55Q-30821-61007

2 vaccinations 9 coded responses 21 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 331 / FL
Registered: 2021-02-09

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

2021-02-08
Dose 2 — Moderna
2021-02-09
Registered in v-safe
2021-02-11
Survey response — days 1–6 daily, dose 1
MedDRA: Hyperhidrosis — Feeling: Fair · Site: Pain, Swelling · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sweating excessively

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Survey response — days 1–6 daily, dose 1
MedDRA: Cold sweat — Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Some cold sweats

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-14
Survey response — days 1–6 daily, dose 1
MedDRA: Emergency care, Eye pain — Feeling: Good · Headache · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): Eye pain. I have had pain in the orbit of one eye for a coiple of days. Am at the opthalmologist checking it out · Healthcare visit (other): Went to eye hospital emergency room

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-14
Report sent to call center — days 1–6 daily, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-02-15
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-01
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-08
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-10
Survey response — 3 months, dose 2
MedDRA: Abdominal pain, Diverticulitis, Pyrexia — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: I had diverticulitis, abdominal pain and fever. I have had other episodes in the past.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-28
Call 1 — Left Voicemail
2021-08-09
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-25
Dose 3 — Moderna
2021-10-25
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-10-26
Survey response — days 1–6 daily, dose 3
MedDRA: No adverse event — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Hyperhidrosis, Pyrexia — Feeling: Fair · Site: Pain, Redness · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Lots of sweating when the fever came down.

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Survey response — days 1–6 daily, dose 3
MedDRA: Gait disturbance — Feeling: Good · Fatigue or tiredness

Free text: A little wobbly when i walk.

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-11-01
Survey response — day 7, dose 3
MedDRA: Rash — Feeling: Good · Site: Redness, Itching · Rash, not including the immediate area around the injection site

Free text: The rash extended to my elbow for a few hours today

MedDRA releases: 2024-11 · check-in free text available
2021-11-15
Survey response — day 21, dose 3
MedDRA: Fatigue, Injection site reaction, Injection site warmth, Rash, Rash pruritic — Feeling: Good · Be unable to do your normal daily activities

Free text: Since the last checkup (week two) I experienced a rash. First on both arms near the elbow bend. Then the arm where I got the shot developed a rash from shoulder to elbow. It was hot and itchy. I also felt very tired all week. 2nd week.

MedDRA releases: 2024-11 · check-in free text available
2021-11-22
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2021-11-29
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-06
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2021-12-07
Call 2 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
2	2021-02-08	Moderna
3	2021-10-25	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-11

Systemic reaction (other): Sweating excessively

2021-02-12

Systemic reaction (other): Some cold sweats

2021-02-14

Systemic reaction (other): Eye pain. I have had pain in the orbit of one eye for a coiple of days. Am at the opthalmologist checking it out

Healthcare visit (other): Went to eye hospital emergency room

Release 8 — 3 months, dose 2

2021-05-10

Symptoms: I had diverticulitis, abdominal pain and fever. I have had other episodes in the past.

Release 10 — days 1–6 daily, dose 3

2021-10-26

Systemic reaction (other): No

2021-10-27

Systemic reaction (other): Lots of sweating when the fever came down.

2021-10-28

Systemic reaction (other): A little wobbly when i walk.

Release 10 — day 7, dose 3

2021-11-01

Systemic reaction (other): The rash extended to my elbow for a few hours today

Release 10 — day 21, dose 3

2021-11-15

Symptoms: Since the last checkup (week two) I experienced a rash. First on both arms near the elbow bend. Then the arm where I got the shot developed a rash from shoulder to elbow. It was hot and itchy. I also felt very tired all week. 2nd week.

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	Emergency care	✓	✓	✓
SD	Abdominal pain	✓	✓	✓
SD	Diverticulitis	✓	✓	✓
SD	Fatigue	·	·	✓
SD	Injection site reaction	·	·	✓
SD	Injection site warmth	·	·	✓
SD	Pyrexia	✓	✓	✓
SD	Rash	·	·	✓
SD	Rash pruritic	·	·	✓
SRO	Cold sweat	✓	✓	✓
SRO	Eye pain	✓	✓	✓
SRO	Gait disturbance	·	·	✓
SRO	Hyperhidrosis	✓	✓	✓
SRO	No adverse event	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Rash	·	·	✓

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