3K2-19406-98185

5 vaccinations 22 coded responses 63 check-ins 21 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 902 / CA
Registered: 2021-03-04

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

2021-03-04
Registered in v-safe
2021-03-04
Dose 1 — Moderna
2021-03-04
Survey response — day 0, dose 1
MedDRA: Dysgeusia, Immediate post-injection reaction — Feeling: Good

Free text: Within a minute or two after the shot, I had a strong metallic taste in my mouth; just lasted a few minutes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Ear pain — Feeling: Fair · Site: Pain · Headache · Be unable to do your normal daily activities

Free text: Slight Earache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 7, dose 1
MedDRA: Ear pain — Feeling: Fair · Headache

Free text: Slight earache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 14, dose 1
MedDRA: Eye infection, Headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Seem to have infection in eye thats not getting better as soon as it think it should. Maybe unrelated. Had bad headache last night too

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — day 21, dose 1
MedDRA: Bacterial infection, Eyelid infection — Feeling: Fair · Be unable to do your normal daily activities

Free text: For one and a half weeks Ive had an infection on/in one of my eyelids. Seems like a bacterial infection. While its somewhat better than a week ago, seems like my normal immune response might not be optimal.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-01
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-04-08
Health check-in — day 35, dose 1
Feeling: Good

Adult check-in
2021-04-13
Dose 2 — Moderna
2021-04-15
Survey response — days 1–6 daily, dose 2
MedDRA: Ear pain — Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Ear ache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-20
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-27
Survey response — day 14, dose 2
MedDRA: Diarrhoea — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Last Friday I had terrible diarrhea; no cramping with it, just flowed right out with no notice.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — day 21, dose 2
MedDRA: Nausea, Somnolence — Feeling: Good

Free text: Last night had feeling of nausea and thought I might vomit. No other explanation I could think of. After sleeping a few hours was fine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — day 28, dose 2
MedDRA: Cough, Productive cough — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lots of coughing of phlegm throughout the day and night yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-25
Survey response — day 42, dose 2
MedDRA: Diarrhoea — Feeling: Good · Be unable to do your normal daily activities

Free text: More small unexplained bouts of diarrhea here & there.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-12
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Itching · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-31
Survey response — days 1–6 daily, dose 3
MedDRA: Malaise — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Better today, but last night I as horrible

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Discomfort, Dyspepsia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Uncomfortable Indigestion

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-06
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain, Redness, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-12
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-03
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-28
Survey response — 3 months, dose 3
MedDRA: Dyspepsia — Feeling: Fair

Free text: Some regular heartburn-like symptoms ever since booster, especially at night when going to bed.

MedDRA releases: 2024-11 · check-in free text available
2022-05-09
Dose 4 — Moderna
2022-05-09
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-05-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Itching · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-11
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-05-12
Survey response — days 1–6 daily, dose 4
MedDRA: Dyspepsia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Heartburn

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Survey response — days 1–6 daily, dose 4
MedDRA: Dyspepsia — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Some heartburn

MedDRA releases: 2024-11 · check-in free text available
2022-05-15
Survey response — days 1–6 daily, dose 4
MedDRA: Dyspepsia, Vomiting — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: Heartburn/seemed connected to vomiting

MedDRA releases: 2024-11 · check-in free text available
2022-05-16
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

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

Adult check-in
2022-05-30
Survey response — day 21, dose 4
MedDRA: Discomfort, Dyspepsia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Seems like this sporadic, but regular, uncomfortable indigestion feeling isn't going away. Is that an effect of the booster?

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

Adult check-in
2022-06-13
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-20
Survey response — day 42, dose 4
MedDRA: Asthenia, Fatigue — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Fatigue and tired way more than I was before 2nd booster. My usual energy level has not returned.

MedDRA releases: 2024-11 · check-in free text available
2022-08-08
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-11-07
Dose 5 — Moderna
Co-administered: Pneumonia
2022-11-07
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2022-11-07
Health check-in — day 0, dose 5
Feeling: Good · None

Adult check-in
2022-11-08
Survey response — days 1–6 daily, dose 5
MedDRA: Injection site pain — Feeling: Fair · Site: Pain, Redness, Swelling · Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Also pain on other arm where received pneumonia vaccine

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Health check-in — days 1–6 daily, dose 5
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-11-10
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Itching · Fever · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-11-11
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-12
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-11-14
Health check-in — day 7, dose 5
Feeling: Fair · Site: Pain, Itching · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-22
Survey response — day 14, dose 5
MedDRA: Diarrhoea, Gastrooesophageal reflux disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Diarrhea Acid reflux

MedDRA releases: 2024-11 · check-in free text available
2022-11-28
Health check-in — day 21, dose 5
Feeling: Fair

Adult check-in
2022-12-05
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-12-12
Survey response — day 35, dose 5
MedDRA: Vomiting — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Occasional vomiting - like today.

