4DN-18974-12384

3 vaccinations 9 coded responses 25 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 780 / TX
Registered: 2021-02-25

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

2021-02-25
Registered in v-safe
2021-02-25
Dose 1 — Moderna
2021-02-25
Survey response — day 0, dose 1
MedDRA: Chest discomfort — Feeling: Good

Free text: Slight heaviness in chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-03-01
Survey response — days 1–6 daily, dose 1
MedDRA: Rash — Feeling: Good · Rash, not including the immediate area around the injection site

Free text: Rash is at waist and belly. Very mild now.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Nausea — Feeling: Good · Chills, Nausea

Free text: Nausea and chills lasted only 4 hours

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

Adult check-in
2021-03-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-25
Dose 2 — Moderna
2021-03-25
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 2
MedDRA: Adverse reaction — Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness

Free text: Symptoms are just beginning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus — Feeling: Good · Site: Itching

Free text: Itching is almost gone.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-08
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-06
Survey response — day 42, dose 2
MedDRA: Diarrhoea, Nausea, Oropharyngeal pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Random nausea and diarrhea that lasts about two days. Began last week and happened again this week. This isnt what Id call a Crohns flare. I dont know if its from the vaccine. I still consider myself in excellent health but this is dif

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-17
Dose 3 — Moderna
2021-09-24
Survey response — 6 months, dose 2
MedDRA: Brain fog, Crohn's disease, Headache, Malaise, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: 3rd shot 08/17. Out of last 30 days spent 20 sick in bed. Every Covid symptom. Thought it gave me Covid. Crohns flares would begin then stop. Brain fog and headache from hell. Every ailment I have was magnified. Dont know about getting booster.

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Survey response — 3 months, dose 3
MedDRA: Immune system disorder, Immunisation reaction, Office visit, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: The third full vaccine for those with compromised immune symptoms blew up my immune system. Severe reaction to full vaccine. Also severe reactions to 10 days of dexamethasone. Advised not to have anymore Covid shots. Period. Nearly killed me! · Healthcare visit (other): Doctor visit

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-18
Call 1 — Could Not Reach Participant
2021-11-23
Call 2 — Could Not Reach Participant
2022-02-16
Survey response — 6 months, dose 3
MedDRA: Crohn's disease, Malaise, Office visit, Parosmia, Pre-existing disease, Taste disorder — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I have Crohn's disease. 3rd full vaccine at 5mo blew up my immune system. Horribly sick! 10 days on Dexamethasone. Tested 02/07/22 have zero antibodies. Zero. Cannot tolerant vaccines. Taste and smell are still messed up. · Healthcare visit (other): Primary care doctor

MedDRA releases: 2024-11 · check-in free text available
2022-02-16
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-02-21
Call 1 — Could Not Reach Participant
2022-02-24
Call 2 — Could Not Reach Participant

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Moderna
2	2021-03-25	Moderna
3	2021-08-17	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 4 — day 0, dose 1

2021-02-25

Systemic reaction (other): Slight heaviness in chest

Release 4 — days 1–6 daily, dose 1

2021-03-01

Systemic reaction (other): Rash is at waist and belly. Very mild now.

2021-03-02

Systemic reaction (other): Nausea and chills lasted only 4 hours

Release 6 — days 1–6 daily, dose 2

2021-03-26

Systemic reaction (other): Symptoms are just beginning

2021-03-30

Systemic reaction (other): Itching is almost gone.

Release 8 — day 42, dose 2

2021-05-06

Symptoms: Random nausea and diarrhea that lasts about two days. Began last week and happened again this week. This isnt what Id call a Crohns flare. I dont know if its from the vaccine. I still consider myself in excellent health but this is dif

Release 9 — 6 months, dose 2

2021-09-24

Symptoms: 3rd shot 08/17. Out of last 30 days spent 20 sick in bed. Every Covid symptom. Thought it gave me Covid. Crohns flares would begin then stop. Brain fog and headache from hell. Every ailment I have was magnified. Dont know about getting booster.

Release 10 — 3 months, dose 3

2021-11-16

Symptoms: The third full vaccine for those with compromised immune symptoms blew up my immune system. Severe reaction to full vaccine. Also severe reactions to 10 days of dexamethasone. Advised not to have anymore Covid shots. Period. Nearly killed me!

Healthcare visit (other): Doctor visit

Release 11 — 6 months, dose 3

2022-02-16

Symptoms: I have Crohn's disease. 3rd full vaccine at 5mo blew up my immune system. Horribly sick! 10 days on Dexamethasone. Tested 02/07/22 have zero antibodies. Zero. Cannot tolerant vaccines. Taste and smell are still messed up.

Healthcare visit (other): Primary care doctor

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	Brain fog	·	·	✓
SD	Crohn's disease	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Headache	·	·	✓
SD	Immune system disorder	·	·	✓
SD	Immunisation reaction	·	·	✓
SD	Malaise	·	·	✓
SD	Nausea	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Parosmia	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Taste disorder	·	·	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Nausea	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓

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