5KH-32517-53724

5 vaccinations 18 coded responses 29 check-ins 17 free-text entries 1 call case

Sex: Female
Age at first dose: 46-50
ZIP prefix: 917 / CA
Registered: 2021-03-16

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Registered dependents

L73-18084-91602 Child or adolescent in my care · Female · 2022-04-15

42Z-26963-44442 Child or adolescent in my care · Female · 2023-04-11

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-03-15
Dose 1 — Moderna
2021-03-16
Registered in v-safe
2021-03-16
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Anosmia, Decreased appetite, Injection site bruising — Feeling: Poor · Site: Pain, Swelling · 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: Bruising in the injection site, loss of appetite, loss of taste and smell.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Survey response — days 1–6 daily, dose 1
MedDRA: Ageusia, Anosmia, Decreased appetite — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Loss of appetite, loss of taste and smell.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — day 7, dose 1
MedDRA: Dizziness, Insomnia, Peripheral swelling, Pruritus — Feeling: Fair · Site: Pain, Swelling · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Free text: Dizziness, swelling on feet and hands, (5 days), insomnia and itchiness all over body.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — day 14, dose 1
MedDRA: Dyspnoea, Insomnia — Feeling: Fair

Free text: Shortness of breath and insomnia.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-05
Survey response — day 21, dose 1
MedDRA: Ageusia, Anosmia, Insomnia — Feeling: Fair

Free text: My insomnia is getting worse!!!! My taste and smell are starting to comeback.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Survey response — day 28, dose 1
MedDRA: Diarrhoea, Dizziness, Fatigue — Feeling: Good

Free text: Dizziness, fatigue, diarrhea.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Dose 2 — Moderna
2021-04-19
Survey response — days 1–6 daily, dose 2
MedDRA: Urinary tract infection — Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Urinal track infection

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-21
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-04-22
Health check-in — day 7, dose 2
Feeling: Good · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain

Adult check-in
2021-04-29
Survey response — day 14, dose 2
MedDRA: Fatigue, Headache, Tachycardia — Feeling: Fair · Be unable to do your normal daily activities

Free text: My tachycardia attacks are getting worse up to 200 bpm. Headaches are lasting almost all day.I am exhausted and tired all the time!

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-06
Survey response — day 21, dose 2
MedDRA: Tachycardia — Feeling: Poor · Be unable to do your normal daily activities

Free text: Tachycardias are getting worse up to 220

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-13
Survey response — day 28, dose 2
MedDRA: Fatigue — Feeling: Good

Free text: Fatigue

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-20
Survey response — day 35, dose 2
MedDRA: Hordeolum, Insomnia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Insomnia, sty in my eyes

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-28
Survey response — day 42, dose 2
MedDRA: Insomnia, Sleep disorder — Feeling: Fair · Be unable to do your normal daily activities

Free text: Insomnia, sleeping problems.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-17
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-10-14
Health check-in — 6 months, dose 2
Feeling: Poor

Adult check-in
2021-11-07
Dose 3 — Moderna
Co-administered: Flu
2022-04-10
Dose 4 — Moderna
2022-04-15
Survey response — days 1–6 daily, dose 4
MedDRA: Dyspnoea — Feeling: Good · Site: Pain, Redness, Swelling · Chills, Headache, Joint pains, Fatigue or tiredness, Nausea, Diarrhea · Be unable to do your normal daily activities

Free text: Shortness of breath

MedDRA releases: 2024-11 · check-in free text available
2022-04-15
Survey response — 12 months, dose 2
MedDRA: Dyspnoea, Ear infection, Pharyngitis, Pyrexia — Feeling: Good · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: High fevers, ear and throat infections, shortness of breath.

