4XD-10832-28324

3 vaccinations 7 coded responses 30 check-ins 7 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 759 / TX
Registered: 2021-01-06

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

2020-12-26
Dose 1 — Moderna
2021-01-06
Registered in v-safe
2021-01-06
Survey response — day 7, dose 1
MedDRA: Unevaluable event — Feeling: Fair

Free text: Upper respiratory

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-20
Dose 2 — Moderna
2021-01-22
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
2021-01-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2021-01-24
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches

Adult check-in
2021-01-25
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches

Adult check-in
2021-01-27
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-03
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-10
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-17
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-24
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-03
Survey response — day 42, dose 2
MedDRA: Fungal infection, Nausea, Unevaluable event, Urine analysis abnormal — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Yeast infection that will not go away. Air bubbles in urine that have never been there before and waves of nausea. · Healthcare visit (other): Appointment is tomorrow went for lab work today

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-21
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-21
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-09-28
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-10-07
Dose 3 — Moderna
2021-10-08
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-10-09
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-10-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-10-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-10-12
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Muscle or body aches, Diarrhea

Adult check-in
2021-10-13
Survey response — days 1–6 daily, dose 3
MedDRA: Respiratory disorder — Feeling: Good · Site: Pain, Redness, Swelling · Joint pains, Muscle or body aches, Diarrhea

Free text: Bad upper respiratory, not sure if any relation to getting shot.

MedDRA releases: 2024-11 · check-in free text available
2021-10-14
Survey response — day 7, dose 3
MedDRA: Unevaluable event — Feeling: Good · Site: Pain, Itching · Muscle or body aches, Diarrhea

Free text: Still have upper respiratory

MedDRA releases: 2024-11 · check-in free text available
2021-10-21
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-10-28
Survey response — day 21, dose 3
MedDRA: Pre-existing disease, Rheumatoid arthritis — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I'm having a horrible flare up with my RA.

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Health check-in — day 28, dose 3
Feeling: Good

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

Adult check-in
2021-11-20
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-06
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-04-09
Survey response — 6 months, dose 3
MedDRA: Adverse reaction, COVID-19, Infection, Office visit, Physiotherapy — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: I got Covid and have had many complications and secondary infections. · Healthcare visit (other): In person PCP, ENT, CT scan and physical therapy

MedDRA releases: 2024-11 · check-in free text available
2022-04-09
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-04-19
Call 1 — Left Voicemail
2022-10-07
Survey response — 12 months, dose 3
MedDRA: Arthropathy, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Joint issues. Had to have two sets of injections. · Healthcare visit (other): Regular Dr appt

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
Report sent to call center — 12 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-10
Call 2 — Left Voicemail
2022-10-10
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-26	Moderna
2	2021-01-20	Moderna
3	2021-10-07	Moderna	No

Call center

3 call center cases

1 successful · 2 unsuccessful

See the call center timeline

Free text

Release 1 — day 7, dose 1

2021-01-06

Systemic reaction (other): Upper respiratory

Release 5 — day 42, dose 2

2021-03-03

Symptoms: Yeast infection that will not go away. Air bubbles in urine that have never been there before and waves of nausea.

Healthcare visit (other): Appointment is tomorrow went for lab work today

Release 10 — days 1–6 daily, dose 3

2021-10-13

Systemic reaction (other): Bad upper respiratory, not sure if any relation to getting shot.

Release 10 — day 7, dose 3

2021-10-14

Systemic reaction (other): Still have upper respiratory

Release 10 — day 21, dose 3

2021-10-28

Symptoms: I'm having a horrible flare up with my RA.

Release 11 — 6 months, dose 3

2022-04-09

Symptoms: I got Covid and have had many complications and secondary infections.

Healthcare visit (other): In person PCP, ENT, CT scan and physical therapy

Release 12 — 12 months, dose 3

2022-10-07

Symptoms: Joint issues. Had to have two sets of injections.

Healthcare visit (other): Regular Dr appt

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	·	·	✓
HCVO	Physiotherapy	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Adverse reaction	·	·	✓
SD	Arthropathy	·	·	✓
SD	COVID-19	·	·	✓
SD	Fungal infection	✓	✓	✓
SD	Infection	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Rheumatoid arthritis	·	·	✓
SD	Urine analysis abnormal	✓	✓	✓
SRO	Respiratory disorder	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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