3QN-21892-20492

4 vaccinations 7 coded responses 40 check-ins 7 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 334 / FL
Registered: 2021-02-05

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-03
Dose 1 — Moderna
2021-02-05
Registered in v-safe
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-02-06
Survey response — days 1–6 daily, dose 1
MedDRA: Tremor — Feeling: Fair · Site: Pain · Fatigue or tiredness, Abdominal pain

Free text: Had body tremors all over when I went to bad last night. Lasted about 30 - 45 minutes.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Mobility decreased — Feeling: Fair · Site: Pain · Chills, Fatigue or tiredness

Free text: Range of motion for moving arm up or lifting dishes into microwave. Cant lift anything heavy.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Muscular weakness — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Lifting any weight with left arm, coffee cup, tender . If too heavy can not lift.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-09
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-10
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Better movement in left arm, better lifting heavier objects.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-03
Dose 2 — Moderna
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Took Tylenol

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Survey response — day 7, dose 2
MedDRA: Headache, Self-medication — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Taking 4-6 Tylenol /day for headaches. May be masking other symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-31
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-07
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-01
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-24
Dose 3 — Moderna
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · None

Adult check-in
2021-10-31
Health check-in — day 7, dose 3
Feeling: Fair · Site: Redness, Itching · None

Adult check-in
2021-11-07
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-14
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-21
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-28
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-05
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-23
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-02
Dose 4 — Moderna
2022-04-18
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-23
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-01
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-07
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-14
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-02
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-03
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-02
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-03	Moderna
3	2021-10-24	Moderna	No
4	2022-04-02	Moderna	No

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-06

Systemic reaction (other): Had body tremors all over when I went to bad last night. Lasted about 30 - 45 minutes.

2021-02-07

Systemic reaction (other): Range of motion for moving arm up or lifting dishes into microwave. Cant lift anything heavy.

2021-02-08

Systemic reaction (other): Lifting any weight with left arm, coffee cup, tender . If too heavy can not lift.

2021-02-09

Systemic reaction (other): No

Release 4 — day 7, dose 1

2021-02-10

Systemic reaction (other): Better movement in left arm, better lifting heavier objects.

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Took Tylenol

Release 5 — day 7, dose 2

2021-03-10

Systemic reaction (other): Taking 4-6 Tylenol /day for headaches. May be masking other symptoms.

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
SRO	Headache	✓	✓	✓
SRO	Mobility decreased	✓	✓	✓
SRO	Muscular weakness	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Tremor	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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