495-90967-71794

4 vaccinations 10 coded responses 26 check-ins 9 free-text entries 6 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 782 / TX
Registered: 2020-12-30

Relationship: Self
Race: Asian
Ethnicity: N/A

Timeline

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

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2020-12-31
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-01
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-01
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

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

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Survey response — day 14, dose 1
MedDRA: Abdominal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Left-Sided abdominal pain, constant.Feels like diverticulitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-20
Survey response — day 21, dose 1
MedDRA: Abdominal pain lower — Feeling: Fair · Be unable to do your normal daily activities

Free text: Left-sided Lower abdominal focal pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Dose 2 — Moderna
2021-03-31
Survey response — 3 months, dose 1
MedDRA: Unevaluable event — Feeling: Poor · Be unable to work

Free text: Symptoms similar to but milder than COVID, but tested negative on both rapid antigen and PCR tests

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — 3 months, dose 2
MedDRA: Cardiac disorder, Cough — Feeling: Good · 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: Chronic coughHeart problems

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-07
Call 3 — Left Voicemail
2021-08-01
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-26
Dose 3 — Moderna
Co-administered: Shingles
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-09
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-16
Survey response — day 21, dose 3
MedDRA: Fatigue, Myalgia — Feeling: Poor

Free text: Myalgia and fatigue. Would not be able to say that it's related to booster.

MedDRA releases: 2024-11 · check-in free text available
2021-11-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-25
Survey response — 3 months, dose 3
MedDRA: Laryngitis, Productive cough — Feeling: Fair · Be unable to do your normal daily activities

Free text: Severe laryngitis and productive cough. Possibly from mycoplasma pneumonia acquired from my physician-daughter.

MedDRA releases: 2024-11 · check-in free text available
2022-04-03
Dose 4 — Moderna
2022-05-19
Survey response — day 42, dose 4
MedDRA: Arthralgia, Neck pain, Nodule — Feeling: Poor · 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: Arthritic-type nodule of right pinky and arthritic type pain in back, neck and base of skull. Deep neck pain.

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Report sent to call center — day 42, 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)
2022-05-20
Call 2 — Left Voicemail
2022-05-20
Call 2 — Left Voicemail
2022-07-04
Survey response — 3 months, dose 4
MedDRA: COVID-19, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Caught COVID, mild symptoms , only fever, went away within 24 hours!

MedDRA releases: 2024-11 · check-in free text available
2023-04-06
Survey response — 12 months, dose 4
MedDRA: Arthralgia, Fatigue, Myalgia, Office visit, Weight increased — 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 · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-06
Report sent to call center — 12 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-07
Call 1 — Left Voicemail
2023-04-07
Call 1 — Left Voicemail
2023-04-07
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-27	Moderna
3	2021-10-26	Moderna	Shingles
4	2022-04-03	Moderna	No

Call center

6 call center cases

3 unsuccessful · 3 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-01

Systemic reaction (other): Dizzy

Release 1 — day 14, dose 1

2021-01-13

Symptoms: Left-Sided abdominal pain, constant.Feels like diverticulitis

Release 2 — day 21, dose 1

2021-01-20

Symptoms: Left-sided Lower abdominal focal pain

Release 6 — 3 months, dose 1

2021-03-31

Symptoms: Symptoms similar to but milder than COVID, but tested negative on both rapid antigen and PCR tests

Release 8 — 3 months, dose 2

2021-04-28

Symptoms: Chronic coughHeart problems

Release 10 — day 21, dose 3

2021-11-16

Symptoms: Myalgia and fatigue. Would not be able to say that it's related to booster.

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Severe laryngitis and productive cough. Possibly from mycoplasma pneumonia acquired from my physician-daughter.

Release 11 — day 42, dose 4

2022-05-19

Symptoms: Arthritic-type nodule of right pinky and arthritic type pain in back, neck and base of skull. Deep neck pain.

Release 12 — 3 months, dose 4

2022-07-04

Symptoms: Caught COVID, mild symptoms , only fever, went away within 24 hours!

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	✓	✓	✓
SD	Abdominal pain lower	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Cardiac disorder	✓	✓	✓
SD	Cough	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Laryngitis	·	·	✓
SD	Myalgia	·	·	✓
SD	Neck pain	·	·	✓
SD	Nodule	·	·	✓
SD	Productive cough	·	·	✓
SD	Pyrexia	·	·	✓
SD	Unevaluable event	✓	✓	✓
SD	Weight increased	·	·	✓
SRO	Dizziness	✓	✓	✓

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