3J8-27868-96323

5 vaccinations 13 coded responses 65 check-ins 11 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 720 / AR
Registered: 2021-01-25

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

2021-01-25
Registered in v-safe
2021-01-25
Dose 1 — Moderna
2021-01-25
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Chills, Joint pains, Fatigue or tiredness, Diarrhea

Adult check-in
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Diarrhea, Abdominal pain

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea, Abdominal pain

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Abdominal pain

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-01
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-15
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-22
Dose 2 — Moderna
2021-02-22
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain, Itching · Chills, Joint pains, Muscle or body aches

Adult check-in
2021-02-23
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, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Swelling, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness · None

Adult check-in
2021-03-01
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-03-08
Survey response — day 14, dose 2
MedDRA: Fatigue, Hypersomnia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme fatigue. Sleeping 14 plus hours a day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-24
Survey response — 3 months, dose 2
MedDRA: Abdominal pain, Abdominal tenderness — Feeling: Poor

Free text: Abdominal pain and tenderness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-23
Survey response — 6 months, dose 2
MedDRA: Arthralgia, Joint swelling — Feeling: Fair

Free text: Generalized arthritis pain and joint swdd we lljng

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-27
Dose 3 — Moderna
2021-10-27
Health check-in — day 0, dose 3
Feeling: Fair · Chills

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Fever · Chills

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · None

Adult check-in
2021-11-03
Health check-in — day 7, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness, Diarrhea

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

Adult check-in
2021-11-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-24
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-08
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-26
Survey response — 3 months, dose 3
MedDRA: COVID-19, Pancreatitis — Feeling: Fair · 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: Pancreatitis and Covid 19

MedDRA releases: 2024-11 · check-in free text available
2022-01-26
Report sent to call center — 3 months, dose 3
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)
2022-01-27
Call 1 — Could Not Reach Participant
2022-02-01
Call 2 — Could Not Reach Participant
2022-04-27
Survey response — 6 months, dose 3
MedDRA: Biliary obstruction, Cholecystectomy, Pneumonia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Cholecystectomy and bile duct obstruction and CB pneumonia

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-04-28
Call 3 — Left Voicemail
2022-05-27
Dose 4 — Moderna
2022-05-28
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches

Adult check-in
2022-05-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-30
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-05-31
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Redness, Swelling · Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2022-06-01
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-06-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Swelling · None

Adult check-in
2022-06-03
Health check-in — day 7, dose 4
Feeling: Fair · Site: Redness, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-06-10
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-06-17
Survey response — day 21, dose 4
MedDRA: Arthralgia, Joint swelling, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Joint pain and swelling · Healthcare visit (other): Visits to doctor office

MedDRA releases: 2024-11 · check-in free text available
2022-06-17
Report sent to call center — day 21, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-06-21
Call 3 — Could Not Reach Participant
2022-06-24
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-07-01
Survey response — day 35, dose 4
MedDRA: Rash — Feeling: Good

Free text: Rash of unknown origin

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Survey response — day 42, dose 4
MedDRA: Arthralgia, Arthritis, Headache, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Prolonged joint pain and inflammation and unexplained headache · Healthcare visit (other): Md office

MedDRA releases: 2024-11 · check-in free text available
2022-07-08
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-07-11
Call 3 — Left Voicemail
2022-08-26
Survey response — 3 months, dose 4
MedDRA: Balance disorder, Dizziness, Hysterectomy, Office visit, Urinary bladder suspension, Vertigo, Weight bearing difficulty — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Extreme vertigo and dizziness and loss of balance. Unable to bear weight on right leg. To have knee replacement when I've recovered from hysterectomy and bladder sling. · Healthcare visit (other): Multiple doctor appts

MedDRA releases: 2024-11 · check-in free text available
2022-08-26
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-08-29
Call 3 — Left Voicemail
2022-10-10
Dose 5 — Moderna
2022-10-11
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-12
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Muscle or body aches

Adult check-in
2022-10-13
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2022-10-14
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2022-10-15
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · None

Adult check-in
2022-10-16
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-10-17
Health check-in — day 7, dose 5
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-10-24
Health check-in — day 14, dose 5
Feeling: Fair

Adult check-in
2022-10-31
Survey response — day 21, dose 5
MedDRA: Influenza like illness — Feeling: Fair

Free text: Flu like symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-11-07
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-11-14
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-21
Survey response — day 42, dose 5
MedDRA: Influenza A virus test negative, Influenza B virus test negative, Office visit, SARS-CoV-2 test negative, Viral upper respiratory tract infection — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Viral infection upper respiratory. Negative for Covid. Negative flu both A and B. · Healthcare visit (other): MD office

