457-24103-22577

4 vaccinations 6 coded responses 23 check-ins 6 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 217 / MD
Registered: 2021-04-06

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

2021-03-10
Dose 1 — Moderna
2021-04-06
Registered in v-safe
2021-04-06
Survey response — day 21, dose 1
MedDRA: Herpes zoster — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Shingles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-07
Dose 2 — Moderna
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Pyrexia — Feeling: Good · Site: Pain, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: The fever was yesterday . Couldnt change it. It was from 1:00 pm til 10 pm last night.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-13
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Poor · Headache, Fatigue or tiredness, Nausea, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Light headed

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 7, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-05
Survey response — day 28, dose 2
MedDRA: Arthralgia, Muscle spasms, Pain in extremity, Sleep disorder — Feeling: Good · Be unable to do your normal daily activities

Free text: Leg cramps but I think its due to meds Im on.hip and legs hurt to point cant sleep good

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-12
Survey response — day 35, dose 2
MedDRA: Blood pressure decreased, Dizziness, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Blood pressure went down to 106/63 pulse 63 so I feel dizzy off and on.allergys too.nothing I think to do with the shot .

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Health check-in — day 42, dose 2
Feeling: Good

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

Adult check-in
2021-10-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-21
Dose 3 — Moderna
2022-01-26
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-07
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-12
Dose 4 — Moderna
2022-04-30
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-10
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-17
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-24
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-12
Survey response — 3 months, dose 4
MedDRA: Abdominal discomfort, Cough, Headache, Pain, Paranasal sinus hypersecretion, SARS-CoV-2 test positive, Wheezing — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sinus drainage, headache, body aching , upset stomach ( but not throwing up) wheezing this morning til I used my asthma inhaler and major cough.I tested yesterday positive for Covid.

MedDRA releases: 2024-11 · check-in free text available
2022-10-11
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-12
Health check-in — 12 months, dose 4
Feeling: Poor

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-07	Moderna
3	2021-10-21	Moderna	No
4	2022-04-12	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 7 — day 21, dose 1

2021-04-06

Symptoms: Shingles

Release 7 — days 1–6 daily, dose 2

2021-04-09

Systemic reaction (other): The fever was yesterday . Couldnt change it. It was from 1:00 pm til 10 pm last night.

2021-04-13

Systemic reaction (other): Light headed

Release 8 — day 28, dose 2

2021-05-05

Symptoms: Leg cramps but I think its due to meds Im on.hip and legs hurt to point cant sleep good

Release 8 — day 35, dose 2

2021-05-12

Symptoms: Blood pressure went down to 106/63 pulse 63 so I feel dizzy off and on.allergys too.nothing I think to do with the shot .

Release 12 — 3 months, dose 4

2022-07-12

Symptoms: Sinus drainage, headache, body aching , upset stomach ( but not throwing up) wheezing this morning til I used my asthma inhaler and major cough.I tested yesterday positive for 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	Abdominal discomfort	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Blood pressure decreased	✓	✓	✓
SD	Cough	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Headache	·	·	✓
SD	Herpes zoster	✓	✓	✓
SD	Muscle spasms	✓	✓	✓
SD	Pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Paranasal sinus hypersecretion	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Sleep disorder	✓	✓	✓
SD	Wheezing	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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