4TR-24325-90789

2 vaccinations 11 coded responses 23 check-ins 11 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 303 / GA
Registered: 2021-02-05

Relationship: Self
Race: Black or African American
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

2021-02-05
Registered in v-safe
2021-02-05
Dose 1 — Moderna
2021-02-05
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Survey response — days 1–6 daily, dose 1
MedDRA: Malaise — Feeling: Poor · Site: Pain, Redness · Fever · Headache, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Simply sick

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-08
Survey response — days 1–6 daily, dose 1
MedDRA: Anxiety, Depression — Feeling: Good · Site: Pain · Fever · Headache, Fatigue or tiredness

Free text: Depression or anciety

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Good · Headache, Fatigue or tiredness

Free text: Brain fog every day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 7, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-02-19
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-26
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-05
Dose 2 — Moderna
2021-03-05
Survey response — day 0, dose 2
MedDRA: Feeling abnormal, Headache — Feeling: Fair · Headache

Free text: Just headache and head fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: No adverse event — Feeling: Good · Site: Pain · Headache

Free text:

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Headache, Joint pains

Adult check-in
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache

Adult check-in
2021-03-10
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Visual impairment — Feeling: Good

Free text: Every day l experience brain fog, little clarity

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Feeling abnormal, Headache — Feeling: Good · Headache

Free text: Brain fog and sharp headache pains have been consistent

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Survey response — day 7, dose 2
MedDRA: Feeling abnormal, Headache — Feeling: Good · Headache, Joint pains

Free text: Brain fog and head aches

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — day 14, dose 2
MedDRA: Fatigue, Somnolence — Feeling: Good · Be unable to do your normal daily activities

Free text: I cant remember if l listed fatigue before, but around -12 or or 1 pm each day, l am exhausted. And that is every day. I am sleepy.

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
2021-04-02
Survey response — day 28, dose 2
MedDRA: Feeling abnormal — Feeling: Fair · Be unable to do your normal daily activities

Free text: I am not experiencing anything new, however, the brain fog is terrible.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-04
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-09-03
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-03-08
Survey response — 12 months, dose 2
MedDRA: Dyspnoea — Feeling: Good · Be unable to do your normal daily activities

Free text: SOB

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-05	Moderna
2	2021-03-05	Moderna

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-07

Systemic reaction (other): Simply sick

2021-02-08

Systemic reaction (other): Depression or anciety

Release 4 — days 1–6 daily, dose 1

2021-02-11

Systemic reaction (other): Brain fog every day

Release 5 — day 0, dose 2

2021-03-05

Systemic reaction (other): Just headache and head fog

Release 5 — days 1–6 daily, dose 2

2021-03-07

2021-03-10

Systemic reaction (other): Every day l experience brain fog, little clarity

2021-03-11

Systemic reaction (other): Brain fog and sharp headache pains have been consistent

Release 5 — day 7, dose 2

2021-03-13

Systemic reaction (other): Brain fog and head aches

Release 5 — day 14, dose 2

2021-03-19

Symptoms: I cant remember if l listed fatigue before, but around -12 or or 1 pm each day, l am exhausted. And that is every day. I am sleepy.

Release 6 — day 28, dose 2

2021-04-02

Symptoms: I am not experiencing anything new, however, the brain fog is terrible.

Release 11 — 12 months, dose 2

2022-03-08

Symptoms: SOB

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	Dyspnoea	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Somnolence	✓	✓	✓
SRO	Anxiety	✓	✓	✓
SRO	Depression	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Malaise	✓	✓	✓
SRO	No adverse event	✓	✓	✓
SRO	Visual impairment	✓	✓	✓

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