3UY-75232-87355

2 vaccinations 7 coded responses 22 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 128 / NY
Registered: 2021-03-12

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

2021-03-12
Registered in v-safe
2021-03-12
Dose 1 — Moderna
2021-03-12
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-13
Survey response — days 1–6 daily, dose 1
MedDRA: Irritability, Pain in extremity — Feeling: Good · Site: Pain

Free text: Just feeling fussy about how much my arm hurts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea

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

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

Adult check-in
2021-03-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-18
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-19
Survey response — day 7, dose 1
MedDRA: Pre-existing disease, Sneezing — Feeling: Fair

Free text: Sneezing consistently since around 6:00 pm yesterday. This is atypical for my allergies. Im assuming that either Im getting a virus or its a vaccine side effect.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-02
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-09
Dose 2 — Moderna
2021-04-09
Survey response — day 0, dose 2
MedDRA: Dizziness, Fatigue, Headache, Immediate post-injection reaction, Nausea — Feeling: Fair · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: I felt dizzy as soon as I received the shot. That passed fairly quickly, but the sensation of fatigue, headache, and nausea kicked in almost immediately. I was surprised, because everyone else Ive talked to didnt get symptoms until 12 to 24 hours after receiving the shot. I am resting now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Dry mouth — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Immediately after receiving my sought yesterday, my mouth felt really really dry. And it stayed like that for about an hour and a half after the shot. Last night is when I had the sensation of having a fever. I was hot then cold, then chills.

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

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-16
Health check-in — day 7, dose 2
Feeling: Fair · Nausea

Adult check-in
2021-04-23
Survey response — day 14, dose 2
MedDRA: Chills — Feeling: Good

Free text: I had chills two days ago.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — day 21, dose 2
MedDRA: Cough, Lymphadenopathy, Nasal congestion, Nasopharyngitis, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Fair · 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: Viral cold since last Tuesday 4/20 sore throat, nasal congestion, cough. Cough went to my lungs, bronchitis, swollen lymph nodes, doctor has prescribed antibiotics which I will start this evening. They tested me for Covid and I am negative.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-07
Survey response — day 28, dose 2
MedDRA: Bronchial disorder, Cough, Malaise, Medical counselling, Nasal congestion, Respiratory tract congestion — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nasal and chest congestion over two weeks now, bronchial cough, took last dose of antibiotic today, still sick.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-21
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-09
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-04-13
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-12	Moderna
2	2021-04-09	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-13

Systemic reaction (other): Just feeling fussy about how much my arm hurts

Release 5 — day 7, dose 1

2021-03-19

Systemic reaction (other): Sneezing consistently since around 6:00 pm yesterday. This is atypical for my allergies. Im assuming that either Im getting a virus or its a vaccine side effect.

Release 7 — day 0, dose 2

2021-04-09

Systemic reaction (other): I felt dizzy as soon as I received the shot. That passed fairly quickly, but the sensation of fatigue, headache, and nausea kicked in almost immediately. I was surprised, because everyone else Ive talked to didnt get symptoms until 12 to 24 hours after receiving the shot. I am resting now.

Release 7 — days 1–6 daily, dose 2

2021-04-10

Systemic reaction (other): Immediately after receiving my sought yesterday, my mouth felt really really dry. And it stayed like that for about an hour and a half after the shot. Last night is when I had the sensation of having a fever. I was hot then cold, then chills.

Release 7 — day 14, dose 2

2021-04-23

Symptoms: I had chills two days ago.

Release 8 — day 21, dose 2

2021-04-30

Symptoms: Viral cold since last Tuesday 4/20 sore throat, nasal congestion, cough. Cough went to my lungs, bronchitis, swollen lymph nodes, doctor has prescribed antibiotics which I will start this evening. They tested me for Covid and I am negative.

Release 8 — day 28, dose 2

2021-05-07

Symptoms: Nasal and chest congestion over two weeks now, bronchial cough, took last dose of antibiotic today, still sick.

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	Bronchial disorder	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Medical counselling	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dry mouth	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Immediate post-injection reaction	✓	✓	✓
SRO	Irritability	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Sneezing	✓	✓	✓

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