3BP-32100-61541

5 vaccinations 8 coded responses 53 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 600 / IL
Registered: 2021-02-14

Relationship: Self
Race: Asian
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-02-13
Dose 1 — Moderna
2021-02-14
Registered in v-safe
2021-02-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-27
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-13
Dose 2 — Moderna
2021-03-13
Health check-in — day 0, dose 2
Feeling: Good · Site: Swelling, Itching · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Fatigue or tiredness

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 — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-27
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-12
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-11
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-19
Dose 3 — Moderna
2021-11-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-21
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-11-22
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Chills, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-23
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Chills, Joint pains

Adult check-in
2021-11-24
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains

Adult check-in
2021-11-25
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-11-26
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-12-03
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-10
Survey response — day 21, dose 3
MedDRA: Dysphonia, Hyperhidrosis, Oropharyngeal pain, Palpitations, Pharyngeal swelling, Tremor — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Sore & swollen throat, heart palpitation, hand & voice tremors, sweating

MedDRA releases: 2024-11 · check-in free text available
2021-12-10
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-13
Call 2 — Could Not Reach Participant
2021-12-16
Call 3 — Could Not Reach Participant
2021-12-17
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-24
Survey response — day 35, dose 3
MedDRA: Dry mouth, Dysphonia, Night sweats, Periorbital swelling, Swelling — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Puffy eyelids & swollen neck, night sweats, very dry mouth, hoarseness in voice

MedDRA releases: 2024-11 · check-in free text available
2021-12-24
Report sent to call center — day 35, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2021-12-27
Call 2 — Could Not Reach Participant
2021-12-30
Call 3 — Could Not Reach Participant
2022-01-01
Survey response — day 42, dose 3
MedDRA: Bone pain, Headache, Oropharyngeal pain — Feeling: Fair

Free text: Throat pains, headache, bone pain

MedDRA releases: 2024-11 · check-in free text available
2022-02-18
Survey response — 3 months, dose 3
MedDRA: Hypothyroidism, Laboratory test abnormal — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Although I suffered from hypothyroidism at the time when I received the booster shot on Nov 19, 2021, I started having symptoms of hyperthyroidism 10 days after the booster shot. Hyperthyroidism continues till now, also shown in blood work results.

MedDRA releases: 2024-11 · check-in free text available
2022-02-18
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-24
Call 1 — Left Voicemail
2022-05-23
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-07-11
Dose 4 — Moderna
2022-07-12
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-07-13
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-07-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-07-16
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Fair · Fatigue or tiredness

Free text: Lightheaded

MedDRA releases: 2024-11 · check-in free text available
2022-07-17
Survey response — days 1–6 daily, dose 4
MedDRA: Dizziness — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Lightheaded

MedDRA releases: 2024-11 · check-in free text available
2022-07-18
Survey response — day 7, dose 4
MedDRA: Dizziness — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Free text: Lightheaded

MedDRA releases: 2024-11 · check-in free text available
2022-07-25
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-08-01
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-08-08
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-08-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-22
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-10-10
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-11-17
Dose 5 — Moderna
2023-01-09
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-02-18
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-05-18
Survey response — 6 months, dose 5
MedDRA: Ear pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-05-18
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-05-19
Call 1 — Left Voicemail
2023-05-19
Call 1 — Left Voicemail
2023-05-19
Call 2 — Left Voicemail
2023-05-19
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Moderna
2	2021-03-13	Moderna
3	2021-11-19	Moderna	No
4	2022-07-11	Moderna	No
5	2022-11-17	Moderna	No

Call center

4 call center cases

4 unsuccessful

See the call center timeline

Free text

Release 10 — day 21, dose 3

2021-12-10

Symptoms: Sore & swollen throat, heart palpitation, hand & voice tremors, sweating

Release 10 — day 35, dose 3

2021-12-24

Symptoms: Puffy eyelids & swollen neck, night sweats, very dry mouth, hoarseness in voice

Release 10 — day 42, dose 3

2022-01-01

Symptoms: Throat pains, headache, bone pain

Release 11 — 3 months, dose 3

2022-02-18

Symptoms: Although I suffered from hypothyroidism at the time when I received the booster shot on Nov 19, 2021, I started having symptoms of hyperthyroidism 10 days after the booster shot. Hyperthyroidism continues till now, also shown in blood work results. cut off by CDC

Release 12 — days 1–6 daily, dose 4

2022-07-16

Systemic reaction (other): Lightheaded

2022-07-17

Systemic reaction (other): Lightheaded

Release 12 — day 7, dose 4

2022-07-18

Systemic reaction (other): Lightheaded

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	Bone pain	·	·	✓
SD	Dry mouth	·	·	✓
SD	Dysphonia	·	·	✓
SD	Ear pain	·	·	✓
SD	Headache	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Hypothyroidism	·	·	✓
SD	Laboratory test abnormal	·	·	✓
SD	Night sweats	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Palpitations	·	·	✓
SD	Periorbital swelling	·	·	✓
SD	Pharyngeal swelling	·	·	✓
SD	Swelling	·	·	✓
SD	Tremor	·	·	✓
SRO	Dizziness	·	·	✓

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