MedDRA releases: 2024-11 · check-in free text available
2022-11-21
Report sent to call center — day 42, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-22
Call X — Left Voicemail
2022-11-22
Call X — Left Voicemail
2022-11-22
Call X — Left Voicemail
2022-11-22
Call X — Left Voicemail
2022-11-22
Call X — Left Voicemail
2022-11-22
Call 3 — Left Voicemail
2023-01-09
Survey response — 3 months, dose 5
MedDRA: Arthralgia, Asthma, Fluid retention, Oedema, Pre-existing disease, Respiratory disorder — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11
2023-04-10
Survey response — 6 months, dose 5
MedDRA: Diverticulitis, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-04-10
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

1 call case(s)
2023-04-11
Call 3 — Could Not Reach Participant
2023-04-11
Call 1 — Could Not Reach Participant
2023-04-11
Call 1 — Could Not Reach Participant
2023-04-11
Call 1 — Could Not Reach Participant
2023-04-11
Call 1 — Could Not Reach Participant
2023-04-11
Call 1 — Could Not Reach Participant
2023-04-11
Call 1 — Could Not Reach Participant
2023-04-14
Call 2 — Could Not Reach Participant
2023-04-14
Call 2 — Could Not Reach Participant
2023-04-14
Call 2 — Could Not Reach Participant
2023-04-14
Call 2 — Could Not Reach Participant
2023-04-14
Call 2 — Could Not Reach Participant
2023-04-14
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-25	Moderna
2	2021-02-22	Moderna
3	2021-10-27	Moderna	No
4	2022-05-27	Moderna	No
5	2022-10-10	Moderna	No

Call center

7 call center cases

7 unsuccessful

See the call center timeline

Free text

Release 5 — day 14, dose 2

2021-03-08

Symptoms: Extreme fatigue. Sleeping 14 plus hours a day

Release 8 — 3 months, dose 2

2021-05-24

Symptoms: Abdominal pain and tenderness

Release 9 — 6 months, dose 2

2021-08-23

Symptoms: Generalized arthritis pain and joint swdd we lljng

Release 11 — 3 months, dose 3

2022-01-26

Symptoms: Pancreatitis and Covid 19

Release 11 — 6 months, dose 3

2022-04-27

Symptoms: Cholecystectomy and bile duct obstruction and CB pneumonia

Release 12 — day 21, dose 4

2022-06-17

Symptoms: Joint pain and swelling

Healthcare visit (other): Visits to doctor office

Release 12 — day 35, dose 4

2022-07-01

Symptoms: Rash of unknown origin

Release 12 — day 42, dose 4

2022-07-08

Symptoms: Prolonged joint pain and inflammation and unexplained headache

Healthcare visit (other): Md office

Release 12 — 3 months, dose 4

2022-08-26

Symptoms: Extreme vertigo and dizziness and loss of balance. Unable to bear weight on right leg. To have knee replacement when I've recovered from hysterectomy and bladder sling.

Healthcare visit (other): Multiple doctor appts

Release 12 — day 21, dose 5

2022-10-31

Symptoms: Flu like symptoms

Release 12 — day 42, dose 5

2022-11-21

Symptoms: Viral infection upper respiratory. Negative for Covid. Negative flu both A and B.

Healthcare visit (other): MD office

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 pain	✓	✓	✓
SD	Abdominal tenderness	✓	✓	✓
SD	Arthralgia	✓	·	✓
SD	Arthritis	·	·	✓
SD	Asthma	·	·	✓
SD	Balance disorder	·	·	✓
SD	Biliary obstruction	·	·	✓
SD	Cholecystectomy	·	·	✓
SD	COVID-19	·	·	✓
SD	Diverticulitis	·	·	✓
SD	Dizziness	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Fluid retention	·	·	✓
SD	Headache	·	·	✓
SD	Hypersomnia	✓	✓	✓
SD	Hysterectomy	·	·	✓
SD	Influenza A virus test negative	·	·	✓
SD	Influenza B virus test negative	·	·	✓
SD	Influenza like illness	·	·	✓
SD	Joint swelling	✓	·	✓
SD	Oedema	·	·	✓
SD	Pancreatitis	·	·	✓
SD	Pneumonia	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rash	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Urinary bladder suspension	·	·	✓
SD	Vertigo	·	·	✓
SD	Viral upper respiratory tract infection	·	·	✓
SD	Weight bearing difficulty	·	·	✓

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