5QZ-24627-02661

5 vaccinations 25 coded responses 42 check-ins 24 free-text entries 7 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 222 / VA
Registered: 2021-01-28

Relationship: Self
Race: N/A
Ethnicity: N/A

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-01-27
Dose 1 — Moderna
2021-01-28
Registered in v-safe
2021-01-28
Survey response — days 1–6 daily, dose 1
MedDRA: Pain in extremity — Feeling: Good · Site: Pain · Fatigue or tiredness

Free text: Soreness Tenderness Left upper arm. Took Tylenol ES with some relief.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Fatigue or tiredness

Adult check-in
2021-01-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Joint pains, Fatigue or tiredness

Adult check-in
2021-01-31
Survey response — days 1–6 daily, dose 1
MedDRA: Cough, Musculoskeletal discomfort, Rhinorrhoea — Feeling: Good · Site: Pain · Joint pains

Free text: Runny nose and cough. Took Naproxen for joint discomfort

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-01
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-03
Health check-in — day 7, dose 1
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-02-10
Survey response — day 14, dose 1
MedDRA: Fatigue — Feeling: Good · Be unable to do your normal daily activities

Free text: Fatigued and tired lastThursday and Friday.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 21, dose 1
MedDRA: Fatigue, Myalgia, Self-medication — Feeling: Good

Free text: Fatigue and achy muscles took naproxen for muscle symptoms.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Dose 2 — Moderna
2021-02-24
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-02-25
Survey response — days 1–6 daily, dose 2
MedDRA: Body temperature increased, Self-medication — Feeling: Fair · Site: Pain · Fever · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Free text: Temperature As of this check in 100.4 Took Tylenol with little relief

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-26
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Joint pains, Muscle or body aches

Adult check-in
2021-02-27
Survey response — days 1–6 daily, dose 2
MedDRA: Self-medication — Feeling: Fair · Fever · Chills, Headache, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Took Tylenol increasing fluids

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Survey response — days 1–6 daily, dose 2
MedDRA: Headache, Periorbital swelling, Self-medication — Feeling: Fair · Headache · Be unable to do your normal daily activities

Free text: Eyes feel puffy. Will take Tylenol for HA

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-01
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-03-03
Survey response — day 7, dose 2
MedDRA: Headache — Feeling: Good · Headache · Be unable to do your normal daily activities

Free text: Took Naproxen for HA

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-03-17
Survey response — day 21, dose 2
MedDRA: Cough — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-17
Report sent to call center — day 21, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-24
Survey response — day 28, dose 2
MedDRA: Cough — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Chronic Cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-24
Report sent to call center — day 28, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-03-31
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-07
Survey response — day 42, dose 2
MedDRA: Abdominal discomfort, Cough, Unevaluable event — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Cough and GI symptoms · Healthcare visit (other): Rx w antibiotics and PPI

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

1 call case(s)
2021-05-26
Survey response — 3 months, dose 2
MedDRA: Cough, Gastrooesophageal reflux disease, Nasal congestion, Office visit — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: CoughingNasal congestion Acid Reflux · Healthcare visit (other): ENT specialist

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-26
Report sent to call center — 3 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-08-27
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-10-23
Dose 3 — Moderna
2021-10-27
Survey response — days 1–6 daily, dose 3
MedDRA: Arthralgia, Chills, Fatigue, Pyrexia — Feeling: Good · Site: Pain · Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: 2nd Day after vaccination experienced Chills, Joint pain, Fatigue, Fever for 2 Days

MedDRA releases: 2024-11 · check-in free text available
2021-10-28
Health check-in — days 1–6 daily, dose 3
Feeling: Good · Fatigue or tiredness

Adult check-in
2021-10-30
Survey response — day 7, dose 3
MedDRA: Unevaluable event — Feeling: Fair · Abdominal pain

Free text: Left upper side started 2 days ago

MedDRA releases: 2024-11 · check-in free text available
2021-11-06
Survey response — day 14, dose 3
MedDRA: Fatigue — Feeling: Good

Free text: Feeling fatigued

MedDRA releases: 2024-11 · check-in free text available
2021-11-13
Survey response — day 21, dose 3
MedDRA: Arthralgia, Fatigue — Feeling: Fair

Free text: Fatigued, joints aching

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Survey response — day 28, dose 3
MedDRA: Arthralgia, Musculoskeletal stiffness, Physiotherapy — Feeling: Good · Get care from a doctor or other healthcare professional

Free text: Symptoms: Muscular stiffness, joint pain. Currently in PT · Healthcare visit (other): PT

MedDRA releases: 2024-11 · check-in free text available
2021-11-20
Report sent to call center — day 28, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2021-11-23
Call 1 — Left Voicemail
2021-11-27
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2021-12-04
Survey response — day 42, dose 3
MedDRA: Epistaxis, Musculoskeletal stiffness — Feeling: Good

Free text: Nose bleeds right nostril. Still with general muscle stiffness.

