5QY-76704-22859

5 vaccinations 16 coded responses 41 check-ins 14 free-text entries 3 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 970 / OR
Registered: 2021-11-04

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
2021-04-09
Dose 2 — Moderna
2021-11-04
Registered in v-safe
2021-11-04
Dose 3 — Moderna
2021-11-04
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Fever · Chills, Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-11-05
Survey response — days 1–6 daily, dose 3
MedDRA: Feeling cold, Malaise, Pain in jaw — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Jaw hurts, and I just can not get warm. I do not feel well

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-11-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-11-09
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Site: Pain, Redness, Swelling · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-11-11
Health check-in — day 7, dose 3
Feeling: Good · Site: Pain, Redness, Swelling, Itching · Joint pains

Adult check-in
2021-11-18
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2021-11-25
Survey response — day 21, dose 3
MedDRA: Fatigue, Oropharyngeal pain, Respiratory tract congestion, Rhinorrhoea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sore throat Congestion Runny nose Tired

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Survey response — day 28, dose 3
MedDRA: Abdominal discomfort, Fatigue, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fatigue Tired Upset stomach Nausea

MedDRA releases: 2024-11 · check-in free text available
2021-12-09
Survey response — day 35, dose 3
MedDRA: Fatigue, Headache, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Nausea, tired, headache

MedDRA releases: 2024-11 · check-in free text available
2021-12-18
Health check-in — day 42, dose 3
Feeling: Fair

Adult check-in
2022-02-03
Survey response — 3 months, dose 3
MedDRA: Gastroenteritis viral — Feeling: Poor · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

Free text: Stomach flu

MedDRA releases: 2024-11 · check-in free text available
2022-02-03
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2022-03-30
Call 2 — Left Voicemail
2022-05-12
Dose 4 — Moderna
2022-05-12
Health check-in — 6 months, dose 3
Feeling: Fair

Adult check-in
2022-05-12
Health check-in — day 0, dose 4
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Nausea

Adult check-in
2022-05-13
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Nausea · Be unable to do your normal daily activities

Adult check-in
2022-05-14
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Site: Pain, Swelling, Itching · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Adult check-in
2022-05-15
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-16
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-05-17
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Swelling, Itching · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2022-05-18
Survey response — days 1–6 daily, dose 4
MedDRA: Dyspnoea exertional — Feeling: Fair · Site: Pain · Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Really short of breath with even walking

MedDRA releases: 2024-11 · check-in free text available
2022-05-19
Survey response — day 7, dose 4
MedDRA: Dyspnoea, Oropharyngeal pain, Rhinorrhoea — Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Short of breath, sore throat, runny nose

MedDRA releases: 2024-11 · check-in free text available
2022-05-27
Health check-in — day 14, dose 4
Feeling: Fair

Adult check-in
2022-06-03
Survey response — day 21, dose 4
MedDRA: Dyspnoea, Gastrointestinal disorder, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Fever, intestinal issues, winded

MedDRA releases: 2024-11 · check-in free text available
2022-06-11
Health check-in — day 28, dose 4
Feeling: Fair

Adult check-in
2022-06-16
Health check-in — day 35, dose 4
Feeling: Fair

Adult check-in
2022-06-25
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2022-10-28
Dose 5 — Moderna
2022-10-28
Health check-in — day 0, dose 5
Feeling: Good · Site: Pain · None

Adult check-in
2022-10-29
Health check-in — days 1–6 daily, dose 5
Feeling: Fair · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2022-10-30
Survey response — days 1–6 daily, dose 5
MedDRA: Rash, Rash erythematous, Rash papular, Skin warm — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Red hot raised areas on both elbows, psoriasis?

MedDRA releases: 2024-11 · check-in free text available
2022-10-31
Survey response — days 1–6 daily, dose 5
MedDRA: Erythema, Nasopharyngitis, Pre-existing disease, Psoriasis — Feeling: Fair · Site: Pain, Redness, Swelling, Itching · Fever · Headache, Joint pains, Muscle or body aches, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Feels like a severe allergic/ cold. Also new to me (Dx) psoriasis with reddened hot elbows.

