4YX-33696-12088

2 vaccinations 8 coded responses 22 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 31-35
ZIP prefix: 840 / UT
Registered: 2020-12-30

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

2020-12-30
Registered in v-safe
2020-12-30
Dose 1 — Moderna
2020-12-30
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Itching · Headache

Adult check-in
2021-01-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-15
Survey response — day 14, dose 1
MedDRA: Arthralgia, Headache, Injection site erythema, Injection site warmth, Myalgia, Oropharyngeal pain, Pain in extremity, Pruritus, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Day 11. Woke to wrist hurting. 2 inch redness surrounding site later noticed, hot to touch, sore shoulder muscle and arm. Itchy elbow w/joint pain. Redness gone by day 12. Sore muscle through day 14. Sore left throat and headaches day 13-14 · Healthcare visit (other): Outlined and discussed with other nurses/NPs on my unit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — day 14, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-27
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-01-29
Dose 2 — Moderna
2021-01-29
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Itching · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Dizziness, Dyspnoea — Feeling: Fair · Site: Pain, Itching · Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Breathy, dry cough, moments of dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Dyspnoea — Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Free text: Mild intermittent breathiness and cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Tachycardia — Feeling: Fair · Site: Itching · Fatigue or tiredness

Free text: Tachycardia at bedtime last night while calm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Office visit, SARS-CoV-2 test — Feeling: Fair · Site: Itching · Headache, Muscle or body aches · Be unable to work, Get care from a doctor or other healthcare professional

Free text: Systemic reaction (other): Intermittent cough still · Healthcare visit (other): Employee health ordered covid test for cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-03
Report sent to call center — days 1–6 daily, dose 2
Be unable to work · Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-05
Survey response — day 7, dose 2
MedDRA: Cough — Feeling: Good · Site: Pain, Itching

Free text: Intermittent cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — day 14, dose 2
MedDRA: Cough, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Continued intermittent dry cough down into chest · Healthcare visit (other): Scheduled appt with clotting specialist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-20
Survey response — day 21, dose 2
MedDRA: Cough — Feeling: Good

Free text: Still have an intermittent chest cough that started at the exact time the vaccine side effects did

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-10
Call 1 — Left Voicemail
2021-03-14
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-21
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-29	Moderna

Call center

3 call center cases

3 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-15

Symptoms: Day 11. Woke to wrist hurting. 2 inch redness surrounding site later noticed, hot to touch, sore shoulder muscle and arm. Itchy elbow w/joint pain. Redness gone by day 12. Sore muscle through day 14. Sore left throat and headaches day 13-14

Healthcare visit (other): Outlined and discussed with other nurses/NPs on my unit

Release 3 — days 1–6 daily, dose 2

2021-01-31

Systemic reaction (other): Breathy, dry cough, moments of dizziness

2021-02-01

Systemic reaction (other): Mild intermittent breathiness and cough

2021-02-02

Systemic reaction (other): Tachycardia at bedtime last night while calm

2021-02-03

Systemic reaction (other): Intermittent cough still

Healthcare visit (other): Employee health ordered covid test for cough

Release 3 — day 7, dose 2

2021-02-05

Systemic reaction (other): Intermittent cough

Release 4 — day 14, dose 2

2021-02-12

Symptoms: Continued intermittent dry cough down into chest

Healthcare visit (other): Scheduled appt with clotting specialist

Release 4 — day 21, dose 2

2021-02-20

Symptoms: Still have an intermittent chest cough that started at the exact time the vaccine side effects did

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	Cough	✓	✓	✓
HCVO	Office visit	✓	✓	✓
HCVO	SARS-CoV-2 test	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Injection site erythema	✓	✓	✓
SD	Injection site warmth	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain in extremity	✓	✓	✓
SD	Pruritus	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Tachycardia	✓	✓	✓

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