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Survey response — 3 months, dose 3
MedDRA: Muscle discomfort, Musculoskeletal discomfort, Self-medication, Unevaluable event — Feeling: Fair · Get care from a doctor or other healthcare professional

Free text: Symptoms: Joint and muscular discomfort- Tylenol and muscle rubs with some relief. Following up with Primary Care Provider. · Healthcare visit (other): Have appointment in February

MedDRA releases: 2024-11 · check-in free text available
2022-01-22
Report sent to call center — 3 months, dose 3
Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-27
Call 1 — Left Voicemail
2022-04-09
Dose 4 — Moderna
2022-04-18
Health check-in — day 7, dose 4
Feeling: Good · Joint pains

Adult check-in
2022-04-23
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-04-30
Survey response — day 21, dose 4
MedDRA: Respiratory tract congestion, Rhinorrhoea — Feeling: Fair

Free text: Congestion, nasal drainage.

MedDRA releases: 2024-11 · check-in free text available
2022-05-07
Survey response — day 28, dose 4
MedDRA: Arthralgia, Rhinorrhoea, Upper-airway cough syndrome — Feeling: Good

Free text: Runny nose, post nasal drainage and joint aches

MedDRA releases: 2024-11 · check-in free text available
2022-05-14
Survey response — day 35, dose 4
MedDRA: Myalgia, Rhinorrhoea — Feeling: Good

Free text: Runny nose, muscle aches, no fever

MedDRA releases: 2024-11 · check-in free text available
2022-05-21
Health check-in — day 42, dose 4
Feeling: Good

Adult check-in
2022-07-09
Survey response — 3 months, dose 4
MedDRA: Migraine, Retching, SARS-CoV-2 test negative — Feeling: Good · Be unable to do your normal daily activities

Free text: Migraine and dry Heaves. Lasted >24 hours Tested negative for Covid x3

MedDRA releases: 2024-11 · check-in free text available
2022-10-08
Survey response — 6 months, dose 4
MedDRA: Fatigue, Myalgia, Office visit, Rhinorrhoea, SARS-CoV-2 antibody test positive — Feeling: Fair

Free text: Fatigue, muscle aches runny nose. Had immunity testing done. Provider indicated my antibodies for Covid 19 where in the 18,000 range. I could hold off on booster?

MedDRA releases: 2024-11 · check-in free text available
2022-11-25
Dose 5 — Moderna
2023-04-09
Survey response — 12 months, dose 4
MedDRA: Cough, Gastroenteritis, Influenza, Pre-existing disease, SARS-CoV-2 test negative, Self-medication — Feeling: Fair · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-04-09
Report sent to call center — 12 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-04-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-04-10
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-05-26
Health check-in — 6 months, dose 5
Feeling: Good

Adult check-in

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-01-27	Moderna
2	2021-02-24	Moderna
3	2021-10-23	Moderna	No
4	2022-04-09	Moderna	No
5	2022-11-25	Moderna	No

Call center

7 call center cases

7 successful

See the call center timeline

Free text

Release 2 — days 1–6 daily, dose 1

2021-01-28

Systemic reaction (other): Soreness Tenderness Left upper arm. Took Tylenol ES with some relief.

Release 3 — days 1–6 daily, dose 1

2021-01-31

Systemic reaction (other): Runny nose and cough. Took Naproxen for joint discomfort

Release 4 — day 14, dose 1

2021-02-10

Symptoms: Fatigued and tired lastThursday and Friday.

Release 4 — day 21, dose 1

2021-02-17

Symptoms: Fatigue and achy muscles took naproxen for muscle symptoms.

