54R-20311-49191

5 vaccinations 12 coded responses 48 check-ins 12 free-text entries 5 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 062 / CT
Registered: 2021-02-23

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

2021-02-23
Registered in v-safe
2021-02-23
Dose 1 — Moderna
2021-02-23
Health check-in — day 0, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-02-24
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-26
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-03-02
Health check-in — day 7, dose 1
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-09
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-23
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-25
Dose 2 — Moderna
2021-03-25
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-03-26
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Itching · Fever · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Fatigue or tiredness

Adult check-in
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Pruritus, Rash — Feeling: Good · Site: Itching · Fatigue or tiredness

Free text: Rash, itching are now on inside part of upper arm, but rash is not at injection area

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Survey response — days 1–6 daily, dose 2
MedDRA: Erythema, Pruritus — Feeling: Good · Site: Itching · Fatigue or tiredness

Free text: A little redness and itchiness on innocaluted arm on inner upper arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-01
Health check-in — day 7, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-04-08
Survey response — day 14, dose 2
MedDRA: Gingival disorder, Office visit, Toothache — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Tooth ache gum issue abcess drained need a root canal. On 2nd day of a 7 day amoxicillin · Healthcare visit (other): Dentist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-15
Survey response — day 21, dose 2
MedDRA: Fatigue, Oropharyngeal pain — Feeling: Good · Be unable to do your normal daily activities

Free text: Sore throat and tiredness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Survey response — day 28, dose 2
MedDRA: Office visit, Rash — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Had root canal and on a 5 day dose of amoxicillin. Last night had a rash on arms , mostly gone now. · Healthcare visit (other): Dentist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-22
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-29
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-06
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-24
Survey response — 3 months, dose 2
MedDRA: Office visit, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: I needed a root canal. · Healthcare visit (other): Dentist and antibiotics amoxicillin

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-24
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-28
Call 1 — Left Voicemail
2021-07-02
Call successful
Not applicable - Accidental Reporting
2021-07-02
Call successful
Not applicable - Accidental Reporting
2021-07-02
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-25
Survey response — 6 months, dose 2
MedDRA: Arthropod bite, Office visit, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Tick bite. Yellow jacket stings · Healthcare visit (other): Naturopath and dr

MedDRA releases: 2024-11 · check-in free text available
2021-09-25
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-29
Call 1 — Left Voicemail
2021-11-02
Dose 3 — Moderna
2022-03-25
Health check-in — 12 months, dose 2
Feeling: Good

Adult check-in
2022-04-08
Dose 4 — Moderna
2022-04-08
Health check-in — day 0, dose 4
Feeling: Good · Site: Pain, Swelling, Itching · None

Adult check-in
2022-04-09
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain, Itching · Fatigue or tiredness

Adult check-in
2022-04-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness, Itching · None

Adult check-in
2022-04-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Redness · None

Adult check-in
2022-04-12
Survey response — days 1–6 daily, dose 4
MedDRA: Oropharyngeal pain — Feeling: Good · Site: Redness

Free text: Sore throat for part of day

MedDRA releases: 2024-11 · check-in free text available
2022-04-15
Survey response — day 7, dose 4
MedDRA: Oropharyngeal pain — Feeling: Good

Free text: A bit of a sore throat

MedDRA releases: 2024-11 · check-in free text available
2022-04-22
Survey response — day 14, dose 4
MedDRA: Fatigue, Malaise, Oropharyngeal pain, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities

Free text: Sore throat and tired feeling blah tested negative for Covid with a pcr test on Tuesday. Feeling better today.

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-13
Survey response — day 35, dose 4
MedDRA: Fatigue, Oropharyngeal pain — Feeling: Good

Free text: Sore throat, tired,

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-08
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-07
Survey response — 6 months, dose 4
MedDRA: Arthropod bite, Cataract operation — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Cataract surgery both eyes. Spider bite · Healthcare visit (other): Cataract surgery

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
Report sent to call center — 6 months, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-10
Dose 5 — Moderna
2022-10-10
Call 2 — Left Voicemail
2022-10-10
Call 1 — Left Voicemail
2022-10-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-19
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-20
Health check-in — day 7, dose 5
Feeling: Good · None

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
2022-11-14
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-21
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2023-01-09
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-04-10
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-23	Moderna
2	2021-03-25	Moderna
3	2021-11-02	Moderna	No
4	2022-04-08	Moderna	No
5	2022-10-10	Moderna	No

Call center

5 call center cases

5 successful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 2

2021-03-29

Systemic reaction (other): Rash, itching are now on inside part of upper arm, but rash is not at injection area

2021-03-30

Systemic reaction (other): A little redness and itchiness on innocaluted arm on inner upper arm

Release 7 — day 14, dose 2

2021-04-08

Symptoms: Tooth ache gum issue abcess drained need a root canal. On 2nd day of a 7 day amoxicillin

Healthcare visit (other): Dentist

Release 7 — day 21, dose 2

2021-04-15

Symptoms: Sore throat and tiredness

Release 7 — day 28, dose 2

2021-04-22

Symptoms: Had root canal and on a 5 day dose of amoxicillin. Last night had a rash on arms , mostly gone now.

Healthcare visit (other): Dentist

Release 9 — 3 months, dose 2

2021-06-24

Symptoms: I needed a root canal.

Healthcare visit (other): Dentist and antibiotics amoxicillin

Release 9 — 6 months, dose 2

2021-09-25

Symptoms: Tick bite. Yellow jacket stings

Healthcare visit (other): Naturopath and dr

Release 11 — days 1–6 daily, dose 4

2022-04-12

Systemic reaction (other): Sore throat for part of day

Release 11 — day 7, dose 4

2022-04-15

Systemic reaction (other): A bit of a sore throat

Release 11 — day 14, dose 4

2022-04-22

Symptoms: Sore throat and tired feeling blah tested negative for Covid with a pcr test on Tuesday. Feeling better today.

Release 11 — day 35, dose 4

2022-05-13

Symptoms: Sore throat, tired,

Release 12 — 6 months, dose 4

2022-10-07

Symptoms: Cataract surgery both eyes. Spider bite

Healthcare visit (other): Cataract surgery

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	Cataract operation	·	·	✓
HCVO	Office visit	✓	✓	✓
SD	Arthropod bite	·	·	✓
SD	Cataract operation	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gingival disorder	✓	✓	✓
SD	Malaise	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Rash	✓	✓	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Toothache	✓	✓	✓
SD	Unevaluable event	✓	✓	✓
SRO	Erythema	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pruritus	✓	✓	✓
SRO	Rash	✓	✓	✓

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