5DM-18206-40301

3 vaccinations 8 coded responses 26 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 46-50
ZIP prefix: 748 / OK
Registered: 2021-01-14

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

2021-01-14
Registered in v-safe
2021-01-14
Dose 1 — Moderna
2021-01-14
Health check-in — day 0, dose 1
Feeling: Fair · Site: Itching · Headache, Fatigue or tiredness

Adult check-in
2021-01-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Adult check-in
2021-01-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2021-01-17
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling hot — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Fatigue or tiredness

Free text: Really warm feeling, but no fever, have checked temp several times.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Survey response — days 1–6 daily, dose 1
MedDRA: COVID-19, Cough, Dyspnoea, Fatigue, Pain — Feeling: Poor · Site: Pain, Redness, Swelling · 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

Free text: Have COVID from husband. He tested positive on Friday. Myself & children started fevers, cough, body aches, fatigue & some shortness of breath for myself yesterday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-18
Report sent to call center — days 1–6 daily, dose 1
Be unable to work · Be unable to do your normal daily activities

1 call case(s)
2021-01-19
Survey response — days 1–6 daily, dose 1
MedDRA: COVID-19, Cough, SARS-CoV-2 test positive — Feeling: Fair · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work, Be unable to do your normal daily activities

Free text: COVID positive, cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-21
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-28
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-04
Survey response — day 21, dose 1
MedDRA: Arthralgia, Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Joint aches, headache, fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-11
Dose 2 — Moderna
2021-02-11
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Itching · Headache

Adult check-in
2021-02-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Fatigue or tiredness

Adult check-in
2021-02-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Headache

Adult check-in
2021-02-15
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling, Itching · Fatigue or tiredness

Adult check-in
2021-02-16
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Swelling · Fatigue or tiredness

Adult check-in
2021-02-17
Survey response — days 1–6 daily, dose 2
MedDRA: Pain in extremity — Feeling: Good · Site: Pain

Free text: Soreness in arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-18
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-05
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-11
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-18
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-25
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-13
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-12
Survey response — 6 months, dose 2
MedDRA: Iron deficiency anaemia — Feeling: Good

Free text: Iron deficiency anemia

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-27
Dose 3 — Moderna
2022-02-13
Survey response — 12 months, dose 2
MedDRA: Heart rate irregular — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Irregular heartbeat has gotten worse

MedDRA releases: 2024-11 · check-in free text available
2022-02-13
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-02-14
Call 1 — Left Voicemail
2022-04-29
Survey response — 6 months, dose 3
MedDRA: COVID-19, Condition aggravated, Pre-existing disease, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Frequent PVC's have increased majorly & fixing to have Ventricular Ablation to correct it. I feel it's more from having COVID vs the Vaccine tho. I had caught COVID between shot #1 & shot #2 in 2021 and that's when it started getting worse. · Healthcare visit (other): Surgery scheduled for May 12th

MedDRA releases: 2024-11 · check-in free text available
2022-04-29
Report sent to call center — 6 months, dose 3
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-05-03
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-05-03
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-14	Moderna
2	2021-02-11	Moderna
3	2021-10-27	Moderna	No

Call center

3 call center cases

2 successful · 1 priority 2/3 (triaged and no follow up)

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-17

Systemic reaction (other): Really warm feeling, but no fever, have checked temp several times.

2021-01-18

Systemic reaction (other): Have COVID from husband. He tested positive on Friday. Myself & children started fevers, cough, body aches, fatigue & some shortness of breath for myself yesterday.

2021-01-19

Systemic reaction (other): COVID positive, cough

Release 3 — day 21, dose 1

2021-02-04

Symptoms: Joint aches, headache, fatigue

Release 4 — days 1–6 daily, dose 2

2021-02-17

Systemic reaction (other): Soreness in arm

Release 9 — 6 months, dose 2

2021-08-12

Symptoms: Iron deficiency anemia

Release 11 — 12 months, dose 2

2022-02-13

Symptoms: Irregular heartbeat has gotten worse

Release 11 — 6 months, dose 3

2022-04-29

Symptoms: Frequent PVC's have increased majorly & fixing to have Ventricular Ablation to correct it. I feel it's more from having COVID vs the Vaccine tho. I had caught COVID between shot #1 & shot #2 in 2021 and that's when it started getting worse.

Healthcare visit (other): Surgery scheduled for May 12th

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	Unevaluable event	·	·	✓
SD	Arthralgia	✓	✓	✓
SD	Condition aggravated	·	·	✓
SD	COVID-19	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Heart rate irregular	·	·	✓
SD	Iron deficiency anaemia	✓	·	✓
SD	Pre-existing disease	·	·	✓
SRO	Cough	✓	✓	✓
SRO	COVID-19	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling hot	✓	✓	✓
SRO	Pain	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	SARS-CoV-2 test positive	○	✓	○

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