MedDRA releases: 2024-11 · check-in free text available
2022-12-19
Health check-in — day 42, dose 5
Feeling: Fair

Adult check-in
2023-02-06
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-05-09
Survey response — 6 months, dose 5
MedDRA: Gastrooesophageal reflux disease, Office visit — Feeling: Good · Be unable to work or attend school, Get care from a doctor or other healthcare professional

MedDRA releases: 2024-11
2023-05-09
Report sent to call center — 6 months, dose 5
Be unable to work or attend school · Get care from a doctor or other healthcare professional

1 call case(s)
2023-05-09
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-04	Moderna
2	2021-04-13	Moderna
3	2021-10-29	Moderna	No
4	2022-05-09	Moderna	No
5	2022-11-07	Moderna	Pneumonia

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-04

Systemic reaction (other): Within a minute or two after the shot, I had a strong metallic taste in my mouth; just lasted a few minutes.

Release 5 — days 1–6 daily, dose 1

2021-03-10

Systemic reaction (other): Slight Earache

Release 5 — day 7, dose 1

2021-03-11

Systemic reaction (other): Slight earache

Release 5 — day 14, dose 1

2021-03-18

Symptoms: Seem to have infection in eye thats not getting better as soon as it think it should. Maybe unrelated. Had bad headache last night too

Release 6 — day 21, dose 1

2021-03-27

Symptoms: For one and a half weeks Ive had an infection on/in one of my eyelids. Seems like a bacterial infection. While its somewhat better than a week ago, seems like my normal immune response might not be optimal.

Release 7 — days 1–6 daily, dose 2

2021-04-15

Systemic reaction (other): Ear ache

Release 8 — day 14, dose 2

2021-04-27

Symptoms: Last Friday I had terrible diarrhea; no cramping with it, just flowed right out with no notice.

Release 8 — day 21, dose 2

2021-05-06

Symptoms: Last night had feeling of nausea and thought I might vomit. No other explanation I could think of. After sleeping a few hours was fine.

Release 8 — day 28, dose 2

2021-05-12

Symptoms: Lots of coughing of phlegm throughout the day and night yesterday

Release 8 — day 42, dose 2

2021-05-25

Symptoms: More small unexplained bouts of diarrhea here & there.

Release 10 — days 1–6 daily, dose 3

2021-10-31

Systemic reaction (other): Better today, but last night I as horrible

2021-11-02

Systemic reaction (other): Uncomfortable Indigestion

Release 11 — 3 months, dose 3

2022-01-28

Symptoms: Some regular heartburn-like symptoms ever since booster, especially at night when going to bed.

Release 11 — days 1–6 daily, dose 4

2022-05-12

Systemic reaction (other): Heartburn

2022-05-13

Systemic reaction (other): Some heartburn

2022-05-15

Systemic reaction (other): Heartburn/seemed connected to vomiting

Release 11 — day 21, dose 4

2022-05-30

Symptoms: Seems like this sporadic, but regular, uncomfortable indigestion feeling isn't going away. Is that an effect of the booster?

Release 12 — day 42, dose 4

2022-06-20

Symptoms: Fatigue and tired way more than I was before 2nd booster. My usual energy level has not returned.

Release 12 — days 1–6 daily, dose 5

2022-11-08

Systemic reaction (other): Also pain on other arm where received pneumonia vaccine

Release 12 — day 14, dose 5

2022-11-22

Symptoms: Diarrhea Acid reflux

Release 12 — day 35, dose 5

2022-12-12

Symptoms: Occasional vomiting - like today.

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	Asthenia	·	·	✓
SD	Bacterial infection	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Discomfort	·	·	✓
SD	Dyspepsia	·	·	✓
SD	Eye infection	✓	✓	✓
SD	Eyelid infection	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Gastrooesophageal reflux disease	·	·	✓
SD	Headache	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Productive cough	✓	✓	✓
SD	Somnolence	✓	✓	✓
SD	Vomiting	·	·	✓
SRO	Discomfort	·	·	✓
SRO	Dysgeusia	✓	✓	✓
SRO	Dyspepsia	·	·	✓
SRO	Ear pain	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Injection site pain	·	·	✓
SRO	Malaise	·	·	✓
SRO	Vomiting	·	·	✓

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