4SN-64583-83294

4 vaccinations 13 coded responses 37 check-ins 11 free-text entries 3 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 088 / NJ
Registered: 2021-01-03

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

2021-01-02
Dose 1 — Moderna
2021-01-03
Registered in v-safe
2021-01-03
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Good · Site: Pain, Swelling, Itching

Free text: Headache yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling, Itching · Fatigue or tiredness, Nausea

Adult check-in
2021-01-06
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-01-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-01-09
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-01-16
Survey response — day 14, dose 1
MedDRA: Headache, Nasal congestion — Feeling: Fair

Free text: Nasal congestion and mild headache.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-23
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-01-30
Dose 2 — Moderna
2021-02-06
Survey response — day 7, dose 2
MedDRA: Diarrhoea, Headache — Feeling: Good · Site: Pain, Redness, Swelling, Itching · Be unable to work

Free text: Had diarrhea for 72 hours post. Temp hovering around 100.0 with mikd headache. Vefy tired since

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-01
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-02
Survey response — 6 months, dose 2
MedDRA: Condition aggravated, Impaired work ability, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: I have autoimmunne issues. I have had a flate nearly monthlynsince February where normally maybe twice a year. I missedcmaybe one wirk day a month to get treatment and recover · Healthcare visit (other): Doctor visit

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-02
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-13
Call 1 — Left Voicemail
2021-10-26
Dose 3 — Moderna
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Chills, Dizziness, Headache, Nausea, Pyrexia — Feeling: Good · Site: Pain, Swelling

Free text: Had masdive headache, nausea, fever, dizzy chills yesterday,

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Swelling · None

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · None

Adult check-in
2021-11-01
Survey response — days 1–6 daily, dose 3
MedDRA: Nasal congestion, Rhinalgia — Feeling: Good

Free text: Nadal confedtikn, sore just inside right nare

MedDRA releases: 2024-11 · check-in free text available
2021-11-02
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-09
Survey response — day 14, dose 3
MedDRA: Fatigue, Myalgia, Nasal congestion — Feeling: Fair

Free text: Stuffy nose, fatigue, muscle soreness

MedDRA releases: 2024-11 · check-in free text available
2021-11-16
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-23
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-30
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-25
Survey response — 3 months, dose 3
MedDRA: Decreased appetite, Diarrhoea, Gastrointestinal viral infection — Feeling: Good · Be unable to do your normal daily activities

Free text: Had a GI.virus with diarrhea and poor sppetite

MedDRA releases: 2024-11 · check-in free text available
2022-04-28
Survey response — 6 months, dose 3
MedDRA: Condition aggravated, Fatigue, Hyperglycaemia, Pre-existing disease — Feeling: Fair · Be unable to work or attend school

Free text: Flare of autoimmune disease of psoriatic disease with hyperglycemia and fatigue

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Health check-in — 12 months, dose 3
Feeling: Good

Adult check-in
2022-11-04
Dose 4 — Moderna
2022-11-14
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain, Swelling, Itching · Joint pains, Fatigue or tiredness

Adult check-in
2022-11-18
Survey response — day 14, dose 4
MedDRA: Hyperhidrosis, Muscle spasms, Pyrexia, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Constant runny nose, sweats( no more fever), cramping in muscles

MedDRA releases: 2024-11 · check-in free text available
2022-11-25
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-12-02
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-12-09
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-12-18
Survey response — day 42, dose 4
MedDRA: Chills, Decreased appetite, Dizziness, Headache, Pain, Pyrexia — 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: Fever, chills, pains generized. Dizziness, headaches. Poor appetite

MedDRA releases: 2024-11 · check-in free text available
2022-12-18
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)
2022-12-21
Call successful
Not applicable - Accidental Reporting
2022-12-21
Call successful
Not applicable - Accidental Reporting
2023-02-03
Survey response — 3 months, dose 4
MedDRA: COVID-19 pneumonia, Dyspnoea, Fatigue, Hospitalisation, Nausea, Pneumonia bacterial — 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, Emergency room or emergency department visit, Hospitalization

MedDRA releases: 2024-11
2023-02-03
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 · Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2023-02-06
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-05
Survey response — 6 months, dose 4
MedDRA: Asthenia, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-02	Moderna
2	2021-01-30	Moderna
3	2021-10-26	Moderna	No
4	2022-11-04	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-03

Systemic reaction (other): Headache yesterday

Release 2 — day 14, dose 1

2021-01-16

Symptoms: Nasal congestion and mild headache.

Release 3 — day 7, dose 2

2021-02-06

Systemic reaction (other): Had diarrhea for 72 hours post. Temp hovering around 100.0 with mikd headache. Vefy tired since

Release 9 — 6 months, dose 2

2021-08-02

Symptoms: I have autoimmunne issues. I have had a flate nearly monthlynsince February where normally maybe twice a year. I missedcmaybe one wirk day a month to get treatment and recover

Healthcare visit (other): Doctor visit

Release 10 — days 1–6 daily, dose 3

2021-10-28

Systemic reaction (other): Had masdive headache, nausea, fever, dizzy chills yesterday,

2021-11-01

Systemic reaction (other): Nadal confedtikn, sore just inside right nare

Release 10 — day 14, dose 3

2021-11-09

Symptoms: Stuffy nose, fatigue, muscle soreness

Release 11 — 3 months, dose 3

2022-01-25

Symptoms: Had a GI.virus with diarrhea and poor sppetite

Release 11 — 6 months, dose 3

2022-04-28

Symptoms: Flare of autoimmune disease of psoriatic disease with hyperglycemia and fatigue

Release 12 — day 14, dose 4

2022-11-18

Symptoms: Constant runny nose, sweats( no more fever), cramping in muscles

Release 12 — day 42, dose 4

2022-12-18

Symptoms: Fever, chills, pains generized. Dizziness, headaches. Poor appetite

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	✓	·	✓
SD	Asthenia	·	·	✓
SD	Chills	·	·	✓
SD	Condition aggravated	✓	·	✓
SD	COVID-19 pneumonia	·	·	✓
SD	Decreased appetite	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrointestinal viral infection	·	·	✓
SD	Headache	✓	✓	✓
SD	Hospitalisation	·	·	✓
SD	Hyperglycaemia	·	·	✓
SD	Hyperhidrosis	·	·	✓
SD	Impaired work ability	✓	·	✓
SD	Muscle spasms	·	·	✓
SD	Myalgia	·	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Nausea	·	·	✓
SD	Pain	·	·	✓
SD	Pneumonia bacterial	·	·	✓
SD	Pre-existing disease	✓	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SRO	Chills	·	·	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Nasal congestion	·	·	✓
SRO	Nausea	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Rhinalgia	·	·	✓

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