47Z-24876-49905

4 vaccinations 11 coded responses 30 check-ins 11 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 791 / TX
Registered: 2020-12-31

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

2020-12-31
Registered in v-safe
2020-12-31
Dose 1 — Moderna
2020-12-31
Health check-in — day 0, dose 1
Feeling: Good · None

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

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Depression, Pre-existing disease — Feeling: Fair · Fatigue or tiredness

Free text: Just a little depressed today which is not new for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Survey response — days 1–6 daily, dose 1
MedDRA: Adjustment disorder with depressed mood — Feeling: Fair · Fatigue or tiredness

Free text: Unrelated mist likely. Situational depression.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-01-21
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-28
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-01-29
Dose 2 — Moderna
2021-02-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · None · Be unable to do your normal daily activities

Adult check-in
2021-02-05
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-12
Survey response — day 14, dose 2
MedDRA: Arthralgia, Repetitive strain injury — Feeling: Good

Free text: Joint pain right side, probably due to overuse of joints.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — day 21, dose 2
MedDRA: Arthralgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Having right shoulder, wrist, hip and knee pain. Got my shot on the right but most likely strain from activities.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-03-12
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-07-30
Survey response — 6 months, dose 2
MedDRA: Fatigue — Feeling: Fair

Free text: Fatigue

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-05
Dose 3 — Moderna
2022-01-29
Survey response — 12 months, dose 2
MedDRA: Arthralgia, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Joint pains. · Healthcare visit (other): In office

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-03-24
Call 1 — Left Voicemail
2022-03-24
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-06-03
Dose 4 — Moderna
2022-06-03
Survey response — day 0, dose 4
MedDRA: COVID-19, Dyspnoea, Fatigue — Feeling: Fair · 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: Have been fatigued and short of breath since having Covid in February

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Report sent to call center — day 0, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-04
Survey response — days 1–6 daily, dose 4
MedDRA: COVID-19, Fatigue, Pre-existing disease — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: The above symptoms are probably unrelated. Having them for a long time. However fatigue started after having Covid.

MedDRA releases: 2024-11 · check-in free text available
2022-06-05
Survey response — days 1–6 daily, dose 4
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Don't believe related to shot.

MedDRA releases: 2024-11 · check-in free text available
2022-06-06
Survey response — days 1–6 daily, dose 4
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Above most likely not related.

MedDRA releases: 2024-11 · check-in free text available
2022-06-06
Call 2 — Could Not Reach Participant
2022-06-06
Call 1 — Could Not Reach Participant
2022-06-07
Survey response — days 1–6 daily, dose 4
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Unrelated most likely

MedDRA releases: 2024-11 · check-in free text available
2022-06-08
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-06-09
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2022-06-09
Call 3 — Could Not Reach Participant
2022-06-09
Call 2 — Could Not Reach Participant
2022-06-10
Health check-in — day 7, dose 4
Feeling: Fair · Fatigue or tiredness

Adult check-in
2022-06-17
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-06-24
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-29	Moderna
3	2021-11-05	Moderna	No
4	2022-06-03	Moderna	No

Call center

2 call center cases

1 successful · 1 unsuccessful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-05

Systemic reaction (other): Just a little depressed today which is not new for me.

2021-01-06

Systemic reaction (other): Unrelated mist likely. Situational depression.

Release 4 — day 14, dose 2

2021-02-12

Symptoms: Joint pain right side, probably due to overuse of joints.

Release 4 — day 21, dose 2

2021-02-19

Symptoms: Having right shoulder, wrist, hip and knee pain. Got my shot on the right but most likely strain from activities.

Release 9 — 6 months, dose 2

2021-07-30

Symptoms: Fatigue

Release 11 — 12 months, dose 2

2022-01-29

Symptoms: Joint pains.

Healthcare visit (other): In office

Release 11 — day 0, dose 4

2022-06-03

Systemic reaction (other): Have been fatigued and short of breath since having Covid in February

Release 11 — days 1–6 daily, dose 4

2022-06-04

Systemic reaction (other): The above symptoms are probably unrelated. Having them for a long time. However fatigue started after having Covid.

2022-06-05

Systemic reaction (other): Don't believe related to shot.

2022-06-06

Systemic reaction (other): Above most likely not related.

2022-06-07

Systemic reaction (other): Unrelated most likely

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	Arthralgia	✓	✓	✓
SD	Fatigue	✓	·	✓
SD	Repetitive strain injury	✓	·	✓
SRO	Adjustment disorder with depressed mood	✓	✓	✓
SRO	COVID-19	·	·	✓
SRO	Depression	✓	✓	✓
SRO	Dyspnoea	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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