5LE-58400-83760

4 vaccinations 7 coded responses 28 check-ins 7 free-text entries 2 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 334 / FL
Registered: 2021-01-27

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

2020-12-30
Dose 1 — Moderna
2021-01-27
Registered in v-safe
2021-01-27
Dose 2 — Moderna
2021-01-27
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-01-28
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-29
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

Adult check-in
2021-01-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · None

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

Adult check-in
2021-02-03
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-02-17
Survey response — day 21, dose 2
MedDRA: Pruritus, Rash — Feeling: Good

Free text: Rash on arm that had shot. Its very itchy and also rash on back.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-03-03
Survey response — day 35, dose 2
MedDRA: Lymphadenopathy, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Have had a swollen lymph node on collarbone since week or so after first shot but didnt relate it to vaccine, but maybe it is related. · Healthcare visit (other): Reg PC appt. May get uktrasound

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Report sent to call center — day 35, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-10
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-04-30
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-07-30
Survey response — 6 months, dose 2
MedDRA: Cough, Respiratory tract congestion, Sinus disorder — Feeling: Good · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Sinus and congestion and cough

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-07-30
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-03
Call 1 — Left Voicemail
2021-11-18
Dose 3 — Moderna
2022-04-08
Dose 4 — Moderna
2022-04-09
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-04-10
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · None

Adult check-in
2022-04-12
Survey response — days 1–6 daily, dose 4
MedDRA: Gastrointestinal disorder — Feeling: Good · Headache, Fatigue or tiredness

Free text: Stomach off

MedDRA releases: 2024-11 · check-in free text available
2022-04-14
Survey response — days 1–6 daily, dose 4
MedDRA: Abdominal pain, Diarrhoea — Feeling: Good · Diarrhea, Abdominal pain

Free text: I think the above is from a flu bug. As far as abdominal pain and diarrhea.

MedDRA releases: 2024-11 · check-in free text available
2022-04-15
Survey response — day 7, dose 4
MedDRA: Unevaluable event — Feeling: Good · Abdominal pain

Free text: Think that is from a bug or diverticulitis flare.

MedDRA releases: 2024-11 · check-in free text available
2022-04-24
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2022-05-06
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-05-15
Survey response — day 35, dose 4
MedDRA: Malaise — Feeling: Fair · Be unable to do your normal daily activities

Free text: Covid symptoms

MedDRA releases: 2024-11 · check-in free text available
2022-05-22
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-08
Health check-in — 3 months, dose 4
Feeling: Good

Adult check-in
2022-10-07
Health check-in — 6 months, dose 4
Feeling: Good

Adult check-in
2023-04-08
Health check-in — 12 months, dose 4
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-27	Moderna
3	2021-11-18	Moderna	No
4	2022-04-08	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 4 — day 21, dose 2

2021-02-17

Symptoms: Rash on arm that had shot. Its very itchy and also rash on back.

Release 5 — day 35, dose 2

2021-03-03

Symptoms: Have had a swollen lymph node on collarbone since week or so after first shot but didnt relate it to vaccine, but maybe it is related.

Healthcare visit (other): Reg PC appt. May get uktrasound

Release 9 — 6 months, dose 2

2021-07-30

Symptoms: Sinus and congestion and cough

Release 11 — days 1–6 daily, dose 4

2022-04-12

Systemic reaction (other): Stomach off

2022-04-14

Systemic reaction (other): I think the above is from a flu bug. As far as abdominal pain and diarrhea.

Release 11 — day 7, dose 4

2022-04-15

Systemic reaction (other): Think that is from a bug or diverticulitis flare.

Release 11 — day 35, dose 4

2022-05-15

Symptoms: Covid symptoms

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	✓	✓	✓
SD	Cough	✓	·	✓
SD	Lymphadenopathy	✓	✓	✓
SD	Malaise	·	·	✓
SD	Pruritus	✓	✓	✓
SD	Rash	✓	✓	✓
SD	Respiratory tract congestion	✓	·	✓
SD	Sinus disorder	✓	·	✓
SRO	Abdominal pain	·	·	✓
SRO	Diarrhoea	·	·	✓
SRO	Gastrointestinal disorder	·	·	✓
SRO	Unevaluable event	·	·	✓

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