3L3-83605-00768

4 vaccinations 24 coded responses 49 check-ins 24 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 770 / TX
Registered: 2021-03-09

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

Registered dependents

SXT-88410-52600 Adult relative or friend · Male · 2022-11-05

Timeline

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

2021-03-09
Registered in v-safe
2021-03-09
Dose 1 — Moderna
2021-03-09
Survey response — day 0, dose 1
MedDRA: Injection site pain — Feeling: Good

Free text: Injection sight is just mildly sore.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Pain — Feeling: Good

Free text: I feel fine and the slight soreness from the shot on Tuesday is gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-06
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-07
Dose 2 — Moderna
2021-04-07
Survey response — day 0, dose 2
MedDRA: Unevaluable event — Feeling: Good

Free text: So far so good !

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Head discomfort, Headache — Feeling: Poor · Headache · Be unable to do your normal daily activities

Free text: My headache is so bad since early this morning it hurts to hold up my head! It feels very heavy!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Poor · Headache · Be unable to do your normal daily activities

Free text: Continue to have a bad headache that will not go away

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Headache — Feeling: Fair · Site: Redness · Headache

Free text: Headache pain has lessened greatly since last two days of horrible headache pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Injection site erythema, Injection site warmth — Feeling: Good · Site: Redness · Headache

Free text: Very slight headache in morning... redness under injection area which is warm to the touch, but not painful.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site warmth — Feeling: Good · Site: Redness

Free text: Slight redness under injection and warm to touch- no headache so far today !

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site erythema, Injection site warmth — Feeling: Good · Site: Redness

Free text: Slight redness still under injection area that is still warm to the touch

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Survey response — day 7, dose 2
MedDRA: Injection site erythema — Feeling: Good · Site: Redness

Free text: Very slight redness under injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-07
Survey response — 3 months, dose 2
MedDRA: Eye pain, Headache, Neck pain — Feeling: Good

Free text: Random extreme headaches mostly behind my eye sockets/forehead but sometimes very low in back of head at neck. I dont remember ever having these type headaches before my 2nd vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-01
Dose 3 — Moderna
2021-11-01
Survey response — day 0, dose 3
MedDRA: Unevaluable event — Feeling: Good

Free text: Just to verify my records my 3rd vaccination was 1/2 dose Moderna

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Asthenia — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No energy

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Asthenia — Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No energy

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Headache — Feeling: Good · Site: Pain · Headache

Free text: Very slight headache compared to past days

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site pruritus, Injection site warmth — Feeling: Good · Site: Itching

Free text: Felt better today - just itching and warm at injection site

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-07
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site pruritus — Feeling: Good · Site: Itching

Free text: Just slight itching still at injection site

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Health check-in — day 7, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-15
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-31
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-11-03
Dose 4 — Moderna
2022-11-05
Survey response — days 1–6 daily, dose 4
MedDRA: Injection site warmth — Feeling: Fair · Site: Pain, Swelling · Headache

Free text: Shot area is very hot to the touch!

MedDRA releases: 2024-11 · check-in free text available
2022-11-06
Survey response — days 1–6 daily, dose 4
MedDRA: Headache — Feeling: Fair · Site: Pain, Redness · Headache

Free text: Slight headache in back of neck - less pain than yesterday

MedDRA releases: 2024-11 · check-in free text available
2022-11-09
Survey response — days 1–6 daily, dose 4
MedDRA: Headache, Neck pain — Feeling: Good · Site: Pain, Itching · Headache

Free text: Slight headache in back of head/neck area -

MedDRA releases: 2024-11 · check-in free text available
2022-11-10
Survey response — day 7, dose 4
MedDRA: Headache, Neck pain — Feeling: Fair · Site: Itching · Headache

Free text: Back of headache at neck area

MedDRA releases: 2024-11 · check-in free text available
2022-11-17
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-11-24
Survey response — day 21, dose 4
MedDRA: Limb mass, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Have what I thought was a swollen hernia in lower abdomen on right side having ultrasound /bone density tests and CT scans to find out what it is ?. · Healthcare visit (other): Doctors visits

MedDRA releases: 2024-11 · check-in free text available
2022-11-24
Report sent to call center — day 21, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-11-25
Call 1 — Could Not Reach Participant
2022-11-30
Call 2 — Could Not Reach Participant
2022-12-04
Survey response — day 28, dose 4
MedDRA: Nephrolithiasis, Renal impairment, Urinary tract obstruction — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I have been diagnosed with kidney stones one very large one blocking kidney function on right side - having out patient surgery. Smaller stones on left side will be addressed later after right side is healed.

MedDRA releases: 2024-11 · check-in free text available
2022-12-04
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-05
Call 3 — Could Not Reach Participant
2022-12-05
Call 1 — Could Not Reach Participant
2022-12-08
Survey response — day 35, dose 4
MedDRA: Drainage, Nephrolithiasis, Office visit, Surgery, Ureteral stent insertion, Ureteric obstruction — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: Symptoms: Had outpatient surgery to remove a 5 mm kidney stone blockage on my right side causing what I thought was a hernia ? they also inserted a stent to help drainage · Healthcare visit (other): Outpatient surgery

MedDRA releases: 2024-11 · check-in free text available
2022-12-08
Report sent to call center — day 35, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Hospitalization · 1 call case(s)
2022-12-09
Call 2 — Could Not Reach Participant
2022-12-09
Call 1 — Could Not Reach Participant
2022-12-14
Call X — Could Not Reach Participant
2022-12-14
Call 3 — Could Not Reach Participant
2022-12-14
Call 2 — Could Not Reach Participant
2022-12-18
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2023-05-04
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-09	Moderna
2	2021-04-07	Moderna
3	2021-11-01	Moderna	No
4	2022-11-03	Moderna	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-09

Systemic reaction (other): Injection sight is just mildly sore.

Release 5 — days 1–6 daily, dose 1

2021-03-11

Systemic reaction (other): I feel fine and the slight soreness from the shot on Tuesday is gone.

Release 7 — day 0, dose 2

2021-04-07

Systemic reaction (other): So far so good !

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): My headache is so bad since early this morning it hurts to hold up my head! It feels very heavy!

2021-04-09

Systemic reaction (other): Continue to have a bad headache that will not go away

2021-04-10

Systemic reaction (other): Headache pain has lessened greatly since last two days of horrible headache pain

2021-04-11

Systemic reaction (other): Very slight headache in morning... redness under injection area which is warm to the touch, but not painful.

2021-04-12

Systemic reaction (other): Slight redness under injection and warm to touch- no headache so far today !

2021-04-13

Systemic reaction (other): Slight redness still under injection area that is still warm to the touch

Release 7 — day 7, dose 2

2021-04-14

Systemic reaction (other): Very slight redness under injection site

Release 9 — 3 months, dose 2

2021-07-07

Symptoms: Random extreme headaches mostly behind my eye sockets/forehead but sometimes very low in back of head at neck. I dont remember ever having these type headaches before my 2nd vaccine

Release 10 — day 0, dose 3

2021-11-01

Systemic reaction (other): Just to verify my records my 3rd vaccination was 1/2 dose Moderna

Release 10 — days 1–6 daily, dose 3

2021-11-02

Systemic reaction (other): No energy

2021-11-03

Systemic reaction (other): No energy

2021-11-04

Systemic reaction (other): Very slight headache compared to past days

2021-11-05

Systemic reaction (other): Felt better today - just itching and warm at injection site

2021-11-07

Systemic reaction (other): Just slight itching still at injection site

Release 12 — days 1–6 daily, dose 4

2022-11-05

Systemic reaction (other): Shot area is very hot to the touch!

2022-11-06

Systemic reaction (other): Slight headache in back of neck - less pain than yesterday

2022-11-09

Systemic reaction (other): Slight headache in back of head/neck area -

Release 12 — day 7, dose 4

2022-11-10

Systemic reaction (other): Back of headache at neck area

Release 12 — day 21, dose 4

2022-11-24

Symptoms: Have what I thought was a swollen hernia in lower abdomen on right side having ultrasound /bone density tests and CT scans to find out what it is ?.

Healthcare visit (other): Doctors visits

Release 12 — day 28, dose 4

2022-12-04

Symptoms: I have been diagnosed with kidney stones one very large one blocking kidney function on right side - having out patient surgery. Smaller stones on left side will be addressed later after right side is healed.

Release 12 — day 35, dose 4

2022-12-08

Symptoms: Had outpatient surgery to remove a 5 mm kidney stone blockage on my right side causing what I thought was a hernia ? they also inserted a stent to help drainage

Healthcare visit (other): Outpatient surgery

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	·	·	✓
HCVO	Surgery	·	·	✓
SD	Drainage	·	·	✓
SD	Eye pain	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Limb mass	·	·	✓
SD	Neck pain	✓	✓	✓
SD	Nephrolithiasis	·	·	✓
SD	Office visit	·	·	✓
SD	Renal impairment	·	·	✓
SD	Surgery	·	·	✓
SD	Ureteral stent insertion	·	·	✓
SD	Ureteric obstruction	·	·	✓
SD	Urinary tract obstruction	·	·	✓
SRO	Asthenia	·	·	✓
SRO	Head discomfort	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site erythema	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Injection site pruritus	·	·	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Neck pain	·	·	✓
SRO	Pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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