58H-26861-91530

3 vaccinations 7 coded responses 20 check-ins 7 free-text entries 1 call case

Sex: Female
Age at first dose: 66+
ZIP prefix: 339 / FL
Registered: 2021-01-22

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

2021-01-12
Dose 1 — Moderna
2021-01-22
Registered in v-safe
2021-01-22
Health check-in — day 7, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-27
Survey response — day 14, dose 1
MedDRA: Fatigue, Headache, Myalgia, Pyrexia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Muscle aches, headaches, fatigue. Similar to the first 2 days following the vaccination but to a lesser degree. I had severe muscle aches, fever, fatigue, which completely incapacitated me, beginning 4 hours after the vaccination and lasting 2 days

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-02-09
Dose 2 — Moderna
2021-02-10
Survey response — days 1–6 daily, dose 2
MedDRA: Lymphadenopathy — Feeling: Poor · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Swollen lymph glands

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Survey response — days 1–6 daily, dose 2
MedDRA: Dyspnoea, Hot flush — Feeling: Fair · Site: Pain · Fever · Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to do your normal daily activities

Free text: Extreme hot flashes, shortness of breath

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-16
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-23
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-02
Survey response — day 21, dose 2
MedDRA: COVID-19, Dizziness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dizziness. I had covid in September 2020 and am continuing with ongoing and intermittent sx

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-23
Survey response — day 42, dose 2
MedDRA: Dyspnoea, Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Intermittent shortness of breath and fatigue. I had covid and have intermittent recurring problems. I do not believe they have anything to do with the vaccination.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-08-11
Survey response — 6 months, dose 2
MedDRA: Brain fog, Fatigue, Pain, Respiratory tract congestion — Feeling: Poor · Be unable to do your normal daily activities

Free text: Intermittent Exhaustion Body aches Brain fog Congestion

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-21
Dose 3 — Moderna
2021-10-26
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-02
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2021-12-21
Survey response — 3 months, dose 3
MedDRA: Ischaemic stroke — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Hospitalization

Free text: Ischemic stroke 11/10/21

MedDRA releases: 2024-11 · check-in free text available
2021-12-21
Report sent to call center — 3 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Hospitalization · 1 call case(s)
2021-12-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-12	Moderna
2	2021-02-09	Moderna
3	2021-09-21	Moderna	No

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 2 — day 14, dose 1

2021-01-27

Symptoms: Muscle aches, headaches, fatigue. Similar to the first 2 days following the vaccination but to a lesser degree. I had severe muscle aches, fever, fatigue, which completely incapacitated me, beginning 4 hours after the vaccination and lasting 2 days cut off by CDC

Release 4 — days 1–6 daily, dose 2

2021-02-10

Systemic reaction (other): Swollen lymph glands

2021-02-11

Systemic reaction (other): Extreme hot flashes, shortness of breath

Release 4 — day 21, dose 2

2021-03-02

Symptoms: Dizziness. I had covid in September 2020 and am continuing with ongoing and intermittent sx

Release 6 — day 42, dose 2

2021-03-23

Symptoms: Intermittent shortness of breath and fatigue. I had covid and have intermittent recurring problems. I do not believe they have anything to do with the vaccination.

Release 9 — 6 months, dose 2

2021-08-11

Symptoms: Intermittent Exhaustion Body aches Brain fog Congestion

Release 10 — 3 months, dose 3

2021-12-21

Symptoms: Ischemic stroke 11/10/21

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	Brain fog	✓	·	✓
SD	COVID-19	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Ischaemic stroke	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Pain	✓	·	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	✓	·	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Hot flush	✓	✓	✓
SRO	Lymphadenopathy	✓	✓	✓

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