49S-74781-50768

4 vaccinations 12 coded responses 47 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 954 / CA
Registered: 2021-01-28

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-28
Registered in v-safe
2021-01-28
Dose 1 — Moderna
2021-01-28
Health check-in — day 0, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-29
Survey response — days 1–6 daily, dose 1
MedDRA: Abdominal discomfort — Feeling: Good · Headache, Fatigue or tiredness

Free text: Upper arm pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-30
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Fatigue or tiredness

Free text: Arm pain is better.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

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

Adult check-in
2021-02-02
Survey response — days 1–6 daily, dose 1
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Good · Headache · Be unable to do your normal daily activities

Free text: Trigeminal neuralgia flare

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-25
Dose 2 — Moderna
2021-02-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None · Be unable to do your normal daily activities

Adult check-in
2021-02-26
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 · Be unable to do your normal daily activities

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Trigeminal neuralgia — Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Trigeminal Neuralgia ongoing last 2 days.

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 · Site: Pain · Headache · Be unable to do your normal daily activities

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-01
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-27
Survey response — 3 months, dose 2
MedDRA: Back pain, Musculoskeletal chest pain, Painful respiration — Feeling: Good

Free text: Pain around ribs and lower back upon inhalation. This is not 24/7, just concerning, and usually at night while laying down.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-26
Dose 3 — Moderna
2021-10-26
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Pain — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Deep stabbing body pains

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Trigeminal neuralgia — Feeling: Fair · Site: Pain, Redness · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Trigeminal neuralgia yesterday.

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Survey response — days 1–6 daily, dose 3
MedDRA: Pain — Feeling: Fair · Site: Pain · Headache

Free text: Right side pain between neck and shoulder. Received shot in right arm.

MedDRA releases: 2024-11 · check-in free text available
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Injection site bruising — Feeling: Good · Site: Pain

Free text: Significant bruising at site injection.

MedDRA releases: 2024-11 · check-in free text available
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · 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
2021-11-17
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-07
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-25
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-04
Dose 4 — Moderna
2022-04-14
Survey response — day 7, dose 4
MedDRA: Rhinorrhoea — Feeling: Fair

Free text: Runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-25
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-02
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-09
Survey response — day 35, dose 4
MedDRA: Fatigue, Headache, Respiratory tract congestion, Rhinorrhoea — Feeling: Poor · 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: Runny nose, congestion, headache, fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-05-09
Report sent to call center — day 35, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-16
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-04
Survey response — 3 months, dose 4
MedDRA: COVID-19, Cough, Fatigue, Myalgia, Oropharyngeal pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · 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: Covid positive - fever, muscle ache, sore throat, congestion, runny nose, cough, fatigue.

MedDRA releases: 2024-11 · check-in free text available
2022-07-04
Report sent to call center — 3 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-07-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-03
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-04
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-28	Moderna
2	2021-02-25	Moderna
3	2021-10-26	Moderna	No
4	2022-04-04	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-01-29

Systemic reaction (other): Upper arm pain

2021-01-30

Systemic reaction (other): Arm pain is better.

2021-02-02

Systemic reaction (other): Trigeminal neuralgia flare

Release 4 — days 1–6 daily, dose 2

2021-02-28

Systemic reaction (other): Trigeminal Neuralgia ongoing last 2 days.

Release 8 — 3 months, dose 2

2021-05-27

Symptoms: Pain around ribs and lower back upon inhalation. This is not 24/7, just concerning, and usually at night while laying down.

Release 10 — days 1–6 daily, dose 3

2021-10-27

Systemic reaction (other): Deep stabbing body pains

2021-10-28

Systemic reaction (other): Trigeminal neuralgia yesterday.

2021-10-29

Systemic reaction (other): Right side pain between neck and shoulder. Received shot in right arm.

2021-10-30

Systemic reaction (other): Significant bruising at site injection.

Release 11 — day 7, dose 4

2022-04-14

Systemic reaction (other): Runny nose

Release 11 — day 35, dose 4

2022-05-09

Symptoms: Runny nose, congestion, headache, fatigue.

Release 12 — 3 months, dose 4

2022-07-04

Symptoms: Covid positive - fever, muscle ache, sore throat, congestion, runny nose, cough, fatigue.

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	Back pain	✓	✓	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	·	·	✓
SD	Headache	·	·	✓
SD	Musculoskeletal chest pain	✓	✓	✓
SD	Myalgia	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Painful respiration	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Abdominal discomfort	✓	✓	✓
SRO	Condition aggravated	✓	✓	✓
SRO	Injection site bruising	·	·	✓
SRO	Pain	·	·	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Trigeminal neuralgia	✓	✓	✓

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