5GV-29601-87553

3 vaccinations 8 coded responses 19 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 209 / MD
Registered: 2021-02-21

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

2021-02-13
Dose 1 — Moderna
2021-02-21
Registered in v-safe
2021-02-21
Survey response — day 7, dose 1
MedDRA: Chills, Emergency care, Fatigue, Feeling abnormal, Pyrexia, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Poor · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Free text: Started with runny nose 2 days after vaccine then on Friday 19th chills and fever thought I had COVID. Went to ER. Was there 6 hours they did a covid test. Negative. Did numerous other blood tests for flys and SARS. All negative. Urine tests. So I have no idea if these are delayed reactions to vaccine or what. I feel awful. My normal temp is 97.5 so when it gets this high I feel it as higher I think. I am also exhausted. I just had major surgery Jan 14 and still recovering. They recommend I see a primary care. I want to have another urine specimen since I feel I have symptoms. Very concerned

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Survey response — day 14, dose 1
MedDRA: Chills, Inflammation, Pneumonia, Pyrexia, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Emergency room or emergency department visit

Free text: Symptoms: I have inflammation/pneumonia and on antibiotics but it began 6 days after vaccine on 13th and continued 7 days till a ct scan showed what is wrong. Blood tests were negative. I had chills and fever · Healthcare visit (other): Ct scan

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-27
Report sent to call center — day 14, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-06
Survey response — day 21, dose 1
MedDRA: Computerised tomogram thorax abnormal, Emergency care, Pneumonia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Pneumonia not diagnosed at hospital 2/19. cT scan detected later. Finally on 2/26 put on antibiotics. To have chest X-ray 3/11. Hoping I can still have my second dose of vaccine on 3/13

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-13
Dose 2 — Moderna
2021-03-20
Survey response — day 7, dose 2
MedDRA: Office visit, Pneumonia, Surgery — Feeling: Fair · Fatigue or tiredness · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

Free text: Systemic reaction (other): Recent major surgery. Had pneumonia · Healthcare visit (other): Doctors appts

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-20
Report sent to call center — day 7, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-27
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-03
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-04-10
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-04-17
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-24
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-09-13
Survey response — 6 months, dose 2
MedDRA: Fungal infection, Lumbar vertebral fracture, Office visit, Pharyngitis — Feeling: Fair · 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: Symptoms: Fractured lumbarFungal infection in throat · Healthcare visit (other): Radiological tests and in person doctor appointments

MedDRA releases: 2024-11 · check-in free text available
2021-09-13
Report sent to call center — 6 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-14
Call 1 — Left Voicemail
2021-10-28
Dose 3 — Moderna
2021-10-28
Survey response — day 0, dose 3
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain

Free text: I have most symptoms but only because I already have allergies. Sinus issues. Back pain etc Normal for me

MedDRA releases: 2024-11 · check-in free text available
2021-10-29
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Joint pains, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-10-30
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-10-31
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-01
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain · Joint pains, Muscle or body aches

Adult check-in
2021-11-02
Survey response — days 1–6 daily, dose 3
MedDRA: Pre-existing disease — Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: I had a fractured lumbar for 3 months so already Have pains which ardzeirsevvb

MedDRA releases: 2024-11 · check-in free text available
2021-11-03
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-11-04
Health check-in — day 7, dose 3
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-11-11
Survey response — day 14, dose 3
MedDRA: Back pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Worse back pains but it connected to booster

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-13	Moderna
2	2021-03-13	Moderna
3	2021-10-28	Moderna	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 4 — day 7, dose 1

2021-02-21

Systemic reaction (other): Started with runny nose 2 days after vaccine then on Friday 19th chills and fever thought I had COVID. Went to ER. Was there 6 hours they did a covid test. Negative. Did numerous other blood tests for flys and SARS. All negative. Urine tests. So I have no idea if these are delayed reactions to vaccine or what. I feel awful. My normal temp is 97.5 so when it gets this high I feel it as higher I think. I am also exhausted. I just had major surgery Jan 14 and still recovering. They recommend I see a primary care. I want to have another urine specimen since I feel I have symptoms. Very concerned

Release 4 — day 14, dose 1

2021-02-27

Symptoms: I have inflammation/pneumonia and on antibiotics but it began 6 days after vaccine on 13th and continued 7 days till a ct scan showed what is wrong. Blood tests were negative. I had chills and fever

Healthcare visit (other): Ct scan

Release 5 — day 21, dose 1

2021-03-06

Symptoms: Pneumonia not diagnosed at hospital 2/19. cT scan detected later. Finally on 2/26 put on antibiotics. To have chest X-ray 3/11. Hoping I can still have my second dose of vaccine on 3/13

Release 6 — day 7, dose 2

2021-03-20

Systemic reaction (other): Recent major surgery. Had pneumonia

Healthcare visit (other): Doctors appts

Release 9 — 6 months, dose 2

2021-09-13

Symptoms: Fractured lumbarFungal infection in throat

Healthcare visit (other): Radiological tests and in person doctor appointments

Release 10 — day 0, dose 3

2021-10-28

Systemic reaction (other): I have most symptoms but only because I already have allergies. Sinus issues. Back pain etc Normal for me

Release 10 — days 1–6 daily, dose 3

2021-11-02

Systemic reaction (other): I had a fractured lumbar for 3 months so already Have pains which ardzeirsevvb

Release 10 — day 14, dose 3

2021-11-11

Symptoms: Worse back pains but it connected to booster

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	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Back pain	·	·	✓
SD	Chills	✓	✓	✓
SD	Computerised tomogram thorax abnormal	✓	✓	✓
SD	Emergency care	✓	✓	✓
SD	Fungal infection	·	·	✓
SD	Inflammation	✓	✓	✓
SD	Lumbar vertebral fracture	·	·	✓
SD	Pharyngitis	·	·	✓
SD	Pneumonia	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SRO	Chills	✓	✓	✓
SRO	Emergency care	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Pneumonia	✓	✓	✓
SRO	Pre-existing disease	·	·	✓
SRO	Pyrexia	✓	✓	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	SARS-CoV-2 test negative	✓	✓	✓
SRO	Surgery	✓	✓	✓

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