4Q6-23694-43297

5 vaccinations 12 coded responses 42 check-ins 11 free-text entries 8 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 410 / KY
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
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fever · Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
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
2021-03-12
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-19
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-26
Dose 2 — Moderna
2021-04-02
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-04-09
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-23
Survey response — day 28, dose 2
MedDRA: Back pain, Inflammation, Neck pain, Pain, Wheezing — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Wheezing, pain and inflamation. Serious pain in back and neck

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Survey response — day 35, dose 2
MedDRA: Disorientation, Fall — Feeling: Poor · Be unable to do your normal daily activities

Free text: I became disoriented quickly and without notice, fell, and fractured my ribs on my lest side. I somehow doubt this is related to the vaccine but i report it and let your scientist determine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — day 42, dose 2
MedDRA: Pain, Rib fracture — Feeling: Poor · 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: Pain, due to fractured ribs, from a fall

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — day 42, dose 2
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: Angina pectoris, Benign prostatic hyperplasia, Blood pressure increased, 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 · Outpatient clinic or urgent care clinic visit, Emergency room or emergency department visit

Free text: Severe headache, high bp spikes, angina

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)
2021-06-30
Call 1 — Left Voicemail
2021-09-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-01
Dose 3 — Moderna
2021-11-01
Health check-in — day 0, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling · None

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Swelling, Itching · Headache, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · None

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Nausea

Adult check-in
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-08
Survey response — day 7, dose 3
MedDRA: Office visit — Feeling: Good · Site: Pain · Joint pains · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: In office visit with doctor

MedDRA releases: 2024-11 · check-in free text available
2021-11-08
Report sent to call center — day 7, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-11-15
Survey response — day 14, dose 3
MedDRA: Arthralgia, Pre-existing disease — Feeling: Good · 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: Just a continued ache surrounding my artificial hip teplacement. I sought treatment and symptoms improved with steroid treatment, but a continued ache returned. I dont anticipate it is vaccine related as i did not experience this with the first 2

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Report sent to call center — day 14, 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 · 1 call case(s)
2021-11-22
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-13
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-31
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-24
Dose 4 — Moderna
2022-05-29
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness, Nausea

Adult check-in
2022-05-31
Survey response — day 7, dose 4
MedDRA: Chest discomfort, Respiratory tract congestion — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: I have been experiencing discomfort from mild chest congestion since 24 hours after this vaccine. Not enough to see doctor yet, but didnt have this with first 3 vaccines.

MedDRA releases: 2024-11 · check-in free text available
2022-06-07
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-14
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-21
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-30
Survey response — day 35, dose 4
MedDRA: Abnormal loss of weight, Condition aggravated, Office visit, Pre-existing disease, Weight decreased — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: I do not believe the vaccine had anything to do with it, but worsening condition of being unable to keep food down to ths point of fast and excessive weight loss. Currently being sent to a specialist, appointment is tomorrow. · Healthcare visit (other): I didnt seek treatment, doctor noticed the wight loss during a routine office visit

MedDRA releases: 2024-11 · check-in free text available
2022-06-30
Report sent to call center — day 35, dose 4
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)
2022-07-01
Call 1 — Left Voicemail
2022-07-01
Call 2 — Left Voicemail
2022-07-01
Call 1 — Left Voicemail
2022-07-01
Call 1 — Left Voicemail
2022-07-01
Call 1 — Left Voicemail
2022-07-06
Survey response — day 42, dose 4
MedDRA: Fatigue, Food refusal, Office visit, Vomiting, Weight decreased — 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: Symptoms: Vomiting, food avoidance, weight loss, fatigue · Healthcare visit (other): Specialist visit

MedDRA releases: 2024-11 · check-in free text available
2022-07-06
Report sent to call center — day 42, dose 4
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)
2022-07-07
Call 2 — Left Voicemail
2022-07-07
Call 2 — Left Voicemail
2022-07-07
Call 1 — Left Voicemail
2022-08-23
Survey response — 3 months, dose 4
MedDRA: Cerebrovascular accident — 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, Emergency room or emergency department visit, Hospitalization

