4RZ-15271-10305

5 vaccinations 10 coded responses 29 check-ins 10 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 958 / CA
Registered: 2021-02-08

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-06
Dose 1 — Moderna
2021-02-08
Registered in v-safe
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness, Abdominal pain

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

Adult check-in
2021-02-12
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Good · Fatigue or tiredness

Free text: I forgot to mention earlier that I had brain fog for a couple days that I was experiencing other symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Survey response — day 7, dose 1
MedDRA: Ear pain — Feeling: Good

Free text: Earache

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-06
Dose 2 — Moderna
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-11
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-03-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-03-20
Survey response — day 14, dose 2
MedDRA: Condition aggravated, Cough, Fatigue, Oral herpes, Pre-existing disease, Sneezing — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sneezing, lots of coughing, tired, cold sore on mouth that I haven't had in 20 years.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-10
Survey response — day 35, dose 2
MedDRA: Fatigue, Somnolence — Feeling: Fair

Free text: Tired and sleepy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-17
Survey response — day 42, dose 2
MedDRA: Intertrigo — Feeling: Good

Free text: Developed intetrego

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-06
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-04
Survey response — 6 months, dose 2
MedDRA: Cough, Fatigue — Feeling: Fair

Free text: Extreme periodic coughing and fatigue.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-11-03
Dose 3 — Moderna
2022-03-06
Survey response — 12 months, dose 2
MedDRA: Palpitations — Feeling: Good

Free text: Some heart palpitations

MedDRA releases: 2024-11 · check-in free text available
2022-04-13
Dose 4 — Moderna
2022-04-25
Health check-in — day 7, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-04
Survey response — day 21, dose 4
MedDRA: Cough, Productive cough — Feeling: Good

Free text: Extreme coughing. Lots of clear phlegm.

MedDRA releases: 2024-11 · check-in free text available
2022-05-11
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-19
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-27
Survey response — day 42, dose 4
MedDRA: Cough, Productive cough — Feeling: Fair

Free text: Lots of coughing and phlegm.

MedDRA releases: 2024-11 · check-in free text available
2022-07-13
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-12
Dose 5 — Moderna
2022-10-12
Survey response — 6 months, dose 4
MedDRA: Chills, Pain in extremity — Feeling: Good

Free text: Sore arm from recent booster ( yesterday) and chills

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-06	Moderna
2	2021-03-06	Moderna
3	2021-11-03	Moderna	No
4	2022-04-13	Moderna	No
5	2022-09-12	Moderna	No

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-12

Systemic reaction (other): I forgot to mention earlier that I had brain fog for a couple days that I was experiencing other symptoms.

Release 4 — day 7, dose 1

2021-02-13

Systemic reaction (other): Earache

Release 6 — day 14, dose 2

2021-03-20

Symptoms: Sneezing, lots of coughing, tired, cold sore on mouth that I haven't had in 20 years.

Release 7 — day 35, dose 2

2021-04-10

Symptoms: Tired and sleepy

Release 7 — day 42, dose 2

2021-04-17

Symptoms: Developed intetrego

Release 9 — 6 months, dose 2

2021-09-04

Symptoms: Extreme periodic coughing and fatigue.

Release 11 — 12 months, dose 2

2022-03-06

Symptoms: Some heart palpitations

Release 11 — day 21, dose 4

2022-05-04

Symptoms: Extreme coughing. Lots of clear phlegm.

Release 11 — day 42, dose 4

2022-05-27

Symptoms: Lots of coughing and phlegm.

Release 12 — 6 months, dose 4

2022-10-12

Symptoms: Sore arm from recent booster ( yesterday) and chills

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	Condition aggravated	✓	·	✓
SD	Cough	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Intertrigo	✓	✓	✓
SD	Oral herpes	✓	✓	○
SD	Pain in extremity	·	·	✓
SD	Palpitations	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Productive cough	·	·	✓
SD	Sneezing	✓	✓	✓
SD	Somnolence	✓	✓	✓
SRO	Ear pain	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓

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