MedDRA releases: 2024-11 · check-in free text available
2022-04-19
Health check-in — day 7, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2022-04-24
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-05-01
Survey response — day 21, dose 4
MedDRA: Diarrhoea, Headache, Medical counselling, Vertigo — 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

Free text: Symptoms: Vertigo, diarrhea headaches · Healthcare visit (other): Home visit

MedDRA releases: 2024-11 · check-in free text available
2022-05-01
Report sent to call center — day 21, dose 4
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-05-04
Call 1 — Could Not Reach Participant
2022-05-08
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-05-09
Call 2 — Could Not Reach Participant
2022-05-15
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2022-05-22
Survey response — day 42, dose 4
MedDRA: Ageusia — Feeling: Good

Free text: Loss of taste

MedDRA releases: 2024-11 · check-in free text available
2022-07-11
Survey response — 3 months, dose 4
MedDRA: Diarrhoea, Headache, Vomiting — Feeling: Good · Be unable to do your normal daily activities

Free text: diarrhea, vomit, headaches

MedDRA releases: 2024-11 · check-in free text available
2022-10-09
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-02-10
Dose 5 — Moderna
2023-04-11
Survey response — 12 months, dose 4
MedDRA: Chills, Night sweats, Productive cough — Feeling: Good

MedDRA releases: 2024-11
2023-05-13
Health check-in — 3 months, dose 5
Feeling: Fair

Adult check-in
2023-05-13
Health check-in — 3 months, dose 3, dependent
Feeling: Fair

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-15	Moderna
2	2021-04-15	Moderna
3	2021-11-07	Moderna	Flu
4	2022-04-10	Moderna	No
5	2023-02-10	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-16

Systemic reaction (other): Bruising in the injection site, loss of appetite, loss of taste and smell.

2021-03-17

Systemic reaction (other): Loss of appetite, loss of taste and smell.

Release 6 — day 7, dose 1

2021-03-22

Systemic reaction (other): Dizziness, swelling on feet and hands, (5 days), insomnia and itchiness all over body.

Release 6 — day 14, dose 1

2021-03-31

Symptoms: Shortness of breath and insomnia.

Release 6 — day 21, dose 1

2021-04-05

Symptoms: My insomnia is getting worse!!!! My taste and smell are starting to comeback.

Release 7 — day 28, dose 1

2021-04-12

Symptoms: Dizziness, fatigue, diarrhea.

Release 7 — days 1–6 daily, dose 2

2021-04-19

Systemic reaction (other): Urinal track infection

Release 8 — day 14, dose 2

2021-04-29

Symptoms: My tachycardia attacks are getting worse up to 200 bpm. Headaches are lasting almost all day.I am exhausted and tired all the time!

Release 8 — day 21, dose 2

2021-05-06

Symptoms: Tachycardias are getting worse up to 220

Release 8 — day 28, dose 2

2021-05-13

Symptoms: Fatigue

Release 8 — day 35, dose 2

2021-05-20

Symptoms: Insomnia, sty in my eyes

Release 8 — day 42, dose 2

2021-05-28

Symptoms: Insomnia, sleeping problems.

Release 11 — 12 months, dose 2

2022-04-15

Symptoms: High fevers, ear and throat infections, shortness of breath.

Release 11 — days 1–6 daily, dose 4

2022-04-15

Systemic reaction (other): Shortness of breath

Release 11 — day 21, dose 4

2022-05-01

Symptoms: Vertigo, diarrhea headaches

Healthcare visit (other): Home visit

Release 11 — day 42, dose 4

2022-05-22

Symptoms: Loss of taste

Release 12 — 3 months, dose 4

2022-07-11

Symptoms: diarrhea, vomit, headaches

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	Medical counselling	·	·	✓
SD	Ageusia	✓	✓	✓
SD	Anosmia	✓	✓	✓
SD	Chills	·	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Ear infection	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hordeolum	✓	✓	✓
SD	Insomnia	✓	✓	✓
SD	Night sweats	·	·	✓
SD	Pharyngitis	·	·	✓
SD	Productive cough	·	·	✓
SD	Pyrexia	·	·	✓
SD	Sleep disorder	✓	✓	✓
SD	Tachycardia	✓	✓	✓
SD	Vertigo	·	·	✓
SD	Vomiting	·	·	✓
SRO	Ageusia	✓	✓	✓
SRO	Anosmia	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dyspnoea	·	·	✓
SRO	Injection site bruising	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Peripheral swelling	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Urinary tract infection	✓	✓	✓

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