3X9-12607-95468

2 vaccinations 10 coded responses 19 check-ins 10 free-text entries 10 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 199 / DE
Registered: 2021-01-17

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

2021-01-17
Registered in v-safe
2021-01-17
Dose 1 — Moderna
2021-01-17
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-24
Health check-in — day 7, dose 1
Feeling: Good · None

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

Adult check-in
2021-02-07
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-14
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-18
Dose 2 — Moderna
2021-02-21
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Hospitalisation, Intensive care — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Systemic reaction (other): In the hospital. Shortness of breath severe on oxygen plus other meds · Healthcare visit (other): Being moved to ICU

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: SARS-CoV-2 test negative — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: COVID symptoms including X-ray but 2 negative tests

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-22
Report sent to call center — days 1–6 daily, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Hospitalisation — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Still in hospital

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Report sent to call center — days 1–6 daily, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-24
Survey response — days 1–6 daily, dose 2
MedDRA: Hospitalisation — Feeling: Poor · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: Systemic reaction (other): In ICU · Healthcare visit (other): Admitted to ICU

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-25
Survey response — day 7, dose 2
MedDRA: Hospitalisation, Intensive care, Unevaluable event — Feeling: Poor · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit, Hospitalization

Free text: ICU

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Report sent to call center — day 7, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-04
Survey response — day 14, dose 2
MedDRA: Asthenia, Headache, Hospitalisation, Myalgia — Feeling: Poor · Be unable to work, 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: Symptoms: Weak Muscle pain headache · Healthcare visit (other): Just discharged from hospital

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

1 call case(s)
2021-03-11
Survey response — day 21, dose 2
MedDRA: Dyspepsia, Dyspnoea, Hospitalisation — Feeling: Poor · 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: Symptoms: Breathing difficulties with activity asks. Heartburn · Healthcare visit (other): Home from hospital

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
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)
2021-03-18
Survey response — day 28, dose 2
MedDRA: Breath sounds abnormal, Dyspnoea, Pleural effusion, Pulmonary thrombosis — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: Fluid and blood clots in lung · Healthcare visit (other): Shortness of breath. Abnormal breath sounds

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 28, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-25
Survey response — day 35, dose 2
MedDRA: Pulmonary embolism, Unevaluable event — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: 2 blood clotting right lung · Healthcare visit (other): Discharged mo

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Report sent to call center — day 35, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-01
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-20
Survey response — 3 months, dose 2
MedDRA: Anaemia, Gastrointestinal haemorrhage, Pulmonary embolism — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Pulmunary embolism. Hi bleed. Anemia

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-16
Call 1 — Left Voicemail
2021-08-19
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-17	Moderna
2	2021-02-18	Moderna

Call center

10 call center cases

10 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-21

Systemic reaction (other): In the hospital. Shortness of breath severe on oxygen plus other meds

Healthcare visit (other): Being moved to ICU

2021-02-22

Systemic reaction (other): COVID symptoms including X-ray but 2 negative tests

2021-02-23

Systemic reaction (other): Still in hospital

2021-02-24

Systemic reaction (other): In ICU

Healthcare visit (other): Admitted to ICU

Release 4 — day 7, dose 2

2021-02-25

Healthcare visit (other): ICU

Release 5 — day 14, dose 2

2021-03-04

Symptoms: Weak Muscle pain headache

Healthcare visit (other): Just discharged from hospital

Release 5 — day 21, dose 2

2021-03-11

Symptoms: Breathing difficulties with activity asks. Heartburn

Healthcare visit (other): Home from hospital

Release 5 — day 28, dose 2

2021-03-18

Symptoms: Fluid and blood clots in lung

Healthcare visit (other): Shortness of breath. Abnormal breath sounds

Release 6 — day 35, dose 2

2021-03-25

Symptoms: 2 blood clotting right lung

Healthcare visit (other): Discharged mo

Release 8 — 3 months, dose 2

2021-05-20

Symptoms: Pulmunary embolism. Hi bleed. Anemia

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	Breath sounds abnormal	✓	✓	✓
HCVO	Dyspnoea	✓	✓	✓
HCVO	Hospitalisation	✓	✓	✓
HCVO	Intensive care	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Anaemia	✓	✓	✓
SD	Asthenia	✓	✓	✓
SD	Dyspepsia	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Gastrointestinal haemorrhage	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Pleural effusion	✓	✓	✓
SD	Pulmonary embolism	✓	✓	✓
SD	Pulmonary thrombosis	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Hospitalisation	✓	✓	✓
SRO	Oxygen therapy	○	○	○
SRO	SARS-CoV-2 test negative	✓	✓	✓

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