49Z-31090-38537

5 vaccinations 7 coded responses 18 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 453 / OH
Registered: 2021-02-26

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
2021-02-26
Registered in v-safe
2021-02-26
Dose 2 — Moderna
2021-02-26
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Redness · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

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

Free text: Still dizzy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Rhinorrhoea — Feeling: Fair · Headache, Muscle or body aches, Diarrhea · Be unable to do your normal daily activities

Free text: Sniffles

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness — Feeling: Good · Site: Pain · Chills, Muscle or body aches

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Muscle or body aches

Adult check-in
2021-03-07
Health check-in — day 7, dose 2
Feeling: Fair · None · Be unable to do your normal daily activities

Adult check-in
2021-03-12
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-19
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-02
Survey response — day 35, dose 2
MedDRA: Abnormal faeces, Anal incontinence, Inflammatory bowel disease, Self-medication — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Severe IBS. cannot keep bowels from dumping. Taking Imodium and lomotil Bad smell. May be C-diff coming on.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — day 42, dose 2
MedDRA: Corneal lesion, Office visit — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: I have a lesion on my right eye, and it looks like a second one is developing there, too. · Healthcare visit (other): Specialist doctors office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Report sent to call center — day 42, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-29
Survey response — 6 months, dose 2
MedDRA: Emergency care, Hospitalisation, Urinary tract infection — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit, Hospitalization

Free text: I have had to go to the ER TWICE for rxs for UTIs. At one point, they admitted me for an overnight for IV antibiotics.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-29
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-31
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-05
Dose 3 — Moderna
2022-02-26
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-08
Dose 4 — Moderna
2022-09-30
Dose 5 — Moderna
2022-10-21
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-12-31
Survey response — 3 months, dose 5
MedDRA: COVID-19, Exposure to SARS-CoV-2, Fall, Malaise, Rotator cuff syndrome, Unevaluable event — Feeling: Good · 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, Emergency room or emergency department visit

Free text: Symptoms: Fell and tore my rotator cuff, but y'all want to hear that husband and I both got the COVID in November and we're very ill ?. He was in ?? hospital 6 days, rehab for over three weeks. I was home but quite ill. We are both ok now. B · Healthcare visit (other): Husband hospitalized

MedDRA releases: 2024-11 · check-in free text available
2022-12-31
Report sent to call center — 3 months, dose 5
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 · Emergency room or emergency department visit · 1 call case(s)
2023-01-03
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	2021-02-26	Moderna
3	2021-11-05	Moderna	No
4	2022-05-08	Moderna	No
5	2022-09-30	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

2021-02-27

Systemic reaction (other): Still dizzy

2021-02-28

Systemic reaction (other): Sniffles

2021-03-01

Systemic reaction (other): Dizziness

Release 6 — day 35, dose 2

2021-04-02

Symptoms: Severe IBS. cannot keep bowels from dumping. Taking Imodium and lomotil Bad smell. May be C-diff coming on.

Release 7 — day 42, dose 2

2021-04-09

Symptoms: I have a lesion on my right eye, and it looks like a second one is developing there, too.

Healthcare visit (other): Specialist doctors office

Release 9 — 6 months, dose 2

2021-08-29

Symptoms: I have had to go to the ER TWICE for rxs for UTIs. At one point, they admitted me for an overnight for IV antibiotics.

Release 12 — 3 months, dose 5

2022-12-31

Symptoms: Fell and tore my rotator cuff, but y'all want to hear that husband and I both got the COVID in November and we're very ill ?. He was in ?? hospital 6 days, rehab for over three weeks. I was home but quite ill. We are both ok now. B

Healthcare visit (other): Husband hospitalized

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	✓	✓	✓
HCVO	Unevaluable event	·	·	✓
SD	Abnormal faeces	✓	✓	✓
SD	Anal incontinence	✓	✓	✓
SD	Corneal lesion	✓	✓	✓
SD	COVID-19	·	·	✓
SD	Emergency care	✓	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Fall	·	·	✓
SD	Hospitalisation	✓	·	✓
SD	Inflammatory bowel disease	✓	✓	✓
SD	Malaise	·	·	✓
SD	Rotator cuff syndrome	·	·	✓
SD	Self-medication	✓	✓	✓
SD	Urinary tract infection	✓	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓

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