56L-27146-72378

5 vaccinations 12 coded responses 54 check-ins 12 free-text entries 0 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 113 / NY
Registered: 2021-02-27

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

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-02-27
Registered in v-safe
2021-02-27
Dose 1 — Moderna
2021-02-27
Survey response — day 0, dose 1
MedDRA: Unevaluable event — Feeling: Good · Site: Swelling · Fatigue or tiredness

Free text: No I was tired before the vaccine so thats not really that significant

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2021-03-03
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Headache

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-04
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 1
MedDRA: No adverse event — Feeling: Good · Fatigue or tiredness

Free text: No

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-20
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-27
Dose 2 — Moderna
2021-05-29
Survey response — 3 months, dose 1
MedDRA: Fall, Fractured sacrum, Pelvic fracture, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: I fell about 2 months ago & have non displaced fractures of the sacral & pelvic areas but are healing Nothing to do with with vaccinations & got my Prolea shot yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-08-28
Health check-in — 6 months, dose 1
Feeling: Good

Adult check-in
2021-12-03
Dose 3 — Moderna
2021-12-04
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-05
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · None

Adult check-in
2021-12-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2021-12-07
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-08
Survey response — days 1–6 daily, dose 3
MedDRA: Oropharyngeal pain — Feeling: Fair · Site: Pain

Free text: Sore throat

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · None

Adult check-in
2021-12-10
Health check-in — day 7, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-12-17
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-12-24
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-12-31
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-07
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-14
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-04
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-05-20
Dose 4 — Moderna
2022-05-20
Survey response — day 0, dose 4
MedDRA: Unevaluable event — Feeling: Good · Site: Pain

Free text: Just received shot so have to wait

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-05-22
Survey response — days 1–6 daily, dose 4
MedDRA: Body temperature increased — Feeling: Fair · Site: Pain, Swelling · Headache

Free text: Temp down to 98.8

MedDRA releases: 2024-11 · check-in free text available
2022-05-23
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fatigue or tiredness

Adult check-in
2022-05-24
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-25
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · None

Adult check-in
2022-05-26
Survey response — days 1–6 daily, dose 4
MedDRA: No adverse event — Feeling: Good · Site: Pain · Headache

Free text: No

MedDRA releases: 2024-11 · check-in free text available
2022-05-27
Health check-in — day 7, dose 4
Feeling: Good · None

Adult check-in
2022-06-03
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-06-14
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-06-17
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-06-24
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-07-01
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-08-19
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-09-24
Dose 5 — Moderna
2022-09-24
Survey response — day 0, dose 5
MedDRA: Headache, Pyrexia, Self-medication — Feeling: Poor · Site: Pain · Fever · Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: No Tylenol helping fever & headache

MedDRA releases: 2024-11 · check-in free text available
2022-09-25
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2022-09-26
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-09-27
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2022-09-28
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain · Joint pains

Adult check-in
2022-09-29
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-09-30
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-01
Survey response — day 7, dose 5
MedDRA: Injection site discolouration, Oropharyngeal pain — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Sore throat today but I think it's because I'm stuffed arm at site of shot still a little black & blue

MedDRA releases: 2024-11 · check-in free text available
2022-10-08
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-10-15
Health check-in — day 21, dose 5
Feeling: Good

Adult check-in
2022-10-22
Health check-in — day 28, dose 5
Feeling: Good

Adult check-in
2022-10-29
Health check-in — day 35, dose 5
Feeling: Good

Adult check-in
2022-11-05
Health check-in — day 42, dose 5
Feeling: Good

Adult check-in
2022-12-24
Health check-in — 3 months, dose 5
Feeling: Good

Adult check-in
2023-03-25
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-27	Moderna
2	2021-03-27	Moderna	No
3	2021-12-03	Moderna	No
4	2022-05-20	Moderna	No
5	2022-09-24	Moderna	No

Free text

Release 4 — day 0, dose 1

2021-02-27

Systemic reaction (other): No I was tired before the vaccine so thats not really that significant

Release 5 — days 1–6 daily, dose 1

2021-03-03

Systemic reaction (other): No

2021-03-04

Systemic reaction (other): No

2021-03-05

Systemic reaction (other): No

Release 8 — 3 months, dose 1

2021-05-29

Symptoms: I fell about 2 months ago & have non displaced fractures of the sacral & pelvic areas but are healing Nothing to do with with vaccinations & got my Prolea shot yesterday

Release 10 — days 1–6 daily, dose 3

2021-12-08

Systemic reaction (other): Sore throat

Release 11 — day 0, dose 4

2022-05-20

Systemic reaction (other): Just received shot so have to wait

Release 11 — days 1–6 daily, dose 4

2022-05-21

Systemic reaction (other): No

2022-05-22

Systemic reaction (other): Temp down to 98.8

2022-05-26

Systemic reaction (other): No

Release 12 — day 0, dose 5

2022-09-24

Systemic reaction (other): No Tylenol helping fever & headache

Release 12 — day 7, dose 5

2022-10-01

Systemic reaction (other): Sore throat today but I think it's because I'm stuffed arm at site of shot still a little black & blue

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
SD	Fall	✓	✓	✓
SD	Fractured sacrum	✓	✓	✓
SD	Pelvic fracture	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SRO	Body temperature increased	·	·	✓
SRO	Headache	·	·	✓
SRO	Injection site discolouration	·	·	✓
SRO	No adverse event	✓	✓	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pyrexia	·	·	✓
SRO	Self-medication	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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