49Q-96164-02030

2 vaccinations 8 coded responses 26 check-ins 8 free-text entries 2 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 136 / NY
Registered: 2021-06-08

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

2021-06-08
Registered in v-safe
2021-06-08
Dose 1 — Moderna
2021-06-08
Health check-in — day 0, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-06-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea

Adult check-in
2021-06-10
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-06-11
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-06-12
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea · Be unable to work or attend school

Adult check-in
2021-06-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-06-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-06-15
Health check-in — day 7, dose 1
Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain

Adult check-in
2021-06-22
Health check-in — day 14, dose 1
Feeling: Poor

Adult check-in
2021-06-29
Survey response — day 21, dose 1
MedDRA: Headache, Nausea — Feeling: Fair · Be unable to work or attend school

Free text: Headache and nauseous

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-06
Dose 2 — Moderna
2021-07-06
Health check-in — day 0, dose 2
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-07-07
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-07-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-07-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-07-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-07-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-07-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-07-13
Health check-in — day 7, dose 2
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-07-20
Survey response — day 14, dose 2
MedDRA: Abdominal pain upper — Feeling: Fair · Be unable to do your normal daily activities

Free text: Stomach pain really bad!

MedDRA releases: 2024-11 · check-in free text available
2021-07-27
Survey response — day 21, dose 2
MedDRA: Abdominal pain upper, Cough, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: I got a cough and reallu bad stomach pains with nauseous

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-03
Survey response — day 28, dose 2
MedDRA: Chest discomfort, Cough, Oropharyngeal pain — Feeling: Poor · Be unable to work or attend school

Free text: Sore throat and cough with pressure in my chest

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-10
Survey response — day 35, dose 2
MedDRA: Chest discomfort, Cough, Migraine, Oropharyngeal pain — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Cough, sore throat, horrible migraine and chest pressure

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-17
Survey response — day 42, dose 2
MedDRA: Fatigue, Throat irritation — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Im exhausted all the time and my throat is scratchy today

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-05
Survey response — 3 months, dose 2
MedDRA: Malaise, Sinusitis — Feeling: Poor · 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

Free text: I feel like i have covid... i have felt like shit since i got this stupid shot! And i have a sinus infection and my dr said thats a sign of the delta one.. i regret this shot 100%! I feel like im dying!

MedDRA releases: 2024-11 · check-in free text available
2021-10-05
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-11
Call 1 — Left Voicemail
2022-01-04
Survey response — 6 months, dose 2
MedDRA: Abdominal pain upper, Headache, Malaise — Feeling: Poor · 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, Outpatient clinic or urgent care clinic visit

Free text: Headaches and stomachache is non stop .. feel like shit!

MedDRA releases: 2024-11 · check-in free text available
2022-01-04
Report sent to call center — 6 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-05
Call 1 — Left Voicemail
2022-01-06
Call 2 — Left Voicemail
2022-07-09
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-06-08	Moderna
2	2021-07-06	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 9 — day 21, dose 1

2021-06-29

Symptoms: Headache and nauseous

Release 9 — day 14, dose 2

2021-07-20

Symptoms: Stomach pain really bad!

Release 9 — day 21, dose 2

2021-07-27

Symptoms: I got a cough and reallu bad stomach pains with nauseous

Release 9 — day 28, dose 2

2021-08-03

Symptoms: Sore throat and cough with pressure in my chest

Release 9 — day 35, dose 2

2021-08-10

Symptoms: Cough, sore throat, horrible migraine and chest pressure

Release 9 — day 42, dose 2

2021-08-17

Symptoms: Im exhausted all the time and my throat is scratchy today

Release 10 — 3 months, dose 2

2021-10-05

Symptoms: I feel like i have covid... i have felt like shit since i got this stupid shot! And i have a sinus infection and my dr said thats a sign of the delta one.. i regret this shot 100%! I feel like im dying!

Release 10 — 6 months, dose 2

2022-01-04

Symptoms: Headaches and stomachache is non stop .. feel like shit!

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 pain upper	✓	·	✓
SD	Chest discomfort	✓	·	✓
SD	Cough	✓	·	✓
SD	Fatigue	✓	·	✓
SD	Headache	✓	✓	✓
SD	Malaise	·	·	✓
SD	Migraine	✓	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	·	✓
SD	Sinusitis	·	·	✓
SD	Throat irritation	✓	·	✓

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