3UD-10366-96007

2 vaccinations 5 coded responses 22 check-ins 5 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 957 / CA
Registered: 2021-02-17

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

2021-02-17
Registered in v-safe
2021-02-17
Dose 1 — Moderna
2021-02-17
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Redness · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-19
Survey response — days 1–6 daily, dose 1
MedDRA: Headache, Hyperhidrosis — Feeling: Good · Site: Pain, Redness

Free text: Mild headache and Sweating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-24
Health check-in — day 7, dose 1
Feeling: Good · Headache

Adult check-in
2021-03-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-13
Dose 2 — Moderna
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-18
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-15
Survey response — 3 months, dose 2
MedDRA: Nasal congestion, Nasopharyngitis, Oropharyngeal discomfort, Rhinorrhoea — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I had cold 8 days ago and still have symptoms like nose and throat congestion. I also have kind of runny nose.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-15
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-23
Call 1 — Left Voicemail
2021-09-11
Survey response — 6 months, dose 2
MedDRA: Bronchitis, Nasal congestion, Nasopharyngitis, Oropharyngeal pain — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Cold, sour throat, nose congestion and bronchitis

MedDRA releases: 2024-11 · check-in free text available
2021-09-11
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-14
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-03-20
Survey response — 12 months, dose 2
MedDRA: Confusional state, Disturbance in attention, Fatigue, Memory impairment, Pain — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Confusion, bad memory and less ability to concentrate and recall what i hear. i used to remember all the details about any conversation, instructions an incidents but not any more. Getting tired easily and occasions of severe pain all over my body.

MedDRA releases: 2024-11 · check-in free text available
2022-03-20
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-24
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-17	Moderna
2	2021-03-13	Moderna

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-19

Systemic reaction (other): Mild headache and Sweating

Release 5 — days 1–6 daily, dose 2

2021-03-18

Systemic reaction (other): No

Release 9 — 3 months, dose 2

2021-06-15

Symptoms: I had cold 8 days ago and still have symptoms like nose and throat congestion. I also have kind of runny nose.

Release 9 — 6 months, dose 2

2021-09-11

Symptoms: Cold, sour throat, nose congestion and bronchitis

Release 11 — 12 months, dose 2

2022-03-20

Symptoms: Confusion, bad memory and less ability to concentrate and recall what i hear. i used to remember all the details about any conversation, instructions an incidents but not any more. Getting tired easily and occasions of severe pain all over my body. cut off by CDC

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	Bronchitis	·	·	✓
SD	Confusional state	·	·	✓
SD	Disturbance in attention	·	·	✓
SD	Fatigue	·	·	✓
SD	Memory impairment	·	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Oropharyngeal discomfort	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	·	·	✓
SD	Rhinorrhoea	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	No adverse event	✓	✓	✓

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