4JC-17994-69826

3 vaccinations 8 coded responses 32 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 453 / OH
Registered: 2021-01-12

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

2020-12-30
Dose 1 — Moderna
2021-01-12
Registered in v-safe
2021-01-12
Survey response — day 7, dose 1
MedDRA: Insomnia — Feeling: Good · Site: Pain

Free text: Day 4-7 post vaccine I had horrible insomnia and could not sleep more than 2 hours

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-13
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-21
Survey response — day 21, dose 1
MedDRA: Chills, Cough, Medical counselling, Oropharyngeal pain — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Cough, sore throat, chills · Healthcare visit (other): Employ health ordering a Covid test

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-27
Dose 2 — Moderna
2021-01-27
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Chills, Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling · Diarrhea

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-24
Survey response — day 28, dose 2
MedDRA: Injection site reaction, Pain, Pyrexia, Urticaria, Vaccine positive rechallenge — Feeling: Good · Be unable to do your normal daily activities

Free text: Received Tdap 3 weeks plus 1 day after second Covid Moderna vaccine. At 24 hours, developed high fever 101 with meds, body aches, and welts around injection site. Last 12 hours. Reacted EXACTLY like Covid #2. No hx if this before Covid shots

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-10
Survey response — day 42, dose 2
MedDRA: Sinusitis — Feeling: Good · Be unable to work

Free text: Sinusitis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Call 1 — Left Voicemail
2021-04-28
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-30
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-22
Dose 3 — Moderna
2021-10-24
Survey response — days 1–6 daily, dose 3
MedDRA: Decreased appetite — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Decreased appetite

MedDRA releases: 2024-11 · check-in free text available
2021-10-25
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-10-26
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Redness, Swelling, Itching · Abdominal pain

Adult check-in
2021-10-27
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-29
Health check-in — day 7, dose 3
Feeling: Good · Rash, not including the immediate area around the injection site

Adult check-in
2021-11-05
Survey response — day 14, dose 3
MedDRA: Rash — Feeling: Fair · Be unable to do your normal daily activities

Free text: Horrific rash on side of ribs

MedDRA releases: 2024-11 · check-in free text available
2021-11-14
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-19
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-11-26
Survey response — day 35, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-21
Survey response — 3 months, dose 3
MedDRA: Diarrhoea, Respiratory tract congestion — Feeling: Fair

Free text: Diarrhea congestion

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Health check-in — 6 months, dose 3
Feeling: Good

Adult check-in
2022-10-22
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-27	Moderna
3	2021-10-22	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 1 — day 7, dose 1

2021-01-12

Systemic reaction (other): Day 4-7 post vaccine I had horrible insomnia and could not sleep more than 2 hours

Release 2 — day 21, dose 1

2021-01-21

Symptoms: Cough, sore throat, chills

Healthcare visit (other): Employ health ordering a Covid test

Release 4 — day 28, dose 2

2021-02-24

Symptoms: Received Tdap 3 weeks plus 1 day after second Covid Moderna vaccine. At 24 hours, developed high fever 101 with meds, body aches, and welts around injection site. Last 12 hours. Reacted EXACTLY like Covid #2. No hx if this before Covid shots

Release 5 — day 42, dose 2

2021-03-10

Symptoms: Sinusitis

Release 10 — days 1–6 daily, dose 3

2021-10-24

Systemic reaction (other): Decreased appetite

Release 10 — day 14, dose 3

2021-11-05

Symptoms: Horrific rash on side of ribs

Release 10 — day 35, dose 3

2021-11-26

Symptoms: Sore throat

Release 10 — 3 months, dose 3

2022-01-21

Symptoms: Diarrhea congestion

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	Medical counselling	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Diarrhoea	·	·	✓
SD	Injection site reaction	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Sinusitis	✓	✓	✓
SD	Urticaria	✓	✓	✓
SD	Vaccine positive rechallenge	✓	✓	✓
SRO	Decreased appetite	·	·	✓
SRO	Insomnia	✓	✓	✓

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