4PJ-17371-73932

2 vaccinations 7 coded responses 19 check-ins 7 free-text entries 6 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 982 / WA
Registered: 2021-01-17

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

2021-01-17
Registered in v-safe
2021-01-17
Dose 1 — Moderna
2021-01-17
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Adult check-in
2021-01-17
Report sent to call center — day 0, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-18
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-21
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches

Adult check-in
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Neck pain — Feeling: Poor · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting · Be unable to do your normal daily activities

Free text: Neck pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Health check-in — day 7, dose 1
Feeling: Poor · Headache, Joint pains, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-01-31
Survey response — day 14, dose 1
MedDRA: Dizziness, Emergency care, Headache, Nausea, SARS-CoV-2 test negative — 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, Emergency room or emergency department visit

Free text: Symptoms: Dizzy, nausea, headaches since the 22nd (5days after 1st vaccination). · Healthcare visit (other): I went to the ER after 3 days of symptoms. Was told to treat the headache after normal CT. After 5 days of symptoms I saw a walk in tested negative for Covid and he prescribed headache medication and antibiotics.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-09
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-14
Dose 2 — Moderna
2021-02-14
Survey response — day 0, dose 2
MedDRA: Anaphylactic reaction — Feeling: Poor · Site: Pain, Itching · Headache, Joint pains, Fatigue or tiredness · 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: Severe anaphylactic response

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Report sent to call center — day 0, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Anaphylactic reaction — Feeling: Poor · Headache, Fatigue or tiredness · Be unable to work

Free text: Continue to have symptoms of anaphylaxis

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Anaphylactic reaction — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · 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: Continuing anaphylactic reaction

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Report sent to call center — days 1–6 daily, 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)
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Anaphylactic reaction — Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Recovering from anaphylactic reaction

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — day 7, dose 2
Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-28
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-03-09
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-14
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-28
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-14
Call 1 — Left Voicemail
2021-08-17
Survey response — 6 months, dose 2
MedDRA: Parainfluenzae virus infection — 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: Paraflu

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-17
Report sent to call center — 6 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)
2021-08-19
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-17	Moderna
2	2021-02-14	Moderna

Call center

6 call center cases

1 successful · 3 unsuccessful · 2 priority 2/3 (triaged and no follow up)

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): Neck pain

Release 3 — day 14, dose 1

2021-01-31

Symptoms: Dizzy, nausea, headaches since the 22nd (5days after 1st vaccination).

Healthcare visit (other): I went to the ER after 3 days of symptoms. Was told to treat the headache after normal CT. After 5 days of symptoms I saw a walk in tested negative for Covid and he prescribed headache medication and antibiotics.

Release 4 — day 0, dose 2

2021-02-14

Systemic reaction (other): Severe anaphylactic response

Release 4 — days 1–6 daily, dose 2

2021-02-17

Systemic reaction (other): Continue to have symptoms of anaphylaxis

2021-02-18

Systemic reaction (other): Continuing anaphylactic reaction

2021-02-20

Systemic reaction (other): Recovering from anaphylactic reaction

Release 9 — 6 months, dose 2

2021-08-17

Symptoms: Paraflu

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	Emergency care	✓	✓	✓
HCVO	Headache	✓	✓	✓
HCVO	SARS-CoV-2 test negative	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Parainfluenzae virus infection	✓	·	✓
SRO	Anaphylactic reaction	✓	✓	✓
SRO	Neck pain	✓	✓	✓

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