5BX-80320-08007

3 vaccinations 8 coded responses 28 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 065 / CT
Registered: 2021-02-04

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

2021-01-03
Dose 1 — Moderna
2021-02-02
Dose 2 — Moderna
2021-02-04
Registered in v-safe
2021-02-04
Survey response — days 1–6 daily, dose 2
MedDRA: Impaired work ability — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Abdominal pain · Be unable to work

Free text: Lost a day of work

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-05
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Redness, Swelling, Itching · Fever · Headache, Joint pains, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · None

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Joint pains

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

Adult check-in
2021-02-09
Health check-in — day 7, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · Headache, Joint pains

Adult check-in
2021-02-17
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-03
Survey response — day 28, dose 2
MedDRA: Fatigue, Headache, Influenza, Oropharyngeal pain, Pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: I feel like I am getting the flu. It might be a viral thing , I am very tired, achy and have a sore throat on my left side of my throat and I have a very bad headache. No fever

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-09
Survey response — day 35, dose 2
MedDRA: Fatigue, Headache, Pain — Feeling: Fair

Free text: Headaches and fatigue. Achiness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-05-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-04
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-02-04
Survey response — 12 months, dose 2
MedDRA: Chills, Headache, Pyrexia — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Headache , fever, chills

MedDRA releases: 2024-11 · check-in free text available
2022-04-27
Dose 3 — Moderna
Co-administered: Flu:Shingles
2022-04-27
Health check-in — day 0, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2022-04-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2022-04-30
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2022-05-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2022-05-02
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2022-05-03
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Itching · Headache, Joint pains, Fatigue or tiredness · Be unable to work or attend school

Adult check-in
2022-05-04
Health check-in — day 7, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2022-05-11
Health check-in — day 14, dose 3
Feeling: Fair

Adult check-in
2022-05-18
Survey response — day 21, dose 3
MedDRA: Bell's palsy, Hypoaesthesia — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Face is numb on left side and I have Bell's palsy from it

MedDRA releases: 2024-11 · check-in free text available
2022-05-18
Report sent to call center — day 21, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-19
Call 1 — Left Voicemail
2022-05-27
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-06-01
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-07-29
Survey response — 3 months, dose 3
MedDRA: Fatigue, Office visit, Pain — Feeling: Poor · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Fatigue, body aches, very bad fatigue · Healthcare visit (other): Primary care

MedDRA releases: 2024-11 · check-in free text available
2022-07-29
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

1 call case(s)
2022-08-01
Call 2 — Left Voicemail
2022-08-01
Call 1 — Left Voicemail
2022-10-26
Survey response — 6 months, dose 3
MedDRA: Pyrexia, Stomatitis — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I received my 4th covid 19 vaccine with the flu shot. After about 16 hours I ran a fever 100.4 for two days and my mouth broke out with sores.

MedDRA releases: 2024-11 · check-in free text available
2022-10-26
Report sent to call center — 6 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-10-27
Call successful
Not applicable - Accidental Reporting
2022-10-27
Call successful
Not applicable - Accidental Reporting
2022-10-27
Call successful
Not applicable - Accidental Reporting
2023-04-29
Survey response — 12 months, dose 3
MedDRA: COVID-19 — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

MedDRA releases: 2024-11
2023-04-29
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2023-05-01
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-03	Moderna
2	2021-02-02	Moderna
3	2022-04-27	Moderna	Flu:Shingles

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 2

2021-02-04

Systemic reaction (other): Lost a day of work

Release 5 — day 28, dose 2

2021-03-03

Symptoms: I feel like I am getting the flu. It might be a viral thing , I am very tired, achy and have a sore throat on my left side of my throat and I have a very bad headache. No fever

Release 5 — day 35, dose 2

2021-03-09

Symptoms: Headaches and fatigue. Achiness

Release 11 — 12 months, dose 2

2022-02-04

Symptoms: Headache , fever, chills

Release 11 — day 21, dose 3

2022-05-18

Symptoms: Face is numb on left side and I have Bell's palsy from it

Release 12 — 3 months, dose 3

2022-07-29

Symptoms: Fatigue, body aches, very bad fatigue

Healthcare visit (other): Primary care

Release 12 — 6 months, dose 3

2022-10-26

Symptoms: I received my 4th covid 19 vaccine with the flu shot. After about 16 hours I ran a fever 100.4 for two days and my mouth broke out with sores.

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	·	·	✓
SD	Bell's palsy	·	·	✓
SD	Chills	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Influenza	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Stomatitis	·	·	✓
SRO	Impaired work ability	✓	✓	✓

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