4Q6-24151-15063

4 vaccinations 7 coded responses 34 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 220 / VA
Registered: 2021-03-27

Relationship: Self
Race: Black or African American
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-24
Dose 1 — Moderna
2021-03-27
Registered in v-safe
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-31
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-08
Survey response — day 14, dose 1
MedDRA: Headache, Self-medication, Sinus congestion — Feeling: Good

Free text: Mild headache and sinus congestion; I drank extra fluids & took Tylenol. Symptoms wete eliminated.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-21
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-04-24
Dose 2 — Moderna
2021-04-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-04-29
Survey response — days 1–6 daily, dose 2
MedDRA: Self-medication, Sinus congestion — Feeling: Good

Free text: I had sinus congestion that was uncomfortable enough to require over-the-counter meds

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-05-01
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-08
Survey response — day 14, dose 2
MedDRA: Vitreous floaters — Feeling: Good

Free text: I seem to have a LOT floaties in my left eye with apparent lightning flashes in my left peripheral range. I do NOT attribute this to the vaccine as I had the same issue in my rt eye last fall.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-15
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-29
Survey response — day 35, dose 2
MedDRA: Headache, Sinus congestion — Feeling: Good

Free text: Woke up with bad sinus congestion & a headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-05
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-24
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-20
Dose 3 — Moderna
2022-04-26
Survey response — 12 months, dose 2
MedDRA: Groin pain, Sciatica — Feeling: Fair

Free text: Sciatic nerve pain, perhaps caysed by groin pain.

MedDRA releases: 2024-11 · check-in free text available
2022-07-22
Dose 4 — Moderna
2022-07-23
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, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-07-24
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-07-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-07-26
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-27
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-07-28
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-07-29
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-08-07
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-08-12
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-08-19
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-08-27
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-09-03
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-10-23
Survey response — 3 months, dose 4
MedDRA: Chills, Migraine, Pain, Pyrexia — 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 · Outpatient clinic or urgent care clinic visit

Free text: Fever, chills, body aches, migraine headaches.

MedDRA releases: 2024-11 · check-in free text available
2022-10-23
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-10-25
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-01-20
Survey response — 6 months, dose 4
MedDRA: COVID-19, Muscular weakness, Pain in extremity — 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 · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-01-20
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-23
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna
2	2021-04-24	Moderna
3	2021-12-20	Moderna	No
4	2022-07-22	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 7 — day 14, dose 1

2021-04-08

Symptoms: Mild headache and sinus congestion; I drank extra fluids & took Tylenol. Symptoms wete eliminated.

Release 8 — days 1–6 daily, dose 2

2021-04-29

Systemic reaction (other): I had sinus congestion that was uncomfortable enough to require over-the-counter meds

Release 8 — day 14, dose 2

2021-05-08

Symptoms: I seem to have a LOT floaties in my left eye with apparent lightning flashes in my left peripheral range. I do NOT attribute this to the vaccine as I had the same issue in my rt eye last fall.

Release 8 — day 35, dose 2

2021-05-29

Symptoms: Woke up with bad sinus congestion & a headache.

Release 11 — 12 months, dose 2

2022-04-26

Symptoms: Sciatic nerve pain, perhaps caysed by groin pain.

Release 12 — 3 months, dose 4

2022-10-23

Symptoms: Fever, chills, body aches, migraine headaches.

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	Chills	·	·	✓
SD	COVID-19	·	·	✓
SD	Groin pain	·	·	✓
SD	Headache	✓	✓	✓
SD	Migraine	·	·	✓
SD	Muscular weakness	·	·	✓
SD	Pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Pyrexia	·	·	✓
SD	Sciatica	·	·	✓
SD	Self-medication	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SD	Vitreous floaters	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓

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