4Y5-15815-18095

3 vaccinations 14 coded responses 37 check-ins 14 free-text entries 3 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 431 / OH
Registered: 2021-03-05

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

2021-03-05
Registered in v-safe
2021-03-05
Dose 1 — Moderna
2021-03-05
Survey response — day 0, dose 1
MedDRA: Somnolence — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Free text: Very sleepy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Paraesthesia, Somnolence — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Dizziness and tingling in my face Very sleepy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Fatigue, Somnolence — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: More tiredness weakness and sleepiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-08
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Fatigue — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Very tired and weak In bed around 21 hours a d as y

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — days 1–6 daily, dose 1
MedDRA: Asthenia, Fatigue, Somnolence — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Very weak tired and sleepy Staying in bed most of the day

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Left message for doctor

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Fatigue, Medical counselling, Pre-existing disease — Feeling: Fair · Headache, Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Exausted Dr said because of my chronic fatigue · Healthcare visit (other): Phone call with my doctors office

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-12
Survey response — day 7, dose 1
MedDRA: Fatigue — Feeling: Fair · Site: Redness, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Very tired Afraid to get the second shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-19
Survey response — day 14, dose 1
MedDRA: Erythema, Fatigue, Loss of personal independence in daily activities, Pain in extremity, Pruritus, Rash, Swelling — Feeling: Fair · Be unable to do your normal daily activities

Free text: Arm pain swelling rash itching redness for a few day Unable to leave my house for 2 weeks after the 1st vaccine because of Exausted Still afraid to get the 2nd shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-02
Health check-in — day 28, dose 1
Feeling: Fair

Adult check-in
2021-04-05
Dose 2 — Moderna
2021-04-09
Survey response — days 1–6 daily, dose 2
MedDRA: Chills, Decreased appetite, Diarrhoea, Headache, Influenza like illness, Pain, Pain in extremity, Pyrexia, Rash — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: 4/5/21 -4/7/21 flu symptoms fever chills body achs headache arm very sore no appitite mild rash 4/7-4/8 diarrhea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Survey response — days 1–6 daily, dose 2
MedDRA: Somnolence — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Very sleepy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-11
Survey response — days 1–6 daily, dose 2
MedDRA: Somnolence — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sleepiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — day 7, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-19
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-26
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-03
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-10
Health check-in — day 35, dose 2
Feeling: Fair

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

Adult check-in
2021-07-05
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-04
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-10-29
Dose 3 — Moderna
2021-10-29
Health check-in — day 0, dose 3
Feeling: Poor · Site: Pain, Redness · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-10-30
Survey response — days 1–6 daily, dose 3
MedDRA: Asthenia, Body temperature decreased, Heart rate increased — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: My temp at the doctor yesterday was 96.8 Mines runs low Heartrate has been over 100 all day I've stayed in bed So weak didn't feel I could get my mail

MedDRA releases: 2024-11 · check-in free text available
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Headache, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-11-02
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-04
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-05
Health check-in — day 7, dose 3
Feeling: Poor · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-12
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2021-11-19
Health check-in — day 21, dose 3
Feeling: Fair

Adult check-in
2021-11-26
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-03
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-12-10
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-01-29
Survey response — 3 months, dose 3
MedDRA: Abdominal distension, Office visit, Weight decreased — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Since receiving the booster vaccine I have lost 20lbs I feel very full and bloated after eating · Healthcare visit (other): Doctor office visits

MedDRA releases: 2024-11 · check-in free text available
2022-01-29
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-31
Call 1 — Left Voicemail
2022-01-31
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2022-04-30
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-05	Moderna
2	2021-04-05	Moderna
3	2021-10-29	Moderna	No

Call center

3 call center cases

3 successful

See the call center timeline

Free text

Release 5 — day 0, dose 1

2021-03-05

Systemic reaction (other): Very sleepy

Release 5 — days 1–6 daily, dose 1

2021-03-06

Systemic reaction (other): Dizziness and tingling in my face Very sleepy

2021-03-07

Systemic reaction (other): More tiredness weakness and sleepiness

2021-03-08

Systemic reaction (other): Very tired and weak In bed around 21 hours a d as y

2021-03-09

Systemic reaction (other): Very weak tired and sleepy Staying in bed most of the day

2021-03-10

Healthcare visit (other): Left message for doctor

2021-03-11

Systemic reaction (other): Exausted Dr said because of my chronic fatigue

Healthcare visit (other): Phone call with my doctors office

Release 5 — day 7, dose 1

2021-03-12

Systemic reaction (other): Very tired Afraid to get the second shot

Release 5 — day 14, dose 1

2021-03-19

Symptoms: Arm pain swelling rash itching redness for a few day Unable to leave my house for 2 weeks after the 1st vaccine because of Exausted Still afraid to get the 2nd shot

Release 7 — days 1–6 daily, dose 2

2021-04-09

Systemic reaction (other): 4/5/21 -4/7/21 flu symptoms fever chills body achs headache arm very sore no appitite mild rash 4/7-4/8 diarrhea

2021-04-10

Systemic reaction (other): Very sleepy

2021-04-11

Systemic reaction (other): Sleepiness

Release 10 — days 1–6 daily, dose 3

2021-10-30

Systemic reaction (other): My temp at the doctor yesterday was 96.8 Mines runs low Heartrate has been over 100 all day I've stayed in bed So weak didn't feel I could get my mail

Release 11 — 3 months, dose 3

2022-01-29

Symptoms: Since receiving the booster vaccine I have lost 20lbs I feel very full and bloated after eating

Healthcare visit (other): Doctor office visits

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	Medical counselling	✓	✓	✓
HCVO	Office visit	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Abdominal distension	·	·	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Swelling	✓	✓	✓
SD	Weight decreased	·	·	✓
SRO	Asthenia	✓	✓	✓
SRO	Body temperature decreased	·	·	✓
SRO	Chills	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Heart rate increased	·	·	✓
SRO	Influenza like illness	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Paraesthesia	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rash	✓	✓	✓
SRO	Somnolence	✓	✓	✓

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