573-20433-52471

2 vaccinations 6 coded responses 21 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 606 / IL
Registered: 2021-03-11

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

2021-03-10
Dose 1 — Moderna
2021-03-11
Registered in v-safe
2021-03-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-24
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-31
Survey response — day 21, dose 1
MedDRA: Body temperature decreased, Chest discomfort, Chills, Dyspepsia — Feeling: Good

Free text: Had tightness with some odd pangs in chest overnight and had chills but temperature was LOW 95.7 ?! I am usually ~97.6. Today feeling better. It may be heatburn-related. If i did not improve by early afternoon I would have called my doctor.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-07
Dose 2 — Moderna
2021-04-08
Survey response — days 1–6 daily, dose 2
MedDRA: Abdominal pain upper — Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Mild stomach ache

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

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-04-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Chills

Adult check-in
2021-04-14
Health check-in — day 7, dose 2
Feeling: Fair · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-04-21
Survey response — day 14, dose 2
MedDRA: Chills — Feeling: Good

Free text: Sometimes I feel extremely chilled from the inside. This is unusual for me. I wouldnt call it chills because theres no modulation to it. No shivering, no fever.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-05-05
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-19
Survey response — day 42, dose 2
MedDRA: Dizziness, Nausea — Feeling: Good

Free text: Some dizziness and mild nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-07
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-06
Survey response — 6 months, dose 2
MedDRA: Flank pain, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Pain in my right side. Going to have it looked at. · Healthcare visit (other): Have not gone yet. Going to go to Urgent care.

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-12-01
Call 1 — Could Not Reach Participant
2021-12-06
Call 2 — Could Not Reach Participant
2022-04-07
Survey response — 12 months, dose 2
MedDRA: Abdominal pain, Fall, Gallbladder disorder, Liver disorder, Office visit, Patella fracture — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: 1. Abdominal pain Anomaly with liver/gall bladder // 2. Broken patella (ice fall) · Healthcare visit (other): Regular office doctor's visit

MedDRA releases: 2024-11 · check-in free text available
2022-04-07
Report sent to call center — 12 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-11
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-07	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 6 — day 21, dose 1

2021-03-31

Symptoms: Had tightness with some odd pangs in chest overnight and had chills but temperature was LOW 95.7 ?! I am usually ~97.6. Today feeling better. It may be heatburn-related. If i did not improve by early afternoon I would have called my doctor.

Release 7 — days 1–6 daily, dose 2

2021-04-08

Systemic reaction (other): Mild stomach ache

Release 7 — day 14, dose 2

2021-04-21

Symptoms: Sometimes I feel extremely chilled from the inside. This is unusual for me. I wouldnt call it chills because theres no modulation to it. No shivering, no fever.

Release 8 — day 42, dose 2

2021-05-19

Symptoms: Some dizziness and mild nausea

Release 10 — 6 months, dose 2

2021-10-06

Symptoms: Pain in my right side. Going to have it looked at.

Healthcare visit (other): Have not gone yet. Going to go to Urgent care.

Release 11 — 12 months, dose 2

2022-04-07

Symptoms: 1. Abdominal pain Anomaly with liver/gall bladder // 2. Broken patella (ice fall)

Healthcare visit (other): Regular office doctor's 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	Abdominal pain	·	·	✓
SD	Body temperature decreased	✓	✓	✓
SD	Chest discomfort	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspepsia	✓	✓	✓
SD	Fall	·	·	✓
SD	Flank pain	·	·	✓
SD	Gallbladder disorder	·	·	✓
SD	Liver disorder	·	·	✓
SD	Nausea	✓	✓	✓
SD	Patella fracture	·	·	✓
SRO	Abdominal pain upper	✓	✓	✓

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