48C-20265-08274

5 vaccinations 9 coded responses 46 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 450 / OH
Registered: 2021-02-04

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

2021-01-26
Dose 1 — Moderna
2021-02-04
Registered in v-safe
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-23
Dose 2 — Moderna
2021-02-23
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Lymph node pain — Feeling: Good · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lymph node pain under right arm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: Mild pain under right arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Diarrhea

Adult check-in
2021-03-02
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-09
Survey response — day 14, dose 2
MedDRA: Diarrhoea — Feeling: Fair

Free text: Diarrhea today. But I occasionally have diarrhea though. It may not be connected with vaccine.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-30
Survey response — day 35, dose 2
MedDRA: Abdominal pain upper, Chills, Hyperhidrosis, Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: Vomiting, 99.6 temp, perspiring, chills, stomach pain for eight hours March 27 - in night. Four weeks after vaccination. Fine now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-25
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-24
Survey response — 6 months, dose 2
MedDRA: Hospitalisation, Office visit, Renal stone removal — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: I had a stay in the hospital for a kidney stone removal. · Healthcare visit (other): Consultation at doctors office.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-24
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-30
Call 2 — Left Voicemail
2021-11-04
Dose 3 — Moderna
2022-02-23
Survey response — 12 months, dose 2
MedDRA: Nephrolithiasis — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Kidney stone

MedDRA releases: 2024-11 · check-in free text available
2022-02-23
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-02-24
Call 1 — Left Voicemail
2022-05-05
Dose 4 — Moderna
2022-05-05
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-05-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-07
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-08
Survey response — days 1–6 daily, dose 4
MedDRA: Lymph node pain — Feeling: Good

Free text: Pain underarm (lymph node)

MedDRA releases: 2024-11 · check-in free text available
2022-05-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-05-12
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-05-19
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-19
Call 1 — Left Voicemail
2022-05-19
Call 2 — Left Voicemail
2022-05-26
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-02
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-06-16
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-04
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-26
Dose 5 — Moderna
2022-09-26
Health check-in — day 0, dose 5
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-27
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · None

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Headache, Muscle or body aches

Adult check-in
2022-09-29
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-09-30
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-01
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-02
Health check-in — days 1–6 daily, dose 5
Feeling: Good · None

Adult check-in
2022-10-05
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-10
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-17
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-24
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-31
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-07
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-26
Survey response — 3 months, dose 5
MedDRA: Malaise, SARS-CoV-2 test positive — Feeling: Poor · Be unable to do your normal daily activities

Free text: Symptoms of COVID. Tested positive yesterday.

MedDRA releases: 2024-11 · check-in free text available
2023-03-27
Survey response — 6 months, dose 5
MedDRA: Back pain, Office visit, Spinal pain — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-03-27
Report sent to call center — 6 months, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-03-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-28
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-26	Moderna
2	2021-02-23	Moderna
3	2021-11-04	Moderna	No
4	2022-05-05	Moderna	No
5	2022-09-26	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): Lymph node pain under right arm.

2021-02-26

Systemic reaction (other): Mild pain under right arm

Release 5 — day 14, dose 2

2021-03-09

Symptoms: Diarrhea today. But I occasionally have diarrhea though. It may not be connected with vaccine.

Release 6 — day 35, dose 2

2021-03-30

Symptoms: Vomiting, 99.6 temp, perspiring, chills, stomach pain for eight hours March 27 - in night. Four weeks after vaccination. Fine now.

Release 9 — 6 months, dose 2

2021-08-24

Symptoms: I had a stay in the hospital for a kidney stone removal.

Healthcare visit (other): Consultation at doctors office.

Release 11 — 12 months, dose 2

2022-02-23

Symptoms: Kidney stone

Release 11 — days 1–6 daily, dose 4

2022-05-08

Systemic reaction (other): Pain underarm (lymph node)

Release 12 — 3 months, dose 5

2022-12-26

Symptoms: Symptoms of COVID. Tested positive yesterday.

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	Abdominal pain upper	✓	✓	✓
SD	Back pain	·	·	✓
SD	Chills	✓	✓	✓
SD	Diarrhoea	✓	✓	✓
SD	Hospitalisation	✓	·	✓
SD	Hyperhidrosis	✓	✓	✓
SD	Malaise	·	·	✓
SD	Nephrolithiasis	·	·	✓
SD	Renal stone removal	✓	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Spinal pain	·	·	✓
SD	Vomiting	✓	✓	✓
SRO	Lymph node pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓

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