4VG-11099-31038

5 vaccinations 10 coded responses 35 check-ins 9 free-text entries 3 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 033 / NH
Registered: 2021-01-22

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-01-22
Registered in v-safe
2021-01-22
Dose 1 — Moderna
2021-01-22
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-27
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Nasal congestion, Respiratory tract congestion — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Stuffiness, congestion, cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Pulmonary congestion — Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Slight lung congestion (tightness) with cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-31
Survey response — day 7, dose 1
MedDRA: Cough, Dyspnoea — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Difficulty breathing; cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Survey response — day 14, dose 1
MedDRA: Cough, Fatigue, Headache, Pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities

Free text: Temp 99.9, headache, chest congestion, bad cough, achy, fatigued for several days. COVID rest was negative.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-19
Dose 2 — Moderna
2021-02-19
Health check-in — day 0, dose 2
Feeling: Poor · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-20
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-26
Survey response — day 7, dose 2
MedDRA: Hyperhidrosis — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sweating

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-03-21
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-26
Health check-in — day 35, dose 2
Feeling: Good

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

Adult check-in
2021-05-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-20
Survey response — 6 months, dose 2
MedDRA: Dyspnoea exertional, Fatigue, Insomnia, Migraine, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Migraines, dyspnea with exertion (now resolved), fatigue, insomnia · Healthcare visit (other): Doctors office

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-08-20
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-26
Call 1 — Left Voicemail
2021-11-12
Dose 3 — Moderna
2022-02-21
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-07-15
Dose 4 — Moderna
2022-07-15
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-07-18
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-07-22
Health check-in — day 7, dose 4
Feeling: Good · Fatigue or tiredness

Adult check-in
2022-07-31
Survey response — day 14, dose 4
MedDRA: Chest discomfort, Dyspnoea, Headache, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities

Free text: Headache, Breathing difficulties (tightness, shortness of breath), probably allergies. Use of asthma medication helped somewhat.

MedDRA releases: 2024-11 · check-in free text available
2022-08-07
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-08-12
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-08-19
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-08-26
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-10-09
Dose 5 — Moderna
2022-10-15
Survey response — days 1–6 daily, dose 5
MedDRA: Tachycardia — Feeling: Fair · Site: Redness, Swelling, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Tachycardia

MedDRA releases: 2024-11 · check-in free text available
2022-10-16
Health check-in — day 7, dose 5
Feeling: Fair · Site: Itching · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain

Adult check-in
2022-10-24
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-31
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-11-07
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-11-13
Survey response — day 35, dose 5
MedDRA: Influenza, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test negative — 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: Diagnosed with Flu type B, Covid negative. Stuffy head, fever, body aches, sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-11-13
Report sent to call center — day 35, dose 5
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)
2022-11-14
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-11-22
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-08
Survey response — 3 months, dose 5
MedDRA: Sinusitis — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-01-08
Report sent to call center — 3 months, dose 5
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-01-09
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-09
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-22	Moderna
2	2021-02-19	Moderna
3	2021-11-12	Moderna	No
4	2022-07-15	Moderna	No
5	2022-10-09	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-27

Systemic reaction (other): Stuffiness, congestion, cough

2021-01-28

Systemic reaction (other): Slight lung congestion (tightness) with cough

Release 3 — day 7, dose 1

2021-01-31

Systemic reaction (other): Difficulty breathing; cough

Release 3 — day 14, dose 1

2021-02-05

Symptoms: Temp 99.9, headache, chest congestion, bad cough, achy, fatigued for several days. COVID rest was negative.

Release 4 — day 7, dose 2

2021-02-26

Systemic reaction (other): Sweating

Release 9 — 6 months, dose 2

2021-08-20

Symptoms: Migraines, dyspnea with exertion (now resolved), fatigue, insomnia

Healthcare visit (other): Doctors office

Release 12 — day 14, dose 4

2022-07-31

Symptoms: Headache, Breathing difficulties (tightness, shortness of breath), probably allergies. Use of asthma medication helped somewhat.

Release 12 — days 1–6 daily, dose 5

2022-10-15

Systemic reaction (other): Tachycardia

Release 12 — day 35, dose 5

2022-11-13

Symptoms: Diagnosed with Flu type B, Covid negative. Stuffy head, fever, body aches, sore throat

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	Chest discomfort	·	·	✓
SD	Cough	✓	✓	✓
SD	Dyspnoea	·	·	✓
SD	Dyspnoea exertional	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Influenza	·	·	✓
SD	Insomnia	✓	·	✓
SD	Migraine	✓	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Sinusitis	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Pulmonary congestion	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓
SRO	Tachycardia	·	·	✓

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