4SW-16795-44114

4 vaccinations 6 coded responses 22 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 726 / AR
Registered: 2021-04-05

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

2021-03-10
Dose 1 — Moderna
2021-04-05
Registered in v-safe
2021-04-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-07
Dose 2 — Moderna
2021-04-07
Health check-in — day 0, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-14
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-04-28
Survey response — day 21, dose 2
MedDRA: Gastrooesophageal reflux disease, Hiatus hernia, Oesophagitis, Throat irritation — Feeling: Good

Free text: Raw esophagus & back of throat. Could be my hiata hernia or acid reflux. Hope thats all.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-19
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-07-09
Survey response — 3 months, dose 2
MedDRA: Back pain — Feeling: Fair

Free text: Pains back side on right. Lasted 12 days. Got C-ray. Looks the same as one from last year. Could be my diverticulitus or ? Pains go down to outside of pelvis. Waiting for bloodwork. Im living in NW Arkansas. Virus numbers are high in AR. I wear my

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-10-06
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-11-15
Dose 3 — Moderna
2022-04-08
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-15
Dose 4 — Moderna
2022-04-30
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-05-06
Survey response — day 21, dose 4
MedDRA: Arthralgia, Fatigue — Feeling: Good

Free text: Hip joint hurts. Tired

MedDRA releases: 2024-11 · check-in free text available
2022-05-15
Survey response — day 28, dose 4
MedDRA: Fatigue — Feeling: Fair

Free text: Very tired by 10am. Hope it's not my heart.

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-27
Survey response — day 42, dose 4
MedDRA: Dizziness, Emergency care, Unevaluable event, Vertigo — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Dizzy incidents so ER & CT scan. No stroke. They say it's vertigo I'm 79 & on no meds. Going for 102 · Healthcare visit (other): Only way in asap

MedDRA releases: 2024-11 · check-in free text available
2022-05-27
Report sent to call center — day 42, dose 4
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-05-31
Call 1 — Left Voicemail
2022-07-15
Survey response — 3 months, dose 4
MedDRA: Emergency care, Joint swelling, Office visit, Physiotherapy, Pruritus, Rash, Rash pruritic, Vertigo, Visual impairment — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Symptoms: Possibly vertigo but physical therapist doesn't think so. It has affected my left eye vision but eye doc say #s =same. Itchy rash on the back of my neck for a year & sometimes my head itches. Some finger joints have knobs/ crooked past 6 months. · Healthcare visit (other): ER first then Doctor & physical therapist for Epstein technique for vertigo but he doesn't think I have vertigo so still trying to figure it out.

MedDRA releases: 2024-11 · check-in free text available
2022-07-15
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2022-07-19
Call 2 — Left Voicemail
2022-07-19
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-07	Moderna
3	2021-11-15	Moderna	No
4	2022-04-15	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 8 — day 21, dose 2

2021-04-28

Symptoms: Raw esophagus & back of throat. Could be my hiata hernia or acid reflux. Hope thats all.

Release 9 — 3 months, dose 2

2021-07-09

Symptoms: Pains back side on right. Lasted 12 days. Got C-ray. Looks the same as one from last year. Could be my diverticulitus or ? Pains go down to outside of pelvis. Waiting for bloodwork. Im living in NW Arkansas. Virus numbers are high in AR. I wear my

Release 11 — day 21, dose 4

2022-05-06

Symptoms: Hip joint hurts. Tired

Release 11 — day 28, dose 4

2022-05-15

Symptoms: Very tired by 10am. Hope it's not my heart.

Release 11 — day 42, dose 4

2022-05-27

Symptoms: Dizzy incidents so ER & CT scan. No stroke. They say it's vertigo I'm 79 & on no meds. Going for 102

Healthcare visit (other): Only way in asap

Release 12 — 3 months, dose 4

2022-07-15

Symptoms: Possibly vertigo but physical therapist doesn't think so. It has affected my left eye vision but eye doc say #s =same. Itchy rash on the back of my neck for a year & sometimes my head itches. Some finger joints have knobs/ crooked past 6 months.

Healthcare visit (other): ER first then Doctor & physical therapist for Epstein technique for vertigo but he doesn't think I have vertigo so still trying to figure it out.

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	Emergency care	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Physiotherapy	·	·	✓
HCVO	Unevaluable event	·	·	✓
HCVO	Vertigo	·	·	✓
SD	Arthralgia	·	·	✓
SD	Back pain	✓	✓	✓
SD	Dizziness	·	·	✓
SD	Emergency care	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Hiatus hernia	✓	✓	✓
SD	Joint swelling	·	·	✓
SD	Oesophagitis	✓	✓	✓
SD	Physiotherapy	·	·	✓
SD	Pruritus	·	·	✓
SD	Rash	·	·	✓
SD	Rash pruritic	·	·	✓
SD	Throat irritation	✓	✓	✓
SD	Vertigo	·	·	✓
SD	Visual impairment	·	·	✓

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