52W-19957-92144

5 vaccinations 15 coded responses 38 check-ins 15 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 027 / MA
Registered: 2021-01-20

Relationship: Self
Race: Multiracial
Ethnicity: Not Hispanic or Latino

Timeline

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

2021-01-20
Registered in v-safe
2021-01-20
Dose 1 — Moderna
2021-01-22
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-23
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Fatigue or tiredness

Free text: Some shortness of breath( have Asthma)

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 1
MedDRA: Asthma, Dyspnoea, Pre-existing disease — Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Free text: Shortness of breath.. I gave Asthma

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Survey response — days 1–6 daily, dose 1
MedDRA: Dyspnoea — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Some shortness of breath..? Due to my Asthma & having y to o wear mask for 11-12hrs while at work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-01-27
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-02-10
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-17
Dose 2 — Moderna
2021-02-17
Survey response — day 0, dose 2
MedDRA: Asthma, Dyspnoea, Nasal congestion, Pre-existing disease — Feeling: Good

Free text: Nasal congestion... some shortness of breath.. but I have Asthma .. could be weather related symptoms

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Poor · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Some shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-19
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-20
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Good · Headache, Joint pains, Fatigue or tiredness

Free text: Slight shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-02-22
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Some shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Headache, Fatigue or tiredness

Free text: Shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — day 7, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Shortness of breath.. remains

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — day 14, dose 2
MedDRA: Asthma, Dyspnoea, Office visit, Pre-existing disease — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: My Asthma has been an issue... shortness of breath...put on Predisone 10mg tabs pack 21 yesterday.....today had EKG & Chest X-ray · Healthcare visit (other): Doctors office today for lab work ,EKG & Chest X-ray

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Survey response — day 21, dose 2
MedDRA: Bone pain, Chest discomfort, Dyspnoea, Fatigue, Pre-existing disease, Unevaluable event — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Chest discomfort. ,bone pain.. continued Shortness of breath ..increased fatigue · Healthcare visit (other): Had CXR,EKG,Lab work on 3/3/21

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Report sent to call center — day 21, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-17
Survey response — day 28, dose 2
MedDRA: Dyspnoea, Fatigue — Feeling: Fair · Be unable to do your normal daily activities

Free text: Still with shortness of breath, some fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Survey response — day 35, dose 2
MedDRA: Dyspnoea, Fatigue — Feeling: Fair

Free text: Fatigue & shortness of breath remains ...have to do things at slower pace..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-19
Survey response — 3 months, dose 2
MedDRA: Chest discomfort, Dyspnoea, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Due to the Shortness of breath & chest discomfort since my second vaccine..my Pul.Func test wasnt good .. Ive been started on Singulair & Symbicort inhaler....they have helped. · Healthcare visit (other): Drs office visit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-19
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-18
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2021-12-20
Dose 3 — Moderna
2022-02-17
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-04-20
Dose 4 — Moderna
2022-05-04
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-11
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-05-22
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-28
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-01
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-21
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-09-19
Dose 5 — Moderna
Co-administered: Flu
2022-10-01
Health check-in — day 7, dose 5
Feeling: Fair · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-10-04
Health check-in — day 14, dose 5
Feeling: Fair

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

Adult check-in
2022-10-19
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-25
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-10-31
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-19
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-03-20
Health check-in — 6 months, dose 5
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-20	Moderna
2	2021-02-17	Moderna
3	2021-12-20	Moderna	No
4	2022-04-20	Moderna	No
5	2022-09-19	Moderna	Flu

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-23

Systemic reaction (other): Some shortness of breath( have Asthma)

2021-01-24

Systemic reaction (other): Shortness of breath.. I gave Asthma

2021-01-25

Systemic reaction (other): Some shortness of breath..? Due to my Asthma & having y to o wear mask for 11-12hrs while at work

Release 4 — day 0, dose 2

2021-02-17

Systemic reaction (other): Nasal congestion... some shortness of breath.. but I have Asthma .. could be weather related symptoms

Release 4 — days 1–6 daily, dose 2

2021-02-18

Systemic reaction (other): Some shortness of breath

2021-02-19

Systemic reaction (other): Shortness of breath

2021-02-20

Systemic reaction (other): Slight shortness of breath

2021-02-22

Systemic reaction (other): Some shortness of breath

2021-02-23

Systemic reaction (other): Shortness of breath

Release 4 — day 7, dose 2

2021-02-24

Systemic reaction (other): Shortness of breath.. remains

Release 4 — day 14, dose 2

2021-03-03

Symptoms: My Asthma has been an issue... shortness of breath...put on Predisone 10mg tabs pack 21 yesterday.....today had EKG & Chest X-ray

Healthcare visit (other): Doctors office today for lab work ,EKG & Chest X-ray

Release 5 — day 21, dose 2

2021-03-10

Symptoms: Chest discomfort. ,bone pain.. continued Shortness of breath ..increased fatigue

Healthcare visit (other): Had CXR,EKG,Lab work on 3/3/21

Release 5 — day 28, dose 2

2021-03-17

Symptoms: Still with shortness of breath, some fatigue

Release 6 — day 35, dose 2

2021-03-24

Symptoms: Fatigue & shortness of breath remains ...have to do things at slower pace..

Release 8 — 3 months, dose 2

2021-05-19

Symptoms: Due to the Shortness of breath & chest discomfort since my second vaccine..my Pul.Func test wasnt good .. Ive been started on Singulair & Symbicort inhaler....they have helped.

Healthcare visit (other): Drs office visit

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	Unevaluable event	✓	✓	✓
SD	Asthma	✓	✓	✓
SD	Bone pain	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Asthma	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Nasal congestion	✓	✓	✓
SRO	Pre-existing disease	✓	✓	✓

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