5BG-12919-72457

4 vaccinations 9 coded responses 27 check-ins 9 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 325 / FL
Registered: 2021-01-30

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

2021-01-07
Dose 1 — Moderna
2021-01-30
Registered in v-safe
2021-01-30
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-04
Dose 2 — Moderna
2021-02-04
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-05
Survey response — days 1–6 daily, dose 2
MedDRA: Fatigue, Headache, Injection site pain, Pain, Sleep disorder — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Arm woke me up during the night. Pain at injection site. Body ache started about 10am, very tired, BAD headache. Took long nap, but still have headache. But we are THANKFUL!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling · Fever · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever · None

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-18
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-25
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-04
Survey response — day 28, dose 2
MedDRA: Contusion, Medical counselling — Feeling: Good

Free text: Probably not related but have bruises popping up ..... like 10 in past 2 weeks and 3 overnight. Notified my doctor this afternoon.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Survey response — day 35, dose 2
MedDRA: Confusional state, Contusion, Dizziness, Lacrimation increased, Memory impairment, Office visit, Pre-existing disease, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Light headed, dizzy, confused, forgetful, teary · Healthcare visit (other): Dr ordered labs fir bruising from last week. Will be calling for a ct brain scan, as i have history of 2 strokes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-11
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-18
Survey response — day 42, dose 2
MedDRA: Contusion, Laboratory test — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Still bruising with no apparent reason. Have seen doctir and he rans blood tests. Waiting fir results of tests he sent off. CBC AND ELECTROLYTES were ok with a slight rise in calcium · Healthcare visit (other): Lab work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-05-06
Survey response — 3 months, dose 2
MedDRA: Supraventricular tachycardia — Feeling: Good · Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: SVT

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

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

Adult check-in
2021-08-23
Dose 3 — Moderna
2021-10-14
Call 1 — Left Voicemail
2021-11-22
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-02-21
Survey response — 6 months, dose 3
MedDRA: Eye pruritus, Nasopharyngitis, Sneezing — Feeling: Fair

Free text: Sneezing, itchy eyes no fever prob a cold

MedDRA releases: 2024-11 · check-in free text available
2022-04-04
Dose 4 — Moderna
2022-04-14
Survey response — day 7, dose 4
MedDRA: Unevaluable event — Feeling: Fair · Fever · Muscle or body aches, Fatigue or tiredness

Free text: My "normal" temp is 97.6

MedDRA releases: 2024-11 · check-in free text available
2022-04-18
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-25
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-02
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-09
Survey response — day 35, dose 4
MedDRA: Lymphadenopathy, Office visit — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Swollen glands both sides of neck · Healthcare visit (other): Dr office

MedDRA releases: 2024-11 · check-in free text available
2022-05-09
Report sent to call center — day 35, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-05-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-16
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-04
Survey response — 3 months, dose 4
MedDRA: Headache, Pain, Pyrexia, Rhinorrhoea, Sneezing — Feeling: Poor · Be unable to do your normal daily activities

Free text: Headache, bodyache, fever runny nose, sneezing

MedDRA releases: 2024-11 · check-in free text available
2022-10-03
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-04
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-07	Moderna
2	2021-02-04	Moderna
3	2021-08-23	Moderna	No
4	2022-04-04	Moderna	No

Call center

4 call center cases

4 successful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-05

Systemic reaction (other): Arm woke me up during the night. Pain at injection site. Body ache started about 10am, very tired, BAD headache. Took long nap, but still have headache. But we are THANKFUL!

Release 5 — day 28, dose 2

2021-03-04

Symptoms: Probably not related but have bruises popping up ..... like 10 in past 2 weeks and 3 overnight. Notified my doctor this afternoon.

Release 5 — day 35, dose 2

2021-03-11

Symptoms: Light headed, dizzy, confused, forgetful, teary

Healthcare visit (other): Dr ordered labs fir bruising from last week. Will be calling for a ct brain scan, as i have history of 2 strokes

Release 5 — day 42, dose 2

2021-03-18

Symptoms: Still bruising with no apparent reason. Have seen doctir and he rans blood tests. Waiting fir results of tests he sent off. CBC AND ELECTROLYTES were ok with a slight rise in calcium

Healthcare visit (other): Lab work

Release 8 — 3 months, dose 2

2021-05-06

Symptoms: SVT

Release 11 — 6 months, dose 3

2022-02-21

Symptoms: Sneezing, itchy eyes no fever prob a cold

Release 11 — day 7, dose 4

2022-04-14

Systemic reaction (other): My "normal" temp is 97.6

Release 11 — day 35, dose 4

2022-05-09

Symptoms: Swollen glands both sides of neck

Healthcare visit (other): Dr office

Release 12 — 3 months, dose 4

2022-07-04

Symptoms: Headache, bodyache, fever runny nose, sneezing

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	Contusion	✓	✓	✓
HCVO	Laboratory test	✓	✓	✓
HCVO	Office visit	✓	·	✓
HCVO	Pre-existing disease	✓	✓	✓
HCVO	Unevaluable event	○	✓	○
SD	Confusional state	✓	✓	✓
SD	Contusion	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Eye pruritus	·	·	✓
SD	Headache	·	·	✓
SD	Lacrimation increased	○	✓	○
SD	Lymphadenopathy	·	·	✓
SD	Medical counselling	✓	✓	✓
SD	Memory impairment	✓	✓	✓
SD	Nasopharyngitis	·	·	✓
SD	Pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sneezing	·	·	✓
SD	Supraventricular tachycardia	✓	✓	✓
SD	Unevaluable event	✓	·	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Injection site pain	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Sleep disorder	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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