5PC-28134-03439

4 vaccinations 9 coded responses 38 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 61-65
ZIP prefix: 128 / NY
Registered: 2021-03-11

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

2021-03-10
Dose 1 — Moderna
2021-03-11
Registered in v-safe
2021-03-11
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Sinus disorder — Feeling: Poor · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Free text: Lightheaded & sinus issues

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-03-15
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-03-16
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-03-17
Health check-in — day 7, dose 1
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-03-24
Health check-in — day 14, dose 1
Feeling: Fair

Adult check-in
2021-03-31
Health check-in — day 21, dose 1
Feeling: Fair

Adult check-in
2021-04-06
Dose 2 — Moderna
2021-04-07
Survey response — days 1–6 daily, dose 2
MedDRA: Joint swelling — Feeling: Fair · Site: Pain · Chills, Joint pains, Fatigue or tiredness

Free text: Ankle swelling

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-08
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-04-10
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Joint pains, Fatigue or tiredness

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-04-13
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2021-04-22
Health check-in — day 14, dose 2
Feeling: Fair

Adult check-in
2021-04-27
Survey response — day 21, dose 2
MedDRA: Chills, Dizziness, Fatigue, Headache, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Lightheaded, nauseous, chills, increased fatigue, headache & sinus problems

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

Free text: Pain in arm, increased fatigue & on & off nausea

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-05-18
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-06
Health check-in — 3 months, dose 2
Feeling: Fair

Adult check-in
2021-10-06
Survey response — 6 months, dose 2
MedDRA: Urticaria — Feeling: Poor

Free text: Hives

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Dose 3 — Moderna
2022-04-08
Health check-in — 12 months, dose 2
Feeling: Fair

Adult check-in
2022-04-30
Dose 4 — Moderna
2022-05-01
Survey response — days 1–6 daily, dose 4
MedDRA: Insomnia — Feeling: Fair · Site: Pain, Redness · Chills, Joint pains, Muscle or body aches, Abdominal pain

Free text: Insomnia

MedDRA releases: 2024-11 · check-in free text available
2022-05-02
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Abdominal pain

Adult check-in
2022-05-03
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Muscle or body aches

Adult check-in
2022-05-04
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Muscle or body aches

Adult check-in
2022-05-05
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Headache, Joint pains, Muscle or body aches

Adult check-in
2022-05-06
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-07
Health check-in — day 7, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-14
Survey response — day 14, dose 4
MedDRA: Abdominal pain, Chest pain, Pain — Feeling: Fair

Free text: Sharp, shooting pain on left side into chest/abdomen area

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Health check-in — day 21, dose 4
Feeling: Poor

Adult check-in
2022-05-28
Survey response — day 28, dose 4
MedDRA: Burning sensation, Dizziness, Exposure to SARS-CoV-2, Fatigue, Gastrointestinal disorder, Medical counselling, Sinus disorder, Telemedicine, Unevaluable event — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: Symptoms: Lightheaded, dizzy, overwhelming fatigue, burning up with no fever, head/sinus problems, GI issues Exposed to someone who was Covid positive · Healthcare visit (other): Phone appointment as well as virtual

MedDRA releases: 2024-11 · check-in free text available
2022-05-28
Report sent to call center — day 28, dose 4
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-05-31
Call 1 — Left Voicemail
2022-06-05
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-11
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-07-31
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2022-10-29
Survey response — 6 months, dose 4
MedDRA: Arthralgia, Hypertension, Myalgia, Office visit — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: High blood pressure; feel like something's attacking all my joints & muscles - not sure if it's related to the vaccines or not · Healthcare visit (other): PCP office visit

MedDRA releases: 2024-11 · check-in free text available
2022-10-29
Report sent to call center — 6 months, dose 4
Get care from a doctor or other healthcare professional

1 call case(s)
2022-10-31
Call 2 — Left Voicemail
2022-10-31
Call 1 — Left Voicemail
2022-11-02
Callback requested for
2022-11-02
Call successful
Not applicable - Accidental Reporting
2022-11-02
Call successful
Not applicable - Accidental Reporting

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna
2	2021-04-06	Moderna
3	2021-12-03	Moderna	No
4	2022-04-30	Moderna	No

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 5 — days 1–6 daily, dose 1

2021-03-11

Systemic reaction (other): Lightheaded & sinus issues

Release 7 — days 1–6 daily, dose 2

2021-04-07

Systemic reaction (other): Ankle swelling

Release 8 — day 21, dose 2

2021-04-27

Symptoms: Lightheaded, nauseous, chills, increased fatigue, headache & sinus problems

Release 8 — day 28, dose 2

2021-05-04

Symptoms: Pain in arm, increased fatigue & on & off nausea

Release 10 — 6 months, dose 2

2021-10-06

Symptoms: Hives

Release 11 — days 1–6 daily, dose 4

2022-05-01

Systemic reaction (other): Insomnia

Release 11 — day 14, dose 4

2022-05-14

Symptoms: Sharp, shooting pain on left side into chest/abdomen area

Release 11 — day 28, dose 4

2022-05-28

Symptoms: Lightheaded, dizzy, overwhelming fatigue, burning up with no fever, head/sinus problems, GI issues Exposed to someone who was Covid positive

Healthcare visit (other): Phone appointment as well as virtual

Release 12 — 6 months, dose 4

2022-10-29

Symptoms: High blood pressure; feel like something's attacking all my joints & muscles - not sure if it's related to the vaccines or not

Healthcare visit (other): PCP office visit

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	·	·	✓
HCVO	Office visit	·	·	✓
HCVO	Telemedicine	·	·	✓
SD	Abdominal pain	·	·	✓
SD	Arthralgia	·	·	✓
SD	Burning sensation	·	·	✓
SD	Chest pain	·	·	✓
SD	Chills	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	✓	✓	✓
SD	Hypertension	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	✓	✓	✓
SD	Pain	·	·	✓
SD	Pain in extremity	✓	✓	✓
SD	Sinus disorder	·	·	✓
SD	Unevaluable event	·	·	✓
SD	Urticaria	·	·	✓
SRO	Dizziness	✓	✓	✓
SRO	Insomnia	·	·	✓
SRO	Joint swelling	✓	✓	✓
SRO	Sinus disorder	✓	✓	✓

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