4Q9-79858-56285

5 vaccinations 9 coded responses 39 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 483 / MI
Registered: 2021-04-03

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Registered dependents

FVM-89641-49079 Child or adolescent in my care · Female · 2022-05-17

E4F-16010-47617 Child or adolescent in my care · Female · 2022-05-17

Timeline

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

2021-03-18
Dose 1 — Moderna
2021-04-03
Registered in v-safe
2021-04-03
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-08
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-15
Dose 2 — Moderna
2021-04-16
Survey response — days 1–6 daily, dose 2
MedDRA: Anger — Feeling: Poor · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work

Free text: Evening of shot, irrational short temper

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-18
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-19
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-29
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-08
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-20
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-27
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-15
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-14
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-01
Dose 3 — Moderna
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Muscle or body aches

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

Adult check-in
2021-11-08
Health check-in — day 7, dose 3
Feeling: Good · None

Adult check-in
2021-11-15
Survey response — day 14, dose 3
MedDRA: Arthralgia, Pain, Pre-existing disease, Systemic lupus erythematosus — Feeling: Fair

Free text: I have lupus, the joint pain is way worse this last week but i have no reason to thibk the vaccine caused this.

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-01
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
2021-12-15
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
2022-04-05
Dose 4 — Moderna
2022-05-02
Survey response — day 21, dose 4
MedDRA: SARS-CoV-2 test positive — 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: Got covid, positive PCR test 4/29

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Survey response — 6 months, dose 3
MedDRA: COVID-19 — 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: Our family came down with COVID. We are recovering now with Paxlovid.

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Report sent to call center — day 21, 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)
2022-05-02
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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-04
Call 1 — Could Not Reach Participant
2022-05-09
Call 2 — Could Not Reach Participant
2022-05-17
Survey response — day 42, dose 4
MedDRA: Malaise, SARS-CoV-2 test negative, SARS-CoV-2 test positive — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: I tested positive for covid on april 29, recovered with paxlovid and tested negative on may 8th, then became symptomatic again and tested positive for a second time on may 14th. Currently still symptomatic.

MedDRA releases: 2024-11 · check-in free text available
2022-05-17
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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-18
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-09-19
Dose 5 — Pfizer-BioNTech
Co-administered: Flu
2022-09-19
Health check-in — day 0, dose 5
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-20
Survey response — days 1–6 daily, dose 5
MedDRA: Oropharyngeal pain, Paranasal sinus hypersecretion — Feeling: Poor · Site: Pain · Fatigue or tiredness · Be unable to work or attend school

Free text: Sore throat, sinus drainage

MedDRA releases: 2024-11 · check-in free text available
2022-09-22
Survey response — days 1–6 daily, dose 5
MedDRA: Oropharyngeal pain, Paranasal sinus hypersecretion — Feeling: Fair · Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Sinus drainage, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-09-24
Survey response — days 1–6 daily, dose 5
MedDRA: Paranasal sinus hypersecretion, Throat irritation — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Sinus drainage, irritated throat

MedDRA releases: 2024-11 · check-in free text available
2022-09-26
Health check-in — day 7, dose 5
Feeling: Good · None

Adult check-in
2022-10-03
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-10
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-19
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-26
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-31
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-19
Survey response — 3 months, dose 5
MedDRA: Influenza — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Flu

MedDRA releases: 2024-11 · check-in free text available
2023-03-22
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-18	Moderna
2	2021-04-15	Moderna
3	2021-11-01	Moderna	No
4	2022-04-05	Moderna	No
5	2022-09-19	Pfizer-BioNTech	Flu

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 2

2021-04-16

Systemic reaction (other): Evening of shot, irrational short temper

Release 10 — day 14, dose 3

2021-11-15

Symptoms: I have lupus, the joint pain is way worse this last week but i have no reason to thibk the vaccine caused this.

Release 11 — day 21, dose 4

2022-05-02

Symptoms: Got covid, positive PCR test 4/29

Release 11 — 6 months, dose 3

2022-05-02

Symptoms: Our family came down with COVID. We are recovering now with Paxlovid.

Release 11 — day 42, dose 4

2022-05-17

Symptoms: I tested positive for covid on april 29, recovered with paxlovid and tested negative on may 8th, then became symptomatic again and tested positive for a second time on may 14th. Currently still symptomatic.

Release 12 — days 1–6 daily, dose 5

2022-09-20

Systemic reaction (other): Sore throat, sinus drainage

2022-09-22

Systemic reaction (other): Sinus drainage, sore throat

2022-09-24

Systemic reaction (other): Sinus drainage, irritated throat

Release 12 — 3 months, dose 5

2022-12-19

Symptoms: Flu

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	Arthralgia	·	·	✓
SD	COVID-19	·	·	✓
SD	Influenza	·	·	✓
SD	Malaise	·	·	✓
SD	Pain	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Systemic lupus erythematosus	·	·	✓
SRO	Anger	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Paranasal sinus hypersecretion	·	·	✓
SRO	Throat irritation	·	·	✓

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