5HQ-27621-23992

2 vaccinations 5 coded responses 18 check-ins 5 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 490 / MI
Registered: 2021-01-09

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

2021-01-08
Dose 1 — Moderna
2021-01-09
Registered in v-safe
2021-01-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-01-11
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-13
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-14
Survey response — days 1–6 daily, dose 1
MedDRA: Burning sensation, Decreased appetite, Incontinence, Pollakiuria — Feeling: Fair · Chills, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: No appetite. I suspect i have a UTI - Increased frequency & burning sensation when urinating, incontinence.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-14
Report sent to call center — days 1–6 daily, dose 1
Be unable to do your normal daily activities

1 call case(s)
2021-01-15
Survey response — day 7, dose 1
MedDRA: Cystitis, Urinary tract discomfort — Feeling: Fair · Fatigue or tiredness · 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: Multiple urinary problems. Diagnosed today w/bladder infection.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-15
Report sent to call center — day 7, dose 1
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-01-22
Survey response — day 14, dose 1
MedDRA: Asthenia, Fatigue, Nausea, Urinary tract infection, Vomiting — 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: Nausea, vomiting, extreme exhaustion & weakness possibly due to new antibiotic &/or interaction w other peescription drugs. Antibiotic was prescribed by PCP for UTI.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-22
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)
2021-01-29
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-05
Survey response — day 28, dose 1
MedDRA: Decreased appetite, Dehydration, Fatigue, Urinary tract infection — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme exhaustion, lack of appetite, dehydration likely caused from UTI that wont go away & side effects of antibiotic in combination with my other daily meds.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Dose 2 — Moderna
2021-02-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-02-13
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-20
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-06
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-10
Call 1 — Left Voicemail
2021-03-12
Call 2 — Left Voicemail
2021-03-13
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-08
Survey response — 3 months, dose 2
MedDRA: Condition aggravated, Pre-existing disease — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit, Hospitalization

Free text: Congestive heart failure that was diagnosed Oct 2020 has become more advanced, more acute.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-01
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-08	Moderna
2	2021-02-06	Moderna

Call center

4 call center cases

4 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-14

Systemic reaction (other): No appetite. I suspect i have a UTI - Increased frequency & burning sensation when urinating, incontinence.

Release 2 — day 7, dose 1

2021-01-15

Systemic reaction (other): Multiple urinary problems. Diagnosed today w/bladder infection.

Release 2 — day 14, dose 1

2021-01-22

Symptoms: Nausea, vomiting, extreme exhaustion & weakness possibly due to new antibiotic &/or interaction w other peescription drugs. Antibiotic was prescribed by PCP for UTI.

Release 3 — day 28, dose 1

2021-02-05

Symptoms: Extreme exhaustion, lack of appetite, dehydration likely caused from UTI that wont go away & side effects of antibiotic in combination with my other daily meds.

Release 8 — 3 months, dose 2

2021-05-08

Symptoms: Congestive heart failure that was diagnosed Oct 2020 has become more advanced, more acute.

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
SD	Asthenia	✓	✓	✓
SD	Condition aggravated	✓	✓	✓
SD	Decreased appetite	✓	✓	✓
SD	Dehydration	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Urinary tract infection	✓	✓	✓
SD	Vomiting	✓	✓	✓
SRO	Burning sensation	✓	✓	✓
SRO	Cystitis	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Incontinence	✓	✓	✓
SRO	Pollakiuria	✓	✓	✓
SRO	Urinary tract discomfort	✓	✓	✓

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