5L9-23371-02953

2 vaccinations 8 coded responses 22 check-ins 8 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 370 / TN
Registered: 2020-12-26

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

2020-12-26
Registered in v-safe
2020-12-26
Dose 1 — Moderna
2020-12-26
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2020-12-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · None

Adult check-in
2020-12-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

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

Adult check-in
2021-01-02
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-11
Survey response — day 14, dose 1
MedDRA: Erythema, Pruritus, Rash, Self-medication, Urticaria — Feeling: Good

Free text: Rash/hives and redness with itching has return mostly on my chest. Thete is a little on my neck and back. I jave used some new skincare products on my chest, neck and face. I akso jave had some professional facials since all these symptoms started.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-16
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-01-19
Dose 2 — Moderna
2021-01-23
Survey response — days 1–6 daily, dose 2
MedDRA: Hypersensitivity — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Free text: Allergy symotons when I was in the woods today. They got better when I git out if there.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-24
Survey response — days 1–6 daily, dose 2
MedDRA: Asthenia, Decreased appetite, Fatigue, Headache, Pyrexia — Feeling: Fair · Headache, Fatigue or tiredness

Free text: The nught I received the shot I ran a high fever with a hadache, loss of appitite and fatique thatlasted all the next day, and my energy and appitite didn't return until Thursday afternoon. I recieved the shot on a Tuesday around 12:30 pm.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-01-26
Survey response — day 7, dose 2
MedDRA: Pruritus — Feeling: Good · Headache

Free text: One spot on my leg itched, but there are no visible signs of a rash.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-02
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-09
Survey response — day 21, dose 2
MedDRA: Fatigue, Headache, Rhinorrhoea — Feeling: Good · Be unable to do your normal daily activities

Free text: Snifles, headache and fatique

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-02-23
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-21
Survey response — 3 months, dose 2
MedDRA: Cough, Fatigue, Oropharyngeal pain, Paranasal sinus hypersecretion, Respiratory tract congestion, Sinus congestion — Feeling: Fair · Be unable to work

Free text: Sinus congestions,fatique, slight cough with sinus drainage. I had a sore throat when this started about 10days ago.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-07-20
Survey response — 6 months, dose 2
MedDRA: Bronchitis, Ear infection, Pharyngitis, Sinusitis — 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 · Outpatient clinic or urgent care clinic visit

Free text: Bronchitis, sinus infection, throat infecton and rar infection.

MedDRA releases: 2024-11 · check-in free text available
2021-07-20
Report sent to call center — 6 months, dose 2
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)
2021-07-27
Call 1 — Left Voicemail
2022-01-19
Survey response — 12 months, dose 2
MedDRA: Headache, Laryngitis, Oropharyngeal pain, Sinus congestion — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: COVID Sinus congestion, mild sore throat, mild laryngitis, mild headache

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-26	Moderna
2	2021-01-19	Moderna

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 1 — day 14, dose 1

2021-01-11

Symptoms: Rash/hives and redness with itching has return mostly on my chest. Thete is a little on my neck and back. I jave used some new skincare products on my chest, neck and face. I akso jave had some professional facials since all these symptoms started. cut off by CDC

Release 2 — days 1–6 daily, dose 2

2021-01-23

Systemic reaction (other): Allergy symotons when I was in the woods today. They got better when I git out if there.

2021-01-24

Systemic reaction (other): The nught I received the shot I ran a high fever with a hadache, loss of appitite and fatique thatlasted all the next day, and my energy and appitite didn't return until Thursday afternoon. I recieved the shot on a Tuesday around 12:30 pm.

Release 2 — day 7, dose 2

2021-01-26

Systemic reaction (other): One spot on my leg itched, but there are no visible signs of a rash.

Release 3 — day 21, dose 2

2021-02-09

Symptoms: Snifles, headache and fatique

Release 7 — 3 months, dose 2

2021-04-21

Symptoms: Sinus congestions,fatique, slight cough with sinus drainage. I had a sore throat when this started about 10days ago.

Release 9 — 6 months, dose 2

2021-07-20

Symptoms: Bronchitis, sinus infection, throat infecton and rar infection.

Release 10 — 12 months, dose 2

2022-01-19

Symptoms: COVID Sinus congestion, mild sore throat, mild laryngitis, mild headache

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	Bronchitis	·	·	✓
SD	Cough	✓	✓	✓
SD	Ear infection	·	·	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Laryngitis	·	·	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Paranasal sinus hypersecretion	✓	✓	✓
SD	Pharyngitis	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SD	Sinusitis	·	·	✓
SD	Urticaria	✓	✓	✓
SRO	Asthenia	✓	✓	✓
SRO	Decreased appetite	✓	✓	✓
SRO	Fatigue	✓	✓	✓
SRO	Headache	✓	✓	✓
SRO	Hypersensitivity	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓

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