder	·	·	✓
SD	COVID-19	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Hepatic enzyme increased	·	·	✓
SD	Inflammatory marker increased	·	·	✓
SD	Neuropathy peripheral	·	·	✓
SD	Office visit	·	·	✓
SD	Physiotherapy	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pulmonary fibrosis	·	·	✓
SD	Vertigo	✓	✓	✓
SD	Vision blurred	✓	✓	✓
SD	Vomiting	✓	✓	✓
SD	Wheezing	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Lip blister	✓	✓	✓
SRO	Night sweats	✓	✓	✓
SRO	Oral herpes	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Tremor	✓	✓	✓

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