3ZF-43264-91055

4 vaccinations 11 coded responses 24 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 948 / CA
Registered: 2021-03-08

Relationship: Self
Race: Other
Ethnicity: Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-03-08
Registered in v-safe
2021-03-08
Dose 1 — Moderna
2021-03-08
Survey response — day 0, dose 1
MedDRA: Dizziness — Feeling: Good · Headache, Fatigue or tiredness

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Flatulence — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Free text: Gas flaunt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-14
Survey response — days 1–6 daily, dose 1
MedDRA: Gastrointestinal disorder — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Intestinal issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — day 7, dose 1
MedDRA: Chills — Feeling: Good · Fatigue or tiredness, Nausea

Free text: Chill

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Survey response — day 14, dose 1
MedDRA: Dizziness, Loss of personal independence in daily activities, Nausea, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Feeling feverish nauseated dizzy and maybe a little headache but I think that could be caused by the dizziness. I have been able to get around but not to do my usual chores and I was thinking about seeing the doctor yesterday but I didn't go because

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-05
Dose 2 — Moderna
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Sinus congestion probably allergy related but not the stomach

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

Adult check-in
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Good · Fever · Headache, Muscle or body aches

Free text: I'm pretty sure that the symptoms I'm having are allergy related

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Hypersensitivity — Feeling: Good · Muscle or body aches, Fatigue or tiredness

Free text: Just allergies but that's not relating to the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — day 7, dose 2
MedDRA: Sinus disorder — Feeling: Good · Headache, Fatigue or tiredness

Free text: Sinus again I'm thinking allergies

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-19
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-26
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-15
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2022-04-05
Dose 3 — Moderna
2022-04-05
Survey response — 12 months, dose 2
MedDRA: Hypersensitivity, Oropharyngeal pain, Pre-existing disease, Unevaluable event — Feeling: Good

Free text: My problems have been allergy related with sinuses and sore throat I have been taking my temperature just to make sure that if I did show a fever I would take a home test just to make sure it's allergies & not covid

MedDRA releases: 2024-11 · check-in free text available
2022-04-05
Survey response — day 0, dose 3
MedDRA: Dyspnoea, Oropharyngeal pain, Pre-existing disease — Feeling: Good · Headache

Free text: Sore throat, breathing tightness, sinus allergy related I'm sure if I show a fever I will test just to r/o covid

MedDRA releases: 2024-11 · check-in free text available
2022-04-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2022-05-09
Dose 4 — Moderna
2022-05-19
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-07-07
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-08-12
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-08	Moderna
2	2021-04-05	Moderna
3	2022-04-05	Moderna	No
4	2022-05-09	Moderna	No

Free text

Release 5 — day 0, dose 1

2021-03-08

Systemic reaction (other): Dizzy

Release 5 — days 1–6 daily, dose 1

2021-03-11

Systemic reaction (other): Gas flaunt

2021-03-14

Systemic reaction (other): Intestinal issues

Release 5 — day 7, dose 1

2021-03-17

Systemic reaction (other): Chill

Release 6 — day 14, dose 1

2021-03-27

Symptoms: Feeling feverish nauseated dizzy and maybe a little headache but I think that could be caused by the dizziness. I have been able to get around but not to do my usual chores and I was thinking about seeing the doctor yesterday but I didn't go because cut off by CDC

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Sinus congestion probably allergy related but not the stomach

2021-04-10

Systemic reaction (other): I'm pretty sure that the symptoms I'm having are allergy related

2021-04-11

Systemic reaction (other): Just allergies but that's not relating to the shot

Release 7 — day 7, dose 2

2021-04-12

Systemic reaction (other): Sinus again I'm thinking allergies

Release 11 — day 0, dose 3

2022-04-05

Systemic reaction (other): Sore throat, breathing tightness, sinus allergy related I'm sure if I show a fever I will test just to r/o covid

Release 11 — 12 months, dose 2

2022-04-05

Symptoms: My problems have been allergy related with sinuses and sore throat I have been taking my temperature just to make sure that if I did show a fever I would take a home test just to make sure it's allergies & not covid

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	Dizziness	✓	✓	✓
SD	Hypersensitivity	·	·	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Unevaluable event	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	·	·	✓
SRO	Flatulence	✓	✓	✓
SRO	Gastrointestinal disorder	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Sinus disorder	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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