5HX-27913-16688

3 vaccinations 7 coded responses 32 check-ins 7 free-text entries 4 call cases

Sex: Female
Age at first dose: 51-55
ZIP prefix: 103 / NY
Registered: 2021-01-24

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

2021-01-24
Registered in v-safe
2021-01-24
Dose 1 — Moderna
2021-01-24
Survey response — day 0, dose 1
MedDRA: Unevaluable event — Feeling: Good

Free text: asthma, food allergies, pollen, dander, DM

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-26
Survey response — days 1–6 daily, dose 1
MedDRA: Diarrhoea, Fatigue, Pain in extremity — Feeling: Good · Site: Pain, Redness · Diarrhea

Free text: The day right after I felt tired and arm hurt, just a little more than reg flu shot pain. I DID have diarrhea but only day after..

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache

Adult check-in
2021-01-31
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-02-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-02-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-02-21
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-02-27
Dose 2 — Moderna
2021-02-28
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness · Chills, Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Headache

Adult check-in
2021-03-02
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Swelling, Itching · None

Adult check-in
2021-03-03
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · Diarrhea

Adult check-in
2021-03-04
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None · Be unable to work

Adult check-in
2021-03-05
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-06
Health check-in — day 7, dose 2
Feeling: Good · Site: Itching · None

Adult check-in
2021-03-13
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-20
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-03-27
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-04-03
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-05-29
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-08-28
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-07
Dose 3 — Moderna
2021-10-27
Survey response — day 14, dose 3
MedDRA: Chills, Diarrhoea, Impaired work ability, Musculoskeletal stiffness, Pain in extremity — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Just chills, diarrhea, arm soreness and extreme stiff neck the day after shot. Symptoms resolved after a day or two; I am fine. I took one day off. These symptoms were similar to other 2 doses. Except diarrhea was a new symptom.

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2021-11-04
Survey response — day 28, dose 3
MedDRA: Office visit, Vertigo positional — Feeling: Poor · Be unable to work or attend school, 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: BPPV. Unrelated to vaccine. · Healthcare visit (other): Saw Neuro PA, PT for head maneuvers and balance training.

MedDRA releases: 2024-11 · check-in free text available
2021-11-04
Report sent to call center — day 28, 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

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-11-05
Call 1 — Left Voicemail
2021-11-05
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-11-11
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2021-11-18
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-01-06
Survey response — 3 months, dose 3
MedDRA: COVID-19, Cough, Diarrhoea, Emergency care, Medical counselling, Physiotherapy, Rhinorrhoea, Unevaluable event, Vertigo, Vertigo positional — Feeling: Fair · 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, Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Had a very bad bout of benign paradoxyl positional vertigo in 11/21; saw emergency Neurologist PA, had MRI. Currently taking PT. Nearly recovered. I had early symptoms of Covid 12/19/21 diarrhea all day, next day cough, runny nose, throat. No fever. · Healthcare visit (other): Talked to my primary care doctor via portal for vertigo, went to a neuro ER clinic, hsd MRI and Physical therapy. For Covid i spoke to my MD. phone.

MedDRA releases: 2024-11 · check-in free text available
2022-01-06
Report sent to call center — 3 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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-01-07
Call 1 — Left Voicemail
2022-04-07
Survey response — 6 months, dose 3
MedDRA: Asthma, COVID-19, Nasopharyngitis, Pre-existing disease — Feeling: Poor · 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, Outpatient clinic or urgent care clinic visit

Free text: I had covid at end of Dec. Recovered well. No ill effects that i can see. My asthma has been acting up and right now im in middle of a nasty cold. Setting off my asthma. I had been boosted w my third vax months before i got covid. Breakthrough case!

MedDRA releases: 2024-11 · check-in free text available
2022-04-07
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 · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-04-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-04-11
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2022-10-07
Survey response — 12 months, dose 3
MedDRA: Blood glucose increased, Dyspnoea, Fatigue, Impaired work ability, Laboratory test abnormal, Medical counselling, Neck pain, SARS-CoV-2 test positive, Telemedicine — Feeling: Fair · 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: Symptoms: Had covid again. Last time I had it was 1/22. Tested poz 9/19/22. I took 5 day antiviral. Over it now; testing neg. Back at work. I took 2 weeks off. Still experiencing some symptoms (fatigue, SOB, head/neckaches, high blood sugar even w my DM meds) · Healthcare visit (other): I called my MD initially when my rapid was poz. Kept in contact w her. Then had televisit.

MedDRA releases: 2024-11 · check-in free text available
2022-10-07
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)
2022-10-10
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-24	Moderna
2	2021-02-27	Moderna
3	2021-10-07	Moderna	No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 2 — day 0, dose 1

2021-01-24

Systemic reaction (other): asthma, food allergies, pollen, dander, DM

Release 2 — days 1–6 daily, dose 1

2021-01-26

Systemic reaction (other): The day right after I felt tired and arm hurt, just a little more than reg flu shot pain. I DID have diarrhea but only day after..

Release 10 — day 14, dose 3

2021-10-27

Symptoms: Just chills, diarrhea, arm soreness and extreme stiff neck the day after shot. Symptoms resolved after a day or two; I am fine. I took one day off. These symptoms were similar to other 2 doses. Except diarrhea was a new symptom.

Release 10 — day 28, dose 3

2021-11-04

Symptoms: BPPV. Unrelated to vaccine.

Healthcare visit (other): Saw Neuro PA, PT for head maneuvers and balance training.

Release 10 — 3 months, dose 3

2022-01-06

Symptoms: Had a very bad bout of benign paradoxyl positional vertigo in 11/21; saw emergency Neurologist PA, had MRI. Currently taking PT. Nearly recovered. I had early symptoms of Covid 12/19/21 diarrhea all day, next day cough, runny nose, throat. No fever. cut off by CDC

Healthcare visit (other): Talked to my primary care doctor via portal for vertigo, went to a neuro ER clinic, hsd MRI and Physical therapy. For Covid i spoke to my MD. phone.

Release 11 — 6 months, dose 3

2022-04-07

Symptoms: I had covid at end of Dec. Recovered well. No ill effects that i can see. My asthma has been acting up and right now im in middle of a nasty cold. Setting off my asthma. I had been boosted w my third vax months before i got covid. Breakthrough case! cut off by CDC

Release 12 — 12 months, dose 3

2022-10-07

Symptoms: Had covid again. Last time I had it was 1/22. Tested poz 9/19/22. I took 5 day antiviral. Over it now; testing neg. Back at work. I took 2 weeks off. Still experiencing some symptoms (fatigue, SOB, head/neckaches, high blood sugar even w my DM meds) cut off by CDC

Healthcare visit (other): I called my MD initially when my rapid was poz. Kept in contact w her. Then had televisit.

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	COVID-19	·	·	✓
HCVO	Emergency care	·	·	✓
HCVO	Laboratory test abnormal	·	·	✓
HCVO	Medical counselling	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Physiotherapy	·	·	✓
HCVO	Telemedicine	·	·	✓
HCVO	Vertigo	·	·	✓
SD	Asthma	·	·	✓
SD	Blood glucose increased	·	·	✓
SD	Chills	·	·	✓
SD	Cough	·	·	✓
SD	COVID-19	·	·	✓
SD	Diarrhoea	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Emergency care	·	·	✓
SD	Fatigue	·	·	✓
SD	Impaired work ability	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Nasopharyngitis	·	·	✓
SD	Neck pain	·	·	✓
SD	Pain in extremity	·	·	✓
SD	Physiotherapy	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Vertigo positional	·	·	✓
SRO	Diarrhoea	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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