3MZ-21049-25807

3 vaccinations 8 coded responses 25 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 921 / CA
Registered: 2021-01-28

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

Timeline

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Chills, Headache

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-02-11
Survey response — day 14, dose 1
MedDRA: Injection site pruritus, Injection site rash — Feeling: Good

Free text: Itchy rash at injection site...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Muscle spasms, Myalgia, Pain — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Significant, whole body muscle spasms and pain with weight bearing in bed/sitting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · 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
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Chills, Fatigue or tiredness

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Progressive cough ...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 7, dose 2
MedDRA: Cough — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Odd cough that began with the vaccination ...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 14, dose 2
MedDRA: Body temperature decreased, Cough, Feeling cold — Feeling: Fair · Be unable to do your normal daily activities

Free text: An odd cough that is becoming more persistent... Cant get warmand temperature is subnormal 96.0-97.2.... 97.6 is my normal .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 21, dose 2
MedDRA: Blood pressure fluctuation, Cough, Dizziness, Headache, Heart rate irregular — Feeling: Fair · Be unable to work, 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: Significant light-headedness, ongoing headache, odd cough and blood pressure and heart rate fluctuations with positional changes...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 21, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-27
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-02
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-04-09
Survey response — day 42, dose 2
MedDRA: Chest discomfort, Cough, Echocardiogram, Office visit — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Increased dry, explosive cough that interferes with light-moderate activity... chest tightness... · Healthcare visit (other): Pulmonary testing; echocardiogram; follow up testing in 10 days...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-25
Dose 3 — Moderna
2021-08-26
Survey response — 6 months, dose 2
MedDRA: Blood immunoglobulin A decreased, Blood immunoglobulin G decreased, Blood immunoglobulin M decreased — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: IG G/M/A levels are significantly suppressed.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-26
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-02
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-08-25	Moderna	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 4 — day 14, dose 1

2021-02-11

Symptoms: Itchy rash at injection site...

Release 4 — days 1–6 daily, dose 2

2021-02-26

Systemic reaction (other): Significant, whole body muscle spasms and pain with weight bearing in bed/sitting

Release 5 — days 1–6 daily, dose 2

2021-03-03

Systemic reaction (other): Progressive cough ...

Release 5 — day 7, dose 2

2021-03-04

Systemic reaction (other): Odd cough that began with the vaccination ...

Release 5 — day 14, dose 2

2021-03-11

Symptoms: An odd cough that is becoming more persistent... Cant get warmand temperature is subnormal 96.0-97.2.... 97.6 is my normal .

Release 5 — day 21, dose 2

2021-03-18

Symptoms: Significant light-headedness, ongoing headache, odd cough and blood pressure and heart rate fluctuations with positional changes...

Release 7 — day 42, dose 2

2021-04-09

Symptoms: Increased dry, explosive cough that interferes with light-moderate activity... chest tightness...

Healthcare visit (other): Pulmonary testing; echocardiogram; follow up testing in 10 days...

Release 9 — 6 months, dose 2

2021-08-26

Symptoms: IG G/M/A levels are significantly suppressed.

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	Echocardiogram	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Blood immunoglobulin A decreased	✓	·	✓
SD	Blood immunoglobulin G decreased	✓	·	✓
SD	Blood immunoglobulin M decreased	✓	·	✓
SD	Blood pressure fluctuation	✓	✓	✓
SD	Body temperature decreased	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Feeling cold	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Heart rate irregular	✓	✓	✓
SD	Injection site pruritus	✓	✓	✓
SD	Injection site rash	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Muscle spasms	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pain	✓	✓	✓

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