35V-30109-87503

3 vaccinations 9 coded responses 37 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 303 / GA
Registered: 2021-01-17

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

2021-01-16
Dose 1 — Moderna
2021-01-17
Registered in v-safe
2021-01-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: Malaise — Feeling: Good · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Yesterday my husband fill this out for me I was feeling feverish but I had no fever and just general malaise.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-23
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-13
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-20
Dose 2 — Moderna
2021-02-20
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Rhinorrhoea — Feeling: Fair · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Slight cough and runny nose

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Feeling abnormal — Feeling: Fair · Fatigue or tiredness

Free text: Light headed, foggy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Feeling abnormal, Sinus disorder — Feeling: Fair · Fever · Fatigue or tiredness

Free text: Foggy tired sinus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — day 7, dose 2
MedDRA: Headache — Feeling: Good · Fatigue or tiredness

Free text: Slight headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-22
Survey response — 3 months, dose 2
MedDRA: Burning sensation, Fatigue, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue and Burning sensation in my arms and legs its not all the time nor every day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-20
Dose 3 — Moderna
2021-12-20
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-21
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-22
Survey response — days 1–6 daily, dose 3
MedDRA: Adverse reaction — Feeling: Fair · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Less than yesterday

MedDRA releases: 2024-11 · check-in free text available
2021-12-23
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Itching · Fever · Fatigue or tiredness, Diarrhea

Adult check-in
2021-12-24
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Fever · Fatigue or tiredness

Adult check-in
2021-12-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-12-26
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Fatigue or tiredness

Adult check-in
2021-12-27
Health check-in — day 7, dose 3
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-01-03
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-10
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-17
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-26
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-31
Survey response — day 42, dose 3
MedDRA: Fatigue, Heart rate irregular, Hypertension, Malaise — Feeling: Fair · Be unable to do your normal daily activities

Free text: It could be unrelated but I've had sort of irregular heartbeat and some Fatigue and higher blood pressure. After the second shot with Moderna I had about 4 to 6 weeks of general malaise and fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-03-21
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-06-20
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-12-20
Survey response — 12 months, dose 3
MedDRA: Fatigue, Office visit, Reaction to previous exposure to any vaccine, Vaccine positive rechallenge — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I've had a lot of fatigue since the the last Covid vaccine. It seems each time I take one I get a little more tired. I don't really have fatigue often. So it feels like it has been related to these vaccines. Perhaps not. · Healthcare visit (other): In office visit

MedDRA releases: 2024-11 · check-in free text available
2022-12-20
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

1 call case(s)
2022-12-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-16	Moderna
2	2021-02-20	Moderna
3	2021-12-20	Moderna	No

Call center

2 call center cases

1 unsuccessful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-18

Systemic reaction (other): Yesterday my husband fill this out for me I was feeling feverish but I had no fever and just general malaise.

Release 4 — days 1–6 daily, dose 2

2021-02-22

Systemic reaction (other): Slight cough and runny nose

2021-02-23

Systemic reaction (other): Light headed, foggy

2021-02-24

Systemic reaction (other): Foggy tired sinus

Release 4 — day 7, dose 2

2021-02-27

Systemic reaction (other): Slight headache.

Release 8 — 3 months, dose 2

2021-05-22

Symptoms: Fatigue and Burning sensation in my arms and legs its not all the time nor every day

Release 10 — days 1–6 daily, dose 3

2021-12-22

Systemic reaction (other): Less than yesterday

Release 11 — day 42, dose 3

2022-01-31

Symptoms: It could be unrelated but I've had sort of irregular heartbeat and some Fatigue and higher blood pressure. After the second shot with Moderna I had about 4 to 6 weeks of general malaise and fatigue.

Release 12 — 12 months, dose 3

2022-12-20

Symptoms: I've had a lot of fatigue since the the last Covid vaccine. It seems each time I take one I get a little more tired. I don't really have fatigue often. So it feels like it has been related to these vaccines. Perhaps not.

Healthcare visit (other): In office visit

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	Burning sensation	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Heart rate irregular	·	·	✓
SD	Hypertension	·	·	✓
SD	Malaise	·	·	✓
SD	Myalgia	✓	✓	○
SD	Reaction to previous exposure to any vaccine	·	·	✓
SD	Vaccine positive rechallenge	·	·	✓
SRO	Adverse reaction	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓

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