Release 4 — days 1–6 daily, dose 2

2021-02-25

Systemic reaction (other): Temperature As of this check in 100.4 Took Tylenol with little relief

2021-02-27

Systemic reaction (other): Took Tylenol increasing fluids

2021-02-28

Systemic reaction (other): Eyes feel puffy. Will take Tylenol for HA

Release 5 — day 7, dose 2

2021-03-03

Systemic reaction (other): Took Naproxen for HA

Release 5 — day 21, dose 2

2021-03-17

Symptoms: Coughing

Release 6 — day 28, dose 2

2021-03-24

Symptoms: Chronic Cough

Release 7 — day 42, dose 2

2021-04-07

Symptoms: Cough and GI symptoms

Healthcare visit (other): Rx w antibiotics and PPI

Release 8 — 3 months, dose 2

2021-05-26

Symptoms: CoughingNasal congestion Acid Reflux

Healthcare visit (other): ENT specialist

Release 10 — days 1–6 daily, dose 3

2021-10-27

Systemic reaction (other): 2nd Day after vaccination experienced Chills, Joint pain, Fatigue, Fever for 2 Days

Release 10 — day 7, dose 3

2021-10-30

Systemic reaction (other): Left upper side started 2 days ago

Release 10 — day 14, dose 3

2021-11-06

Symptoms: Feeling fatigued

Release 10 — day 21, dose 3

2021-11-13

Symptoms: Fatigued, joints aching

Release 10 — day 28, dose 3

2021-11-20

Symptoms: Muscular stiffness, joint pain. Currently in PT

Healthcare visit (other): PT

Release 10 — day 42, dose 3

2021-12-04

Symptoms: Nose bleeds right nostril. Still with general muscle stiffness.

Release 11 — 3 months, dose 3

2022-01-22

Symptoms: Joint and muscular discomfort- Tylenol and muscle rubs with some relief. Following up with Primary Care Provider.

Healthcare visit (other): Have appointment in February

Release 11 — day 21, dose 4

2022-04-30

Symptoms: Congestion, nasal drainage.

Release 11 — day 28, dose 4

2022-05-07

Symptoms: Runny nose, post nasal drainage and joint aches

Release 11 — day 35, dose 4

2022-05-14

Symptoms: Runny nose, muscle aches, no fever

Release 12 — 3 months, dose 4

2022-07-09

Symptoms: Migraine and dry Heaves. Lasted >24 hours Tested negative for Covid x3

Release 12 — 6 months, dose 4

2022-10-08

Symptoms: Fatigue, muscle aches runny nose. Had immunity testing done. Provider indicated my antibodies for Covid 19 where in the 18,000 range. I could hold off on booster?

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	Physiotherapy	·	·	✓
HCVO	Unevaluable event	✓	✓	✓
SD	Abdominal discomfort	✓	✓	✓
SD	Arthralgia	·	·	✓
SD	Cough	✓	✓	✓
SD	Epistaxis	·	·	✓
SD	Fatigue	✓	✓	✓
SD	Gastroenteritis	·	·	✓
SD	Gastrooesophageal reflux disease	✓	✓	✓
SD	Influenza	·	·	✓
SD	Migraine	·	·	✓
SD	Muscle discomfort	·	·	✓
SD	Musculoskeletal discomfort	·	·	✓
SD	Musculoskeletal stiffness	·	·	✓
SD	Myalgia	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Office visit	·	·	✓
SD	Physiotherapy	·	·	✓
SD	Pre-existing disease	·	·	✓
SD	Respiratory tract congestion	·	·	✓
SD	Retching	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	SARS-CoV-2 antibody test positive	·	·	✓
SD	SARS-CoV-2 test negative	·	·	✓
SD	Self-medication	✓	✓	✓
SD	Upper-airway cough syndrome	·	·	✓
SRO	Arthralgia	·	·	✓
SRO	Body temperature increased	✓	✓	✓
SRO	Chills	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Fatigue	·	·	✓
SRO	Headache	✓	✓	✓
SRO	Musculoskeletal discomfort	✓	✓	✓
SRO	Pain in extremity	✓	✓	✓
SRO	Periorbital swelling	✓	✓	✓
SRO	Pyrexia	·	·	✓
SRO	Rhinorrhoea	✓	✓	✓
SRO	Self-medication	✓	✓	✓
SRO	Unevaluable event	·	·	✓

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