4TV-56206-98512

3 vaccinations 13 coded responses 27 check-ins 13 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 930 / CA
Registered: 2021-02-25

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

2021-02-25
Registered in v-safe
2021-02-25
Dose 1 — Moderna
2021-02-25
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-26
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction, Self-medication — Feeling: Good · Site: Pain · Headache, Muscle or body aches

Free text: no but I took my normal 200 mg ibuprofen and symptoms subsided

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — days 1–6 daily, dose 1
MedDRA: Adverse reaction — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Nausea

Free text: all three come and go. like a wave; then it passes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 1
MedDRA: Pain, Unevaluable event — Feeling: Good · Site: Pain · Headache, Muscle or body aches, Nausea

Free text: still occurs in waves... hurts.. then goes away quickly

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Pain · Diarrhea

Free text: I have IBS so sure that is it; better take a close look at my diet!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-02
Survey response — days 1–6 daily, dose 1
MedDRA: Headache — Feeling: Good · Headache

Free text: headache waves in once in awhile and then goes

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

Adult check-in
2021-03-04
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-03-11
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-25
Dose 2 — Moderna
2021-03-25
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-26
Survey response — days 1–6 daily, dose 2
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches, Nausea

Free text: just to mention my normal temp is 97.5 appr so 99 + is 2 degrees higher than my normal

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Joint pains, Diarrhea

Adult check-in
2021-03-28
Survey response — days 1–6 daily, dose 2
MedDRA: Tenderness — Feeling: Good · Site: Pain · Headache, Muscle or body aches

Free text: just to say arm pain is to touch, not so much when using it

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-04-01
Survey response — day 7, dose 2
MedDRA: Myalgia — Feeling: Good · Headache, Muscle or body aches

Free text: sounds weird but musculature on left side (shot side) is painful

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Survey response — day 14, dose 2
MedDRA: Dysgeusia — Feeling: Good

Free text: just reached end of 2week after 2nd vaccination but am noticing an odd taste in my mouth, usually after frozen prepared foods not my own foods prepared from scratch. not normal.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 21, dose 2
MedDRA: Cough, Nasal congestion, Nasopharyngitis, Oral pruritus — Feeling: Good

Free text: stuffy nose, allergy type itchy mouth, dry cough. but we took 3 day drive to (b)(6) and did our first restaurant type encounters. it feels like a common cold; treating it as such.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-06
Survey response — day 42, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: extraordinarily tired. I am not normally exhausted. this is a new thing for me.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-09-23
Survey response — 6 months, dose 2
MedDRA: Fall, Hernia repair, Hip fracture, Hip surgery, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Symptoms: quite sure unrelated to Covid. had fall, broke hip then after that repair had hernia and another surgery to repair that. · Healthcare visit (other): see above

MedDRA releases: 2024-11 · check-in free text available
2021-09-23
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · Hospitalization · 1 call case(s)
2021-09-28
Call 1 — Left Voicemail
2021-11-18
Dose 3 — Moderna
2022-03-25
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-05-19
Survey response — 6 months, dose 3
MedDRA: Joint injury — Feeling: Good

Free text: clunked my knee. tending to that. separate from that considering second booster.

MedDRA releases: 2024-11 · check-in free text available
2022-11-18
Health check-in — 12 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-25	Moderna
2	2021-03-25	Moderna
3	2021-11-18	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-26

Systemic reaction (other): no but I took my normal 200 mg ibuprofen and symptoms subsided

2021-02-27

Systemic reaction (other): all three come and go. like a wave; then it passes

2021-02-28

Systemic reaction (other): still occurs in waves... hurts.. then goes away quickly

2021-03-01

Systemic reaction (other): I have IBS so sure that is it; better take a close look at my diet!

2021-03-02

Systemic reaction (other): headache waves in once in awhile and then goes

Release 6 — days 1–6 daily, dose 2

2021-03-26

Systemic reaction (other): just to mention my normal temp is 97.5 appr so 99 + is 2 degrees higher than my normal

2021-03-28

Systemic reaction (other): just to say arm pain is to touch, not so much when using it

Release 6 — day 7, dose 2

2021-04-01

Systemic reaction (other): sounds weird but musculature on left side (shot side) is painful

Release 7 — day 14, dose 2

2021-04-08

Symptoms: just reached end of 2week after 2nd vaccination but am noticing an odd taste in my mouth, usually after frozen prepared foods not my own foods prepared from scratch. not normal.

Release 7 — day 21, dose 2

2021-04-15

Symptoms: stuffy nose, allergy type itchy mouth, dry cough. but we took 3 day drive to (b)(6) and did our first restaurant type encounters. it feels like a common cold; treating it as such.

redacted (b)(6)

Release 8 — day 42, dose 2

2021-05-06

Symptoms: extraordinarily tired. I am not normally exhausted. this is a new thing for me.

Release 9 — 6 months, dose 2

2021-09-23

Symptoms: quite sure unrelated to Covid. had fall, broke hip then after that repair had hernia and another surgery to repair that.

Healthcare visit (other): see above

Release 11 — 6 months, dose 3

2022-05-19

Symptoms: clunked my knee. tending to that. separate from that considering second booster.

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	Unevaluable event	·	·	✓
SD	Cough	✓	✓	✓
SD	Dysgeusia	✓	✓	✓
SD	Fall	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Hernia repair	·	·	✓
SD	Hip fracture	·	·	✓
SD	Hip surgery	·	·	✓
SD	Joint injury	·	·	✓
SD	Nasal congestion	✓	✓	✓
SD	Nasopharyngitis	✓	✓	✓
SD	Oral pruritus	✓	✓	✓
SRO	Adverse reaction	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Myalgia	✓	✓	✓
SRO	Pain	·	·	✓
SRO	Self-medication	✓	✓	✓
SRO	Tenderness	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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