3QM-28329-56459

2 vaccinations 10 coded responses 20 check-ins 10 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 613 / IL
Registered: 2021-04-16

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

2021-04-14
Dose 1 — Moderna
2021-04-16
Registered in v-safe
2021-04-16
Survey response — days 1–6 daily, dose 1
MedDRA: Pruritus — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Itchiness distal to injection site on wrist without rash

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-04-21
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-05-01
Survey response — day 14, dose 1
MedDRA: Abdominal pain, Nausea, Ovarian cyst — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: 5 cm ovarian cyst. Severe abd pain & nausea. Trip to ER last night 4/30

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-01
Report sent to call center — day 14, dose 1
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)
2021-05-07
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-05-13
Dose 2 — Moderna
2021-05-14
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Dizziness, Lethargy — Feeling: Poor · Site: Pain · 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: Severe lethargy, back pain, lightheadedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-05-19
Survey response — days 1–6 daily, dose 2
MedDRA: Back pain, Dyspepsia, Insomnia — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Heartburn, insomnia, muscle pain in my back in atypical area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Survey response — day 7, dose 2
MedDRA: Back pain — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Back pain started 24 hrs after vaccine- muscular

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Survey response — day 14, dose 2
MedDRA: Aphonia, Respiratory tract congestion — Feeling: Fair

Free text: Congestion/allergies, losing my voice at times

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-04
Survey response — day 21, dose 2
MedDRA: Asthma, Inhalation therapy, Sinus disorder, Wheezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Asthma and sinus problems. Increase in use in inhaler and wheezing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-10
Survey response — day 28, dose 2
MedDRA: Headache, Palatal swelling, Respiratory tract congestion, Swelling face — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Facial swelling, congestion, headaches, swelling to roof of mouth started on 6/7

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-08-12
Survey response — 3 months, dose 2
MedDRA: Localised 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 · Outpatient clinic or urgent care clinic visit

Free text: Infection to R Thumb- antibiotics for 10 days

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-12
Report sent to call center — 3 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

1 call case(s)
2021-08-16
Call 1 — Left Voicemail
2021-11-11
Survey response — 6 months, dose 2
MedDRA: Diarrhoea, Headache — Feeling: Poor · Be unable to do your normal daily activities

Free text: Diarrhea, headache

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-14	Moderna
2	2021-05-13	Moderna

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-16

Systemic reaction (other): Itchiness distal to injection site on wrist without rash

Release 8 — day 14, dose 1

2021-05-01

Symptoms: 5 cm ovarian cyst. Severe abd pain & nausea. Trip to ER last night 4/30

Release 8 — days 1–6 daily, dose 2

2021-05-14

Systemic reaction (other): Severe lethargy, back pain, lightheadedness

2021-05-19

Systemic reaction (other): Heartburn, insomnia, muscle pain in my back in atypical area

Release 8 — day 7, dose 2

2021-05-20

Systemic reaction (other): Back pain started 24 hrs after vaccine- muscular

Release 8 — day 14, dose 2

2021-05-27

Symptoms: Congestion/allergies, losing my voice at times

Release 8 — day 21, dose 2

2021-06-04

Symptoms: Asthma and sinus problems. Increase in use in inhaler and wheezing

Release 9 — day 28, dose 2

2021-06-10

Symptoms: Facial swelling, congestion, headaches, swelling to roof of mouth started on 6/7

Release 9 — 3 months, dose 2

2021-08-12

Symptoms: Infection to R Thumb- antibiotics for 10 days

Release 10 — 6 months, dose 2

2021-11-11

Symptoms: Diarrhea, headache

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 pain	✓	✓	✓
SD	Aphonia	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Headache	✓	✓	✓
SD	Inhalation therapy	✓	✓	✓
SD	Localised infection	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Ovarian cyst	✓	✓	✓
SD	Palatal swelling	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Sinus disorder	✓	✓	✓
SD	Swelling face	✓	✓	✓
SD	Wheezing	✓	✓	✓
SRO	Back pain	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspepsia	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Lethargy	✓	✓	✓
SRO	Pruritus	✓	✓	✓

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