5LU-21649-87824

2 vaccinations 8 coded responses 20 check-ins 8 free-text entries 3 call cases

Sex: Female
Age at first dose: 26-30
ZIP prefix: 728 / AR
Registered: 2021-02-22

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

2021-02-22
Registered in v-safe
2021-02-22
Dose 1 — Moderna
2021-02-22
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-02-23
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-02-24
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness, Nausea

Free text: Breathing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-25
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Fatigue or tiredness, Nausea

Adult check-in
2021-02-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-01
Health check-in — day 7, dose 1
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-03-08
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-03-16
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-03-22
Survey response — day 28, dose 1
MedDRA: Dizziness — Feeling: Poor

Free text: Shock wave coming from brain and then it goes through out my body and I feel like Im blacking out. Been getting worse

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Dose 2 — Moderna
2021-03-29
Survey response — days 1–6 daily, dose 2
MedDRA: Cough, Oropharyngeal pain — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Cough sore throat

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-30
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea

Adult check-in
2021-03-31
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site

Adult check-in
2021-04-01
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain, Electric shock sensation — Feeling: Fair

Free text: Chest pains and o feel like Im electrocuted from the brain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Survey response — day 14, dose 2
MedDRA: Dyspnoea, Memory impairment, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Breathing. And forgetfulness · Healthcare visit (other): Made an apt for check up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-15
Report sent to call center — day 14, dose 2
Get care from a doctor or other healthcare professional

no matching call case
2021-04-18
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-24
Survey response — day 28, dose 2
MedDRA: Dyspnoea, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Hospitalization

Free text: Symptoms: Hard to Breath · Healthcare visit (other): Had to make an apt

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-24
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-04-30
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-05-07
Survey response — day 42, dose 2
MedDRA: Electric shock sensation, Heart rate increased, Palpitations, Shock symptom, Weight decreased — Feeling: Poor · 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: Breathing. Heart rate staying over 100 and a shocking feeling all through my body starting with my brain and losing weight

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Report sent to call center — day 42, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-25
Survey response — 3 months, dose 2
MedDRA: Amnesia, Hypertension, Office visit, Seizure — Feeling: Poor · 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: Seizures. Loss of short term memory hypertension · Healthcare visit (other): Seen a neurologist and cardiologist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-25
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)
2021-06-28
Call 1 — Left Voicemail
2021-09-24
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-12
Call 2 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-22	Moderna
2	2021-03-26	Moderna

Call center

3 call center cases

3 unsuccessful

1 check-in flagged for a call with no call center case on record

See the call center timeline

Free text

Release 4 — days 1–6 daily, dose 1

2021-02-24

Systemic reaction (other): Breathing

Release 6 — day 28, dose 1

2021-03-22

Symptoms: Shock wave coming from brain and then it goes through out my body and I feel like Im blacking out. Been getting worse

Release 6 — days 1–6 daily, dose 2

2021-03-29

Systemic reaction (other): Cough sore throat

2021-04-01

Systemic reaction (other): Chest pains and o feel like Im electrocuted from the brain

Release 7 — day 14, dose 2

2021-04-15

Symptoms: Breathing. And forgetfulness

Healthcare visit (other): Made an apt for check up

Release 7 — day 28, dose 2

2021-04-24

Symptoms: Hard to Breath

Healthcare visit (other): Had to make an apt

Release 8 — day 42, dose 2

2021-05-07

Symptoms: Breathing. Heart rate staying over 100 and a shocking feeling all through my body starting with my brain and losing weight

Release 9 — 3 months, dose 2

2021-06-25

Symptoms: Seizures. Loss of short term memory hypertension

Healthcare visit (other): Seen a neurologist and cardiologist

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	✓	✓	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Amnesia	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dyspnoea	✓	✓	✓
SD	Electric shock sensation	✓	✓	✓
SD	Heart rate increased	✓	✓	✓
SD	Hypertension	✓	✓	✓
SD	Memory impairment	✓	✓	✓
SD	Palpitations	✓	✓	✓
SD	Seizure	✓	✓	✓
SD	Shock symptom	✓	✓	✓
SD	Weight decreased	✓	✓	✓
SRO	Chest pain	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Electric shock sensation	✓	✓	✓
SRO	Oropharyngeal pain	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓

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