3QU-18957-01885

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

Sex: Female
Age at first dose: 56-60
ZIP prefix: 922 / CA
Registered: 2021-01-28

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

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

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Pre-existing disease — Feeling: Good

Free text: Yesterday, I felt unusually exhausted from work, but Im a Nurse...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-01
Dose 2 — Moderna
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Arthralgia, Arthritis, Pre-existing disease — Feeling: Good

Free text: Right hip arthritis pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Abdominal pain

Adult check-in
2021-03-08
Survey response — day 7, dose 2
MedDRA: Abdominal pain — Feeling: Good

Free text: Not today, but the last 3 days I had abdominal cramps intermittently and very mild

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Survey response — day 14, dose 2
MedDRA: Dizziness, Medical counselling, Road traffic accident — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Dizziness in am, was in car accident though last Wednesday · Healthcare visit (other): Chiropractor visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-15
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-22
Survey response — day 21, dose 2
MedDRA: Abdominal pain upper — Feeling: Good

Free text: Stomach aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Survey response — day 28, dose 2
MedDRA: Dizziness postural, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: I have had dizziness at night every night since receiving vaccine, this is the only time I get dizzy, when I lay down, and turn in bed · Healthcare visit (other): MD appt this thursday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-05
Survey response — day 35, dose 2
MedDRA: Dizziness, Electrocardiogram abnormal, Office visit, Supraventricular extrasystoles — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: An EKG was done and found to have PVCs. Still having dizziness only at night when laying down. All of this started happening after the vaccine. Will be on a holter monitor this week, also getting CT scan of head. · Healthcare visit (other): PCP visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-31
Survey response — 3 months, dose 2
MedDRA: Varicose vein — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Varicose veins, insufficiency

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-31
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-17
Call 1 — Left Voicemail
2021-08-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-01
Survey response — 12 months, dose 2
MedDRA: Ear infection, Heart rate increased, Tooth infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Racing heart rate, ear infection from infected tooth

MedDRA releases: 2024-11 · check-in free text available
2022-03-01
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · Emergency room or emergency department visit · 1 call case(s)
2022-03-02
Call 1 — Left Voicemail
2022-03-02
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-03-01	Moderna

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-03

Systemic reaction (other): Yesterday, I felt unusually exhausted from work, but Im a Nurse...

Release 5 — days 1–6 daily, dose 2

2021-03-06

Systemic reaction (other): Right hip arthritis pain

Release 5 — day 7, dose 2

2021-03-08

Systemic reaction (other): Not today, but the last 3 days I had abdominal cramps intermittently and very mild

Release 5 — day 14, dose 2

2021-03-15

Symptoms: Dizziness in am, was in car accident though last Wednesday

Healthcare visit (other): Chiropractor visit

Release 6 — day 21, dose 2

2021-03-22

Symptoms: Stomach aches

Release 6 — day 28, dose 2

2021-03-29

Symptoms: I have had dizziness at night every night since receiving vaccine, this is the only time I get dizzy, when I lay down, and turn in bed

Healthcare visit (other): MD appt this thursday

Release 6 — day 35, dose 2

2021-04-05

Symptoms: An EKG was done and found to have PVCs. Still having dizziness only at night when laying down. All of this started happening after the vaccine. Will be on a holter monitor this week, also getting CT scan of head.

Healthcare visit (other): PCP visit

Release 8 — 3 months, dose 2

2021-05-31

Symptoms: Varicose veins, insufficiency

Release 11 — 12 months, dose 2

2022-03-01

Symptoms: Racing heart rate, ear infection from infected tooth

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	Medical counselling	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Abdominal pain upper	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dizziness postural	✓	✓	✓
SD	Ear infection	·	·	✓
SD	Electrocardiogram abnormal	✓	✓	✓
SD	Heart rate increased	·	·	✓
SD	Road traffic accident	✓	✓	✓
SD	Supraventricular extrasystoles	✓	✓	✓
SD	Tooth infection	·	·	✓
SD	Varicose vein	✓	✓	✓
SRO	Abdominal pain	✓	✓	✓
SRO	Arthralgia	✓	✓	✓
SRO	Arthritis	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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