MedDRA releases: 2024-11 · check-in free text available
2022-11-01
Survey response — days 1–6 daily, dose 5
MedDRA: Psoriasis, Rash — Feeling: Fair · Site: Redness, Swelling, Itching

Free text: Rash on elbows/ psoriasis (new)

MedDRA releases: 2024-11 · check-in free text available
2022-11-02
Survey response — days 1–6 daily, dose 5
MedDRA: Erythema — Feeling: Fair · Site: Redness, Swelling, Itching · Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Red raised area on elbows

MedDRA releases: 2024-11 · check-in free text available
2022-11-03
Health check-in — days 1–6 daily, dose 5
Feeling: Good · Site: Redness, Itching · Muscle or body aches

Adult check-in
2022-11-04
Health check-in — day 7, dose 5
Feeling: Fair · Site: Itching · Nausea, Abdominal pain

Adult check-in
2022-11-12
Health check-in — day 14, dose 5
Feeling: Good

Adult check-in
2022-11-18
Survey response — day 21, dose 5
MedDRA: Muscle swelling, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Swelling Muscle pain, soreness

MedDRA releases: 2024-11 · check-in free text available
2022-11-25
Health check-in — day 28, dose 5
Feeling: Fair

Adult check-in
2022-12-06
Health check-in — day 35, dose 5
Feeling: Fair

Adult check-in
2022-12-10
Survey response — day 42, dose 5
MedDRA: Influenza, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

Free text: Flu and Gastric

MedDRA releases: 2024-11 · check-in free text available
2023-01-29
Survey response — 3 months, dose 5
MedDRA: Cough, Fatigue, Infection — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation, Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-01-29
Report sent to call center — 3 months, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Telehealth, virtual health, or email health consultation · Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-01-30
Call 1 — Left Voicemail
2023-01-30
Call 1 — Left Voicemail
2023-05-03
Survey response — 6 months, dose 5
MedDRA: Cardiac disorder — Feeling: Fair · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-05-03
Report sent to call center — 6 months, dose 5
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-05-04
Call 3 — Left Voicemail
2023-05-04
Call 2 — Left Voicemail
2023-05-04
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-10	Moderna	No
2	2021-04-09	Moderna	No
3	2021-11-04	Moderna	No
4	2022-05-12	Moderna	No
5	2022-10-28	Moderna	No

Call center

3 call center cases

3 unsuccessful

See the call center timeline

Free text

Release 10 — days 1–6 daily, dose 3

2021-11-05

Systemic reaction (other): Jaw hurts, and I just can not get warm. I do not feel well

Release 10 — day 21, dose 3

2021-11-25

Symptoms: Sore throat Congestion Runny nose Tired

Release 10 — day 28, dose 3

2021-12-03

Symptoms: Fatigue Tired Upset stomach Nausea

Release 10 — day 35, dose 3

2021-12-09

Symptoms: Nausea, tired, headache

Release 11 — 3 months, dose 3

2022-02-03

Symptoms: Stomach flu

Release 11 — days 1–6 daily, dose 4

2022-05-18

Systemic reaction (other): Really short of breath with even walking

Release 11 — day 7, dose 4

2022-05-19

Systemic reaction (other): Short of breath, sore throat, runny nose

Release 11 — day 21, dose 4

2022-06-03

Symptoms: Fever, intestinal issues, winded

Release 12 — days 1–6 daily, dose 5

2022-10-30

Systemic reaction (other): Red hot raised areas on both elbows, psoriasis?

2022-10-31

Systemic reaction (other): Feels like a severe allergic/ cold. Also new to me (Dx) psoriasis with reddened hot elbows.

2022-11-01

Systemic reaction (other): Rash on elbows/ psoriasis (new)

2022-11-02

Systemic reaction (other): Red raised area on elbows

Release 12 — day 21, dose 5

2022-11-18

Symptoms: Swelling Muscle pain, soreness

Release 12 — day 42, dose 5

2022-12-10

Symptoms: Flu and Gastric

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	Abdominal discomfort	·	·	✓
SD	Cardiac disorder	·	·	✓
SD	Cough	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Fatigue	·	·	✓
SD	Gastroenteritis viral	·	·	✓
SD	Gastrointestinal disorder	·	·	✓
SD	Headache	·	·	✓
SD	Infection	·	·	✓
SD	Influenza	·	·	✓
SD	Muscle swelling	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Pyrexia	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Dyspnoea exertional	·	·	✓
SRO	Erythema	·	·	✓
SRO	Feeling cold	·	·	✓
SRO	Malaise	·	·	✓
SRO	Nasopharyngitis	·	·	✓
SRO	Oropharyngeal pain	·	·	✓
SRO	Pain in jaw	·	·	✓
SRO	Pre-existing disease	·	·	✓
SRO	Psoriasis	·	·	✓
SRO	Rash	·	·	✓
SRO	Rash erythematous	·	·	✓
SRO	Rash papular	·	·	✓
SRO	Rhinorrhoea	·	·	✓
SRO	Skin warm	·	·	✓

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