4RA-14297-29897

2 vaccinations 7 coded responses 22 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 840 / UT
Registered: 2021-03-06

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

2021-03-06
Registered in v-safe
2021-03-06
Dose 1 — Moderna
2021-03-06
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Fatigue or tiredness

Free text: I have fibromyalgia, so fatigue is normal. Also going through extra stress, so i was extra tired.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Fatigue or tiredness · Be unable to work

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Chills, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Poor · Chills, Headache, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-03-13
Survey response — day 7, dose 1
MedDRA: Oropharyngeal pain — Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-28
Survey response — day 21, dose 1
MedDRA: Headache — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Headache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-28
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-09
Dose 2 — Moderna
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fever · None

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · None

Adult check-in
2021-04-14
Survey response — days 1–6 daily, dose 2
MedDRA: Nasopharyngitis — Feeling: Poor · Chills, Headache · Be unable to work, Be unable to do your normal daily activities

Free text: Head cold started moving to my chest. Im very susceptable to ashthmatic bronchitis.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-01
Survey response — day 21, dose 2
MedDRA: Fatigue, Pain — Feeling: Fair · Be unable to work

Free text: Exhausted. Achy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-14
Survey response — day 35, dose 2
MedDRA: Nasal congestion, Upper-airway cough syndrome — Feeling: Fair · Be unable to work

Free text: Nasal congestion and post nasal drip

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-09
Health check-in — 3 months, dose 2
Feeling: Fair

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

Adult check-in
2022-01-13
Call 1 — Left Voicemail
2022-04-09
Survey response — 12 months, dose 2
MedDRA: COVID-19, Cough, Pre-existing disease, Respiratory tract congestion — 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 · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: In early Jan my husband and I both got COVID. My symptoms were much like the asthmatic bronchitis I get frequently plus lots of chest congestion and coughing. I had some heavy duty cough medicine w codine that my doc had prescribed for me in Nov. I a

MedDRA releases: 2024-11 · check-in free text available
2022-04-09
Report sent to call center — 12 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

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-13
Call successful
Not applicable - Accidental Reporting
2022-04-13
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-06	Moderna
2	2021-04-09	Moderna

Call center

2 call center cases

2 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-07

Systemic reaction (other): I have fibromyalgia, so fatigue is normal. Also going through extra stress, so i was extra tired.

Release 5 — day 7, dose 1

2021-03-13

Systemic reaction (other): Sore throat

Release 6 — day 21, dose 1

2021-03-28

Symptoms: Headache

Release 7 — days 1–6 daily, dose 2

2021-04-14

Systemic reaction (other): Head cold started moving to my chest. Im very susceptable to ashthmatic bronchitis.

Release 8 — day 21, dose 2

2021-05-01

Symptoms: Exhausted. Achy

Release 8 — day 35, dose 2

2021-05-14

Symptoms: Nasal congestion and post nasal drip

Release 11 — 12 months, dose 2

2022-04-09

Symptoms: In early Jan my husband and I both got COVID. My symptoms were much like the asthmatic bronchitis I get frequently plus lots of chest congestion and coughing. I had some heavy duty cough medicine w codine that my doc had prescribed for me in Nov. I a cut off by CDC

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	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Upper-airway cough syndrome	✓	✓	✓
SRO	Nasopharyngitis	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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