59R-78335-76976

2 vaccinations 9 coded responses 20 check-ins 9 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 920 / CA
Registered: 2021-01-04

Relationship: Self
Race: N/A
Ethnicity: Not Hispanic or Latino

Timeline

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

2020-12-31
Dose 1 — Moderna
2021-01-04
Registered in v-safe
2021-01-05
Survey response — days 1–6 daily, dose 1
MedDRA: Chills, Diarrhoea, Fatigue, Headache, Insomnia, Pain, Pyrexia — Feeling: Good · Site: Pain, Redness, Swelling · Headache

Free text: I was delayed in signing up for this reporting. I feel good today but had the vaccine on Dec 31. Within 24 hours after I had , fever of 100.8, chills, body aches, fatique, diarrhea, headaches and insomnia. Most have resolved after 48 hours.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-06
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Headache

Free text: Intermittent dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-07
Survey response — day 7, dose 1
MedDRA: Dizziness — Feeling: Fair · Headache

Free text: Dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-01-21
Survey response — day 21, dose 1
MedDRA: Dizziness, Headache, Medical counselling, Productive cough, Throat clearing — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Headaches and dizziness. Phlegm to clear in my throat. · Healthcare visit (other): MD told me to monitor and if worsen to contact her.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Report sent to call center — day 21, dose 1
Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-28
Dose 2 — Moderna
2021-01-28
Survey response — day 0, dose 2
MedDRA: Dizziness — Feeling: Fair · Headache

Free text: Dizziness. Just got shot 3 hrs ago but feel something coming on

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling · Fatigue or tiredness

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Itching · None

Adult check-in
2021-02-01
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good

Free text: Congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Survey response — days 1–6 daily, dose 2
MedDRA: Respiratory tract congestion — Feeling: Good · Headache, Joint pains

Free text: Congestion

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — day 7, dose 2
Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-02-11
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-04
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-13
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-03-26
Call 1 — Left Voicemail
2021-04-29
Survey response — 3 months, dose 2
MedDRA: Alopecia, Arthritis, Feeling abnormal, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Hair loss, inflamed joints, headaches, brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-07-29
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2022-01-28
Survey response — 12 months, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Covid in December 2020 and then again in January 2022

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-31	Moderna
2	2021-01-28	Moderna

Call center

1 call center case

1 successful

See the call center timeline

Free text

Release 1 — days 1–6 daily, dose 1

2021-01-05

Systemic reaction (other): I was delayed in signing up for this reporting. I feel good today but had the vaccine on Dec 31. Within 24 hours after I had , fever of 100.8, chills, body aches, fatique, diarrhea, headaches and insomnia. Most have resolved after 48 hours.

2021-01-06

Systemic reaction (other): Intermittent dizziness

Release 1 — day 7, dose 1

2021-01-07

Systemic reaction (other): Dizziness

Release 2 — day 21, dose 1

2021-01-21

Symptoms: Headaches and dizziness. Phlegm to clear in my throat.

Healthcare visit (other): MD told me to monitor and if worsen to contact her.

Release 2 — day 0, dose 2

2021-01-28

Systemic reaction (other): Dizziness. Just got shot 3 hrs ago but feel something coming on

Release 3 — days 1–6 daily, dose 2

2021-02-01

Systemic reaction (other): Congestion

2021-02-02

Systemic reaction (other): Congestion

Release 8 — 3 months, dose 2

2021-04-29

Symptoms: Hair loss, inflamed joints, headaches, brain fog

Release 11 — 12 months, dose 2

2022-01-28

Symptoms: Covid in December 2020 and then again in January 2022

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	Medical counselling	✓	✓	✓
SD	Alopecia	✓	✓	✓
SD	Arthritis	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	Dizziness	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Pre-existing disease	·	·	✓
SD	Productive cough	✓	✓	✓
SD	Throat clearing	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Respiratory tract congestion	✓	✓	✓

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