3QF-19212-99190

5 vaccinations 9 coded responses 24 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 481 / MI
Registered: 2020-12-29

Relationship: Self
Race: Asian
Ethnicity: N/A

Timeline

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

2020-12-29
Registered in v-safe
2020-12-29
Dose 1 — Moderna
2020-12-29
Survey response — day 0, dose 1
MedDRA: Injection site haemorrhage — Feeling: Poor · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: At the time of injection on left deltoid area, there was bleeding , which was controlled with applying pressure by staff for a while with paper towel. Is the vaccine dose enough? Or need another first dose ?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-30
Survey response — days 1–6 daily, dose 1
MedDRA: Arthralgia, Dizziness, Fatigue, Malaise, Mobility decreased, Nausea, Pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Very sick, like when first had Covid-19 in end of March 2020. Severe fatigue, tiredness, joint pains, body aches, not able to get up from bed and laid on the wooden floor for 2 hours after urination due to dizziness and nausea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2020-12-30
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Antibody test positive — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I do have corona antibodies positive for over 8 months,as of last testing on 11/27/2020. With the immune response I had with dose, Question do I need second dose of vaccine?

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-02
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I am not scheduled to work on 12/31/2020,1/1/2021&2/1/2021 and 3/1/2021.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-05
Survey response — day 7, dose 1
MedDRA: Arthralgia, Fatigue, Hypersomnia, Pain — Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Still has joint pains in back, left SI joint and fatigue , body aches, tired and sleeping a lot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-12
Survey response — day 14, dose 1
MedDRA: Rash — Feeling: Fair

Free text: Rash on the left lower abdomen and left hip.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Survey response — day 21, dose 1
MedDRA: Dry skin, Pain of skin, Pruritus, Rash — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Developed skin rash , vesicular itchy with mild pain. Getting dried up slowly. Primary physician thinks likely Shingles, on valacyclovir. No testing done. Is second dose of Moderna. Recommended on 1/26/21 ? Appreciate the response.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-19
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-26
Dose 2 — Moderna
2021-01-26
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-02
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-02-23
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-03-02
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-09
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-03-23
Call 1 — Left Voicemail
2021-04-27
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-29
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-11-05
Dose 3 — Moderna
2022-05-18
Dose 4 — Moderna
2022-12-02
Dose 5 — Pfizer-BioNTech
2022-12-04
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-29	Moderna
2	2021-01-26	Moderna
3	2021-11-05	Moderna	No
4	2022-05-18	Moderna	No
5	2022-12-02	Pfizer-BioNTech	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 1 — day 0, dose 1

2020-12-29

Systemic reaction (other): At the time of injection on left deltoid area, there was bleeding , which was controlled with applying pressure by staff for a while with paper towel. Is the vaccine dose enough? Or need another first dose ?

Release 1 — days 1–6 daily, dose 1

2020-12-30

Systemic reaction (other): Very sick, like when first had Covid-19 in end of March 2020. Severe fatigue, tiredness, joint pains, body aches, not able to get up from bed and laid on the wooden floor for 2 hours after urination due to dizziness and nausea.

2021-01-01

Systemic reaction (other): I do have corona antibodies positive for over 8 months,as of last testing on 11/27/2020. With the immune response I had with dose, Question do I need second dose of vaccine?

2021-01-02

Systemic reaction (other): I am not scheduled to work on 12/31/2020,1/1/2021&2/1/2021 and 3/1/2021.

Release 1 — day 7, dose 1

2021-01-05

Systemic reaction (other): Still has joint pains in back, left SI joint and fatigue , body aches, tired and sleeping a lot

Release 1 — day 14, dose 1

2021-01-12

Symptoms: Rash on the left lower abdomen and left hip.

Release 2 — day 21, dose 1

2021-01-19

Symptoms: Developed skin rash , vesicular itchy with mild pain. Getting dried up slowly. Primary physician thinks likely Shingles, on valacyclovir. No testing done. Is second dose of Moderna. Recommended on 1/26/21 ? Appreciate the response.

Release 2 — day 0, dose 2

2021-01-26

Systemic reaction (other): Dizziness

Release 2 — days 1–6 daily, dose 2

2021-01-28

Systemic reaction (other): Dizziness

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	Dry skin	✓	✓	✓
SD	Pain of skin	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SRO	Antibody test positive	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Hypersomnia	✓	✓	✓
SRO	Injection site haemorrhage	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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