4P7-89798-02644

4 vaccinations 13 coded responses 40 check-ins 13 free-text entries 5 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 060 / CT
Registered: 2021-03-20

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

2021-03-19
Dose 1 — Moderna
2021-03-20
Registered in v-safe
2021-03-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-22
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-24
Survey response — days 1–6 daily, dose 1
MedDRA: Chest discomfort — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Slight tightness in my chest

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-03-26
Health check-in — day 7, dose 1
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Dose 2 — Moderna
2021-04-16
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-04-17
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, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-18
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, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain

Adult check-in
2021-04-23
Health check-in — day 7, dose 2
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site

Adult check-in
2021-05-02
Survey response — day 14, dose 2
MedDRA: Arthralgia, Chest discomfort, Dyspnoea, Fatigue, Headache, Post-acute COVID-19 syndrome — Feeling: Poor · Be unable to do your normal daily activities

Free text: Tighter chest, shortness of breath, headache, fatigue, joint pain.I was diagnosed with covid longhaul in the fall '20 after having covid for nearly 3 months in the spring '20. I have never felt fully back to my regular self. It's been a rollercoaster

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-14
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-21
Survey response — day 35, dose 2
MedDRA: Chest discomfort, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: More fatigue, tight chest, headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-30
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-16
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-15
Survey response — 6 months, dose 2
MedDRA: Palpitations — Feeling: Fair · 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: Heart palpitations

MedDRA releases: 2024-11 · check-in free text available
2021-10-15
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-10-20
Call 2 — Left Voicemail
2021-12-11
Dose 3 — Moderna
2021-12-12
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-14
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness, Mental disorder, Miosis — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Two + days of Dizzy/loopy sensation that pulsates on and off with pinprick pupils for two days, too

MedDRA releases: 2024-11 · check-in free text available
2021-12-16
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-12-17
Survey response — days 1–6 daily, dose 3
MedDRA: Dizziness, Eye irritation — Feeling: Fair · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Burning eyes since last week and strange dizzy visual since the booster

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Survey response — day 7, dose 3
MedDRA: Chest discomfort — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tight chest

MedDRA releases: 2024-11 · check-in free text available
2022-01-01
Survey response — day 21, dose 3
MedDRA: Chest discomfort — Feeling: Poor · Be unable to do your normal daily activities

Free text: Tight chest

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Survey response — day 28, dose 3
MedDRA: Back pain, Chest discomfort, Diarrhoea, Fatigue, Headache, Pain, Productive cough, Pyrexia — Feeling: Poor · 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: Fever 100.9Â°, headache, body aches particularly in lower back, tight chest w/slightly productive cough, diarrhea,fatigue, etc

MedDRA releases: 2024-11 · check-in free text available
2022-01-08
Report sent to call center — day 28, dose 3
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 · 1 call case(s)
2022-01-10
Call 1 — Could Not Reach Participant
2022-01-13
Call 2 — Could Not Reach Participant
2022-01-15
Survey response — day 35, dose 3
MedDRA: Chest discomfort, Chest pain, Fatigue, Headache — 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 · Telehealth, virtual health, or email health consultation

Free text: Tightness in chest when talking, pain in chest, Headache, fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-01-15
Report sent to call center — day 35, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-18
Call 1 — Left Voicemail
2022-01-25
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-03-13
Survey response — 3 months, dose 3
MedDRA: Arrhythmia, COVID-19, Cardiac ventricular scarring, Myocarditis — 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, Outpatient clinic or urgent care clinic visit

Free text: Arrthymias confirmed....scarring in the left ventricular apex from prior myocarditis occurring with covid(prior to vaccine)

MedDRA releases: 2024-11 · check-in free text available
2022-03-13
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-15
Call 1 — Left Voicemail
2022-06-13
Survey response — 6 months, dose 3
MedDRA: Brain fog, Chest discomfort, Fatigue — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Extreme fatigue, brain fog - cognitive communication disorder, tight chest

MedDRA releases: 2024-11 · check-in free text available
2022-06-13
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-06-14
Call 1 — Left Voicemail
2022-06-14
Call 3 — Left Voicemail
2022-06-14
Call 2 — Left Voicemail
2022-06-14
Call 2 — Left Voicemail
2022-06-14
Call 1 — Left Voicemail
2022-10-14
Dose 4 — Moderna
Co-administered: Flu
2022-10-14
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-10-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-10-17
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-10-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2022-10-19
Survey response — days 1–6 daily, dose 4
MedDRA: Chest discomfort — Feeling: Poor · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Tight chest, needed albuterol many x's

MedDRA releases: 2024-11 · check-in free text available
2022-10-22
Health check-in — day 7, dose 4
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-11-06
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-11-28
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-04-17
Health check-in — 6 months, dose 4
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-19	Moderna
2	2021-04-16	Moderna
3	2021-12-11	Moderna	No
4	2022-10-14	Moderna	Flu

Call center

5 call center cases

5 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-24

Systemic reaction (other): Slight tightness in my chest

Release 8 — day 14, dose 2

2021-05-02

Symptoms: Tighter chest, shortness of breath, headache, fatigue, joint pain.I was diagnosed with covid longhaul in the fall '20 after having covid for nearly 3 months in the spring '20. I have never felt fully back to my regular self. It's been a rollercoaster cut off by CDC

Release 8 — day 35, dose 2

2021-05-21

Symptoms: More fatigue, tight chest, headache

Release 10 — 6 months, dose 2

2021-10-15

Symptoms: Heart palpitations

Release 10 — days 1–6 daily, dose 3

2021-12-14

Systemic reaction (other): Two + days of Dizzy/loopy sensation that pulsates on and off with pinprick pupils for two days, too

2021-12-17

Systemic reaction (other): Burning eyes since last week and strange dizzy visual since the booster

Release 10 — day 7, dose 3

2021-12-20

Systemic reaction (other): Tight chest

Release 10 — day 21, dose 3

2022-01-01

Symptoms: Tight chest

Release 10 — day 28, dose 3

2022-01-08

Symptoms: Fever 100.9Â°, headache, body aches particularly in lower back, tight chest w/slightly productive cough, diarrhea,fatigue, etc

Release 10 — day 35, dose 3

2022-01-15

Symptoms: Tightness in chest when talking, pain in chest, Headache, fatigue

Release 11 — 3 months, dose 3

2022-03-13

Symptoms: Arrthymias confirmed....scarring in the left ventricular apex from prior myocarditis occurring with covid(prior to vaccine)

Release 12 — 6 months, dose 3

2022-06-13

Symptoms: Extreme fatigue, brain fog - cognitive communication disorder, tight chest

Release 12 — days 1–6 daily, dose 4

2022-10-19

Systemic reaction (other): Tight chest, needed albuterol many x's

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	Arrhythmia	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Back pain	·	·	✓
SD	Brain fog	·	·	✓
SD	Cardiac ventricular scarring	·	·	✓
SD	Chest discomfort	✓	✓	✓
SD	Chest pain	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Myocarditis	·	·	✓
SD	Pain	·	·	✓
SD	Palpitations	·	·	✓
SD	Post-acute COVID-19 syndrome	✓	✓	✓
SD	Productive cough	·	·	✓
SD	Pyrexia	·	·	✓
SRO	Chest discomfort	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Eye irritation	·	·	✓
SRO	Mental disorder	·	·	✓
SRO	Miosis	·	·	✓

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