5RX-16759-93669

2 vaccinations 6 coded responses 18 check-ins 6 free-text entries 2 call cases

Sex: Female
Age at first dose: 56-60
ZIP prefix: 553 / MN