Free text: Stroke

MedDRA releases: 2024-11 · check-in free text available
2022-08-23
Report sent to call center — 3 months, dose 4
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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-08-24
Call 3 — Left Voicemail
2022-08-24
Call 3 — Left Voicemail
2022-08-24
Call 2 — Left Voicemail
2022-08-24
Call 1 — Left Voicemail
2022-11-22
Survey response — 6 months, dose 4
MedDRA: Cerebrovascular accident — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Stroke

MedDRA releases: 2024-11 · check-in free text available
2022-11-22
Report sent to call center — 6 months, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2022-11-23
Call X — Could Not Reach Participant
2022-11-23
Call X — Left Voicemail
2022-11-23
Call 3 — Left Voicemail
2022-11-23
Call 2 — Left Voicemail
2022-11-23
Call 1 — Left Voicemail
2022-11-25
Dose 5 — Moderna
2023-05-26
Survey response — 6 months, dose 5
MedDRA: Cerebrovascular accident — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Moderna
2	2021-03-26	Moderna
3	2021-11-01	Moderna	No
4	2022-05-24	Moderna	No
5	2022-11-25	Moderna	No

Call center

8 call center cases

3 successful · 5 unsuccessful

3 waits over 3 months for a first call

See the call center timeline

Free text

Release 7 — day 28, dose 2

2021-04-23

Symptoms: Wheezing, pain and inflamation. Serious pain in back and neck

Release 8 — day 35, dose 2

2021-04-30

Symptoms: I became disoriented quickly and without notice, fell, and fractured my ribs on my lest side. I somehow doubt this is related to the vaccine but i report it and let your scientist determine

Release 8 — day 42, dose 2

2021-05-07

Symptoms: Pain, due to fractured ribs, from a fall

Release 9 — 3 months, dose 2

2021-06-25

Symptoms: Severe headache, high bp spikes, angina

Release 10 — day 7, dose 3

2021-11-08

Healthcare visit (other): In office visit with doctor

Release 10 — day 14, dose 3

2021-11-15

Symptoms: Just a continued ache surrounding my artificial hip teplacement. I sought treatment and symptoms improved with steroid treatment, but a continued ache returned. I dont anticipate it is vaccine related as i did not experience this with the first 2 cut off by CDC

Release 11 — day 7, dose 4

2022-05-31

Systemic reaction (other): I have been experiencing discomfort from mild chest congestion since 24 hours after this vaccine. Not enough to see doctor yet, but didnt have this with first 3 vaccines.

Release 12 — day 35, dose 4

2022-06-30

Symptoms: I do not believe the vaccine had anything to do with it, but worsening condition of being unable to keep food down to ths point of fast and excessive weight loss. Currently being sent to a specialist, appointment is tomorrow.

Healthcare visit (other): I didnt seek treatment, doctor noticed the wight loss during a routine office visit

Release 12 — day 42, dose 4

2022-07-06

Symptoms: Vomiting, food avoidance, weight loss, fatigue

Healthcare visit (other): Specialist visit

Release 12 — 3 months, dose 4

2022-08-23

Symptoms: Stroke

Release 12 — 6 months, dose 4

2022-11-22

Symptoms: Stroke

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	·	·	✓
HCVO	Weight decreased	·	·	✓
SD	Abnormal loss of weight	·	·	✓
SD	Angina pectoris	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Back pain	✓	✓	✓
SD	Benign prostatic hyperplasia	○	✓	○
SD	Blood pressure increased	✓	·	✓
SD	Cerebrovascular accident	·	·	✓
SD	Condition aggravated	·	·	✓
SD	Disorientation	✓	✓	✓
SD	Fall	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Food refusal	·	·	✓
SD	Headache	✓	✓	✓
SD	Inflammation	✓	✓	✓
SD	Neck pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Rib fracture	✓	✓	✓
SD	Vomiting	·	·	✓
SD	Weight decreased	·	·	✓
SD	Wheezing	✓	✓	✓
SRO	Chest discomfort	·	·	✓
SRO	Respiratory tract congestion	·	·	✓

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