3FA-29227-91828

2 vaccinations 8 coded responses 25 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 791 / TX
Registered: 2021-01-05

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-05
Registered in v-safe
2021-01-05
Dose 1 — Moderna
2021-01-05
Survey response — day 0, dose 1
MedDRA: Angina pectoris, Atrial fibrillation, Dyspnoea, Pre-existing disease — Feeling: Fair · Site: Pain · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Free text: I have Angina and Afib. I had a little Angina epidode (pain) that I hadn't had in a long time. Also a little bit of shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-08
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Headache, Nausea — Feeling: Good · Chills, Headache, Nausea

Free text: Chills and headache didn't kast long and I had nausea for a few seconds as I sat up when I woke up this morning

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

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Self-medication — Feeling: Good · Headache

Free text: The headache was as I woke up this morning before I got out of bed but once I got upvit was gone within minutes. Maybe 2 or three minutes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Survey response — day 14, dose 1
MedDRA: Abdominal discomfort — Feeling: Good

Free text: Upset stomach yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — day 21, dose 1
MedDRA: Myalgia — Feeling: Fair

Free text: Muscle aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Dose 2 — Moderna
2021-02-02
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: I had shortness of breath last night but I can't pinpoint it to the vaccine because I have Afib and that's one of the symptoms to Afib

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · None

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-09
Survey response — day 35, dose 2
MedDRA: Fall, Headache — Feeling: Good · Be unable to do your normal daily activities

Free text: I have fallen four times in one week. I get slight head aches in the evening which don't last very long.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-16
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-03
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-02-02
Survey response — 12 months, dose 2
MedDRA: Axillary pain, Bone pain, Chest pain, Fatigue, Injection site pain, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I have been doing pretty good except the day after i got the booster. My arm hurt all the way from the place of shot to my under arm to my chest. My chest bone hurts every morning when I get out of bed for about 5 minutes. I also felt tired. · Healthcare visit (other): Dr's appt. He asked for a chest xray

MedDRA releases: 2024-11 · check-in free text available
2022-02-02
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

1 call case(s)
2022-03-25
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-05	Moderna
2	2021-02-02	Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 1 — day 0, dose 1

2021-01-05

Systemic reaction (other): I have Angina and Afib. I had a little Angina epidode (pain) that I hadn't had in a long time. Also a little bit of shortness of breath

Release 1 — days 1–6 daily, dose 1

2021-01-08

Systemic reaction (other): Chills and headache didn't kast long and I had nausea for a few seconds as I sat up when I woke up this morning

2021-01-11

Systemic reaction (other): The headache was as I woke up this morning before I got out of bed but once I got upvit was gone within minutes. Maybe 2 or three minutes.

Release 2 — day 14, dose 1

2021-01-19

Symptoms: Upset stomach yesterday

Release 2 — day 21, dose 1

2021-01-26

Symptoms: Muscle aches

Release 3 — days 1–6 daily, dose 2

2021-02-03

Systemic reaction (other): I had shortness of breath last night but I can't pinpoint it to the vaccine because I have Afib and that's one of the symptoms to Afib

Release 5 — day 35, dose 2

2021-03-09

Symptoms: I have fallen four times in one week. I get slight head aches in the evening which don't last very long.

Release 11 — 12 months, dose 2

2022-02-02

Symptoms: I have been doing pretty good except the day after i got the booster. My arm hurt all the way from the place of shot to my under arm to my chest. My chest bone hurts every morning when I get out of bed for about 5 minutes. I also felt tired.

Healthcare visit (other): Dr's appt. He asked for a chest xray

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	Abdominal discomfort	✓	✓	✓
SD	Axillary pain	·	·	✓
SD	Bone pain	·	·	✓
SD	Chest pain	·	·	✓
SD	Fall	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Headache	✓	✓	✓
SD	Injection site pain	·	·	✓
SD	Myalgia	✓	✓	✓
SRO	Angina pectoris	✓	✓	✓
SRO	Atrial fibrillation	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Self-medication	✓	✓	✓

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