4JX-33206-16696

2 vaccinations 9 coded responses 26 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 925 / CA
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
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 1
MedDRA: Tremor — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Head was shaking this morning involuntarily

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Joint pains, 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 1
MedDRA: Chest pain, Dyspnoea, Joint swelling, Peripheral swelling — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Mild chest pain, shortness of breath, swollen feet and ankles, feel really awful all over

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort, Decreased appetite, Dyspnoea, Pain — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: Chest tightness, shortness of breath, loss of appetite, hurt all over, left urgent message for doctor but no response

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: Dyspnoea, Emergency care, Office visit — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · 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: Systemic reaction (other): Shortness of breath. Doctor sent me to ER · Healthcare visit (other): Doctor told me to go to ER for shortness of breath.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — day 7, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Still experiencing shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Health check-in — day 14, dose 1
Feeling: Fair

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 · Site: Pain · None

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-01
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

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: Abdominal distension, Dyspnoea, Fatigue, Joint swelling, Peripheral swelling, Weight increased — Feeling: Fair · Be unable to work, 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: Extreme swelling of legs, ankles, feet, frequent shortness of breath and fatigue, stomach bloating, weight gain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
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)
2021-06-25
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, Echocardiogram, Fatigue, Laboratory test, Peripheral swelling — Feeling: Fair · 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: Symptoms: Extreme swelling of legs and feet, shortness of breath and fatigue. · Healthcare visit (other): Echocardiogram. Lab tests

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
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

1 call case(s)
2021-06-28
Call 1 — Left Voicemail
2021-09-25
Survey response — 6 months, dose 2
MedDRA: Fatigue, Feeling abnormal, Hypothyroidism, Peripheral venous disease, Weight increased — Feeling: Poor · Be unable to work or attend school

Free text: Veinous insufficiency and u deractive thyroid, fatigue, sudden weight gain causing different daily problems. I just feel awful everyday since the first vaccine shot. My new phone number for talk and text is (b)(6)

MedDRA releases: 2024-11 · check-in free text available
2022-03-27
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Moderna
2	2021-03-25	Moderna

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-26

Systemic reaction (other): Head was shaking this morning involuntarily

2021-02-28

Systemic reaction (other): Mild chest pain, shortness of breath, swollen feet and ankles, feel really awful all over

2021-03-01

Systemic reaction (other): Chest tightness, shortness of breath, loss of appetite, hurt all over, left urgent message for doctor but no response

2021-03-02

Systemic reaction (other): Shortness of breath. Doctor sent me to ER

Healthcare visit (other): Doctor told me to go to ER for shortness of breath.

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): Shortness of breath

Release 5 — day 7, dose 1

2021-03-04

Systemic reaction (other): Still experiencing shortness of breath

Release 8 — day 42, dose 2

2021-05-06

Symptoms: Extreme swelling of legs, ankles, feet, frequent shortness of breath and fatigue, stomach bloating, weight gain

Release 9 — 3 months, dose 2

2021-06-25

Symptoms: Extreme swelling of legs and feet, shortness of breath and fatigue.

Healthcare visit (other): Echocardiogram. Lab tests

Release 9 — 6 months, dose 2

2021-09-25

Symptoms: Veinous insufficiency and u deractive thyroid, fatigue, sudden weight gain causing different daily problems. I just feel awful everyday since the first vaccine shot. My new phone number for talk and text is (b)(6)

redacted (b)(6)

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	Dyspnoea	✓	✓	✓
HCVO	Echocardiogram	✓	✓	✓
HCVO	Emergency care	✓	✓	✓
HCVO	Laboratory test	✓	✓	✓
HCVO	Office visit	✓	✓	✓
SD	Abdominal distension	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	·	·	✓
SD	Hypothyroidism	·	·	✓
SD	Joint swelling	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Peripheral venous disease	·	·	✓
SD	Weight increased	✓	✓	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Joint swelling	✓	✓	✓
SRO	Office visit	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Tremor	✓	✓	✓

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