3U8-28801-53543

5 vaccinations 15 coded responses 63 check-ins 14 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 315 / GA
Registered: 2021-01-26

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-26
Registered in v-safe
2021-01-26
Dose 1 — Moderna
2021-01-26
Survey response — day 0, dose 1
MedDRA: Injection site pain, Pain in extremity — Feeling: Good

Free text: Right arm a little sore at injection site.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Injection site pain — Feeling: Good

Free text: Right arm hurts at injection site; a little tired

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Pain — Feeling: Good

Free text: A little body ache and a little tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue — Feeling: Good

Free text: Little tired

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

Adult check-in
2021-02-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-24
Survey response — day 28, dose 1
MedDRA: Gout, Office visit, Specialist consultation — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Gout in right ankle. · Healthcare visit (other): Primary Care Providers

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Report sent to call center — day 28, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Injection site pain — Feeling: Good · Fatigue or tiredness

Free text: Sore at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-05
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-02
Survey response — day 35, dose 2
MedDRA: Gout, Hyperhidrosis, Medical counselling — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Gout in right ankle; 2nd time in 6 weeks; occasionally sweating a little more than usual. · Healthcare visit (other): Phone call

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-09
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-06-08
Call 1 — Left Voicemail
2021-06-08
Call 1 — Left Voicemail
2021-08-27
Survey response — 6 months, dose 2
MedDRA: Gout — Feeling: Good · Be unable to do your normal daily activities

Free text: Gout in my right bottom heel.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-01
Dose 3 — Moderna
2021-11-01
Survey response — day 0, dose 3
MedDRA: Pain in extremity — Feeling: Good

Free text: Right arm is a little sore.

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site bruising — Feeling: Good

Free text: A little bruising around the injection site.

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Survey response — days 1–6 daily, dose 3
MedDRA: Gout — Feeling: Good · Site: Pain · Joint pains

Free text: Gout in right heel

MedDRA releases: 2024-11 · check-in free text available
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Gout — Feeling: Good · Site: Pain · Joint pains

Free text: Gout in right heel bone. Taking medication.

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-08
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-11-16
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-31
Survey response — 3 months, dose 3
MedDRA: Office visit, Tinnitus — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have a sizzling in my right ear. · Healthcare visit (other): Ear Nose and Throat physician

MedDRA releases: 2024-11 · check-in free text available
2022-01-31
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-05-03
Survey response — 6 months, dose 3
MedDRA: Arthralgia, Dyspepsia, Dyspnoea, Flatulence, Gout, Office visit, Tinnitus — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Gout in right knee and left knee pains at times; gas and heartburn; shortness of breath at times; sizzling in right ear. · Healthcare visit (other): Primary care physician, ENT specialist

MedDRA releases: 2024-11 · check-in free text available
2022-05-03
Report sent to call center — 6 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-04
Call 1 — Left Voicemail
2022-05-27
Dose 4 — Moderna
2022-05-27
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · None

Adult check-in
2022-05-30
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-05-31
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-06-01
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2022-06-02
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains

Adult check-in
2022-06-04
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-10
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-18
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-25
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-07-02
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-09
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-29
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-21
Dose 5 — Moderna
2022-10-23
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Joint pains

Adult check-in
2022-10-25
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-27
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-28
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-11-06
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-12
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-18
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-25
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-12-03
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-21
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-21
Survey response — 6 months, dose 5
MedDRA: Gout — Feeling: Good · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Moderna
2	2021-02-26	Moderna
3	2021-11-01	Moderna	No
4	2022-05-27	Moderna	No
5	2022-10-21	Moderna	No

Call center

4 call center cases

1 successful · 3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-26

Systemic reaction (other): Right arm a little sore at injection site.

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): Right arm hurts at injection site; a little tired

Release 3 — days 1–6 daily, dose 1

2021-01-28

Systemic reaction (other): A little body ache and a little tired.

2021-01-29

Systemic reaction (other): Little tired

Release 4 — day 28, dose 1

2021-02-24

Symptoms: Gout in right ankle.

Healthcare visit (other): Primary Care Providers

Release 4 — days 1–6 daily, dose 2

2021-02-27

Systemic reaction (other): Sore at injection site

Release 6 — day 35, dose 2

2021-04-02

Symptoms: Gout in right ankle; 2nd time in 6 weeks; occasionally sweating a little more than usual.

Healthcare visit (other): Phone call

Release 9 — 6 months, dose 2

2021-08-27

Symptoms: Gout in my right bottom heel.

Release 10 — day 0, dose 3

2021-11-01

Systemic reaction (other): Right arm is a little sore.

Release 10 — days 1–6 daily, dose 3

2021-11-03

Systemic reaction (other): A little bruising around the injection site.

2021-11-04

Systemic reaction (other): Gout in right heel

2021-11-05

Systemic reaction (other): Gout in right heel bone. Taking medication.

Release 11 — 3 months, dose 3

2022-01-31

Symptoms: I have a sizzling in my right ear.

Healthcare visit (other): Ear Nose and Throat physician

Release 11 — 6 months, dose 3

2022-05-03

Symptoms: Gout in right knee and left knee pains at times; gas and heartburn; shortness of breath at times; sizzling in right ear.

Healthcare visit (other): Primary care physician, ENT specialist

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	Specialist consultation	○	✓	○
SD	Arthralgia	·	·	✓
SD	Dyspepsia	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Flatulence	·	·	✓
SD	Gout	✓	✓	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Tinnitus	·	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Gout	·	·	✓
SRO	Injection site bruising	·	·	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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