3MM-14250-34569

4 vaccinations 9 coded responses 33 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 402 / KY
Registered: 2021-02-27

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

2021-02-27
Registered in v-safe
2021-02-27
Dose 1 — Moderna
2021-02-27
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-13
Survey response — day 14, dose 1
MedDRA: Diarrhoea, Nausea — Feeling: Good · Be unable to work

Free text: Had some diarrhea and nausea on 3/10-3/12

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-30
Dose 2 — Moderna
2021-03-30
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-01
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Swelling · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work

Adult check-in
2021-04-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-04-03
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fatigue or tiredness

Adult check-in
2021-04-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-06
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Survey response — day 14, dose 2
MedDRA: Fatigue, Nasal congestion, Oropharyngeal pain, Pre-existing disease — Feeling: Poor · Be unable to work

Free text: I think they are allergy related but stuffiness, sore throat and fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-11
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-29
Survey response — 3 months, dose 2
MedDRA: Fatigue, Nasal congestion — Feeling: Good

Free text: Fatigue, stuffiness which could be due to allergies.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-28
Survey response — 6 months, dose 2
MedDRA: SARS-CoV-2 test negative, Upper respiratory tract infection, Urinary tract infection — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Upper respiratory infection and a UTI but I don't think it was related. Took a Covid test and it was negative.

MedDRA releases: 2024-11 · check-in free text available
2021-09-28
Report sent to call center — 6 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-09-30
Call 1 — Left Voicemail
2021-11-24
Dose 3 — Moderna
2022-03-30
Survey response — 12 months, dose 2
MedDRA: Fatigue, Oropharyngeal pain, Respiratory tract congestion, Viral infection — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Fatigue, stuffiness and sore throat diagnosed as a viral infection brought on by exhaustion from moving offices last week.

MedDRA releases: 2024-11 · check-in free text available
2022-03-30
Report sent to call center — 12 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-31
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-09-14
Dose 4 — Moderna
2022-10-11
Survey response — day 21, dose 4
MedDRA: Abdominal discomfort, Fatigue, Immunisation reaction, Respiratory tract congestion, Viral infection — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Had side effects from booster; Last week, I had a virus last week with fatigue, stuffiness and upset stomach.

MedDRA releases: 2024-11 · check-in free text available
2022-10-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-10-19
Survey response — day 35, dose 4
MedDRA: Cough — Feeling: Good

Free text: I have a cough but I think it's from allergies

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-12-14
Survey response — 3 months, dose 4
MedDRA: Cellulitis, Mouth swelling, Swelling face — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I had cellulitis inside my nose last week so my right side of my face and mouth were swollen most of the week.

MedDRA releases: 2024-11 · check-in free text available
2022-12-14
Report sent to call center — 3 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-12-15
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-15
Survey response — 6 months, dose 4
MedDRA: Fatigue, Respiratory tract congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-27	Moderna
2	2021-03-30	Moderna
3	2021-11-24	Moderna	No
4	2022-09-14	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — day 14, dose 1

2021-03-13

Symptoms: Had some diarrhea and nausea on 3/10-3/12

Release 7 — day 14, dose 2

2021-04-13

Symptoms: I think they are allergy related but stuffiness, sore throat and fatigue

Release 9 — 3 months, dose 2

2021-06-29

Symptoms: Fatigue, stuffiness which could be due to allergies.

Release 9 — 6 months, dose 2

2021-09-28

Symptoms: Upper respiratory infection and a UTI but I don't think it was related. Took a Covid test and it was negative.

Release 11 — 12 months, dose 2

2022-03-30

Symptoms: Fatigue, stuffiness and sore throat diagnosed as a viral infection brought on by exhaustion from moving offices last week.

Release 12 — day 21, dose 4

2022-10-11

Symptoms: Had side effects from booster; Last week, I had a virus last week with fatigue, stuffiness and upset stomach.

Release 12 — day 35, dose 4

2022-10-19

Symptoms: I have a cough but I think it's from allergies

Release 12 — 3 months, dose 4

2022-12-14

Symptoms: I had cellulitis inside my nose last week so my right side of my face and mouth were swollen most of the week.

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	Abdominal discomfort	·	·	✓
SD	Cellulitis	·	·	✓
SD	Cough	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Immunisation reaction	·	·	✓
SD	Mouth swelling	·	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Respiratory tract congestion	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Swelling face	·	·	✓
SD	Upper respiratory tract infection	·	·	✓
SD	Urinary tract infection	·	·	✓
SD	Viral infection	·	·	✓

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