459-33796-79660

2 vaccinations 14 coded responses 26 check-ins 14 free-text entries 1 call case

Sex: Female
Age at first dose: 61-65
ZIP prefix: 347 / FL
Registered: 2021-03-02

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-03-02
Registered in v-safe
2021-03-02
Dose 1 — Moderna
2021-03-02
Survey response — day 0, dose 1
MedDRA: Injection site warmth — Feeling: Good · Site: Itching

Free text: Warmth at injection site

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Headache, Somnolence — Feeling: Good · Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Had a slight headache late yesterday, but took Tylenol for the aching arm (shot site), and to make sure I stayed ahead of any possible fever. Was really tired and sleepy this morning, but was better after 12 noon.

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

Adult check-in
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea, Pre-existing disease — Feeling: Fair · Site: Pain · Headache, Muscle or body aches · Be unable to do your normal daily activities

Free text: Restricted breathing, had to use nebulizer. During course of lung cancer surgery, I had chest reconstruction with a muscle flap; which was very tight today... my surgery was January 6th...

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Ear discomfort — Feeling: Good · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Moderate pressure on right ear; injection site on left side.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — day 7, dose 1
Feeling: Good · Headache, Fatigue or tiredness, Diarrhea

Adult check-in
2021-03-16
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-30
Dose 2 — Moderna
2021-03-30
Health check-in — day 0, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Dizziness, Productive cough — Feeling: Fair · Site: Redness, Swelling · Fever · Chills, Headache, Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Free text: Extreme dizziness, cough w/phlegm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-02
Survey response — days 1–6 daily, dose 2
MedDRA: Diarrhoea, Dizziness, Lymphadenopathy, Nausea — Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Swollen glands, dizziness (the last 2 days extreme dizziness, nausea & diarrhea )

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-03
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Dizziness, Nausea — Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Coughing, and fluctuating dizziness with nausea (mild to severe)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-04
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Photophobia — Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Extreme dizziness, some light sensitivity

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal distension, Dizziness, Flatulence, Nausea — Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Extreme dizziness with nausea, all week terrible gas and bloating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Survey response — day 7, dose 2
MedDRA: Dizziness, Nausea, Respiratory tract congestion — Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Congestion, exttreme dizziness with nausea

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

Adult check-in
2021-04-22
Survey response — day 21, dose 2
MedDRA: Cough, Dizziness, Headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Headaches, coughing, & dizziness.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — day 28, dose 2
MedDRA: Cough — Feeling: Fair

Free text: Coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-04
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-11
Survey response — day 42, dose 2
MedDRA: Headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Headaches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-29
Survey response — 3 months, dose 2
MedDRA: Diverticulitis, Headache, Office visit — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Headaches, diverticulitis · Healthcare visit (other): Also in-office visit; was told that I could have covid19, but some symptoms of diverticulitis similiar to covid19

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-29
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2021-07-02
Call 1 — Left Voicemail
2021-09-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-03-30
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-02	Moderna
2	2021-03-30	Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-03-02

Systemic reaction (other): Warmth at injection site

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): Had a slight headache late yesterday, but took Tylenol for the aching arm (shot site), and to make sure I stayed ahead of any possible fever. Was really tired and sleepy this morning, but was better after 12 noon.

2021-03-05

Systemic reaction (other): Restricted breathing, had to use nebulizer. During course of lung cancer surgery, I had chest reconstruction with a muscle flap; which was very tight today... my surgery was January 6th...

2021-03-08

Systemic reaction (other): Moderate pressure on right ear; injection site on left side.

Release 6 — days 1–6 daily, dose 2

2021-04-01

Systemic reaction (other): Extreme dizziness, cough w/phlegm

2021-04-02

Systemic reaction (other): Swollen glands, dizziness (the last 2 days extreme dizziness, nausea & diarrhea )

2021-04-03

Systemic reaction (other): Coughing, and fluctuating dizziness with nausea (mild to severe)

2021-04-04

Systemic reaction (other): Extreme dizziness, some light sensitivity

2021-04-05

Systemic reaction (other): Extreme dizziness with nausea, all week terrible gas and bloating

Release 7 — day 7, dose 2

2021-04-06

Systemic reaction (other): Congestion, exttreme dizziness with nausea

Release 7 — day 21, dose 2

2021-04-22

Symptoms: Headaches, coughing, & dizziness.

Release 8 — day 28, dose 2

2021-04-27

Symptoms: Coughing

Release 8 — day 42, dose 2

2021-05-11

Symptoms: Headaches

Release 9 — 3 months, dose 2

2021-06-29

Symptoms: Headaches, diverticulitis

Healthcare visit (other): Also in-office visit; was told that I could have covid19, but some symptoms of diverticulitis similiar to covid19

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	Office visit	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Diverticulitis	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Headache	✓	✓	✓
SRO	Abdominal distension	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Ear discomfort	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Flatulence	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site warmth	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Photophobia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Productive cough	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Somnolence	✓	✓	✓

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