42S-86633-84751

4 vaccinations 6 coded responses 29 check-ins 6 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 958 / CA
Registered: 2021-01-30

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

2021-01-30
Registered in v-safe
2021-01-30
Dose 1 — Moderna
2021-01-30
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

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

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

Adult check-in
2021-02-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · None

Adult check-in
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-28
Dose 2 — Moderna
2021-02-28
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-02
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Fatigue or tiredness

Free text: Lightheadedness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · 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 — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-07
Health check-in — day 7, dose 2
Feeling: Good · None

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

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

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

Adult check-in
2021-04-05
Survey response — day 35, dose 2
MedDRA: Adverse reaction, Pre-existing disease, SARS-CoV-2 test negative — Feeling: Fair · Be unable to do your normal daily activities

Free text: Had thoracic back surgery. Unrelated to Covid. Do not feel I have had any further effects from the vaccine...very minimal for me just first 2 days. 3 recent Covid tests all negative as expected

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — day 42, dose 2
MedDRA: Spinal operation — Feeling: Fair · Be unable to do your normal daily activities

Free text: Had back surgery. Cannot walk yet. Unrelated to Covid...due to complex difficult spinal cird surgery

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-05
Dose 3 — Moderna
2022-03-02
Survey response — 12 months, dose 2
MedDRA: Eye excision, Ocular neoplasm, Pre-existing disease, Subcutaneous abscess, Surgery — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Right eye enucleation due to ocular cancer. Skin abcess. Nothing due to Covid vaccine though. · Healthcare visit (other): Outpatient surgery

MedDRA releases: 2024-11 · check-in free text available
2022-03-02
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-04
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-11
Dose 4 — Moderna
2022-04-25
Survey response — day 14, dose 4
MedDRA: Muscle spasms, Musculoskeletal stiffness, Pre-existing disease — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Legs stiffer and more cramps, but likely due to my wheelchair status and tumor in my back, not Covid vaccine.

MedDRA releases: 2024-11 · check-in free text available
2022-04-25
Report sent to call center — day 14, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-26
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-04
Survey response — day 21, dose 4
MedDRA: Pruritus, Rash, Urinary tract infection — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Probable UTI but likely unrelated to Covid. I do have increasing rashes and itching without a known cause.

MedDRA releases: 2024-11 · check-in free text available
2022-05-04
Report sent to call center — day 21, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-05
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-30	Moderna
2	2021-02-28	Moderna
3	2021-11-05	Moderna	No
4	2022-04-11	Moderna	No

Call center

3 call center cases

2 successful · 1 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-03-02

Systemic reaction (other): Lightheadedness

Release 6 — day 35, dose 2

2021-04-05

Symptoms: Had thoracic back surgery. Unrelated to Covid. Do not feel I have had any further effects from the vaccine...very minimal for me just first 2 days. 3 recent Covid tests all negative as expected

Release 7 — day 42, dose 2

2021-04-11

Symptoms: Had back surgery. Cannot walk yet. Unrelated to Covid...due to complex difficult spinal cird surgery

Release 11 — 12 months, dose 2

2022-03-02

Symptoms: Right eye enucleation due to ocular cancer. Skin abcess. Nothing due to Covid vaccine though.

Healthcare visit (other): Outpatient surgery

Release 11 — day 14, dose 4

2022-04-25

Symptoms: Legs stiffer and more cramps, but likely due to my wheelchair status and tumor in my back, not Covid vaccine.

Release 11 — day 21, dose 4

2022-05-04

Symptoms: Probable UTI but likely unrelated to Covid. I do have increasing rashes and itching without a known cause.

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	Surgery	·	·	✓
SD	Adverse reaction	✓	✓	✓
SD	Eye excision	·	·	✓
SD	Muscle spasms	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Ocular neoplasm	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	·	·	✓
SD	Rash	·	·	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Spinal operation	✓	✓	✓
SD	Subcutaneous abscess	·	·	✓
SD	Urinary tract infection	·	·	✓
SRO	Dizziness	✓	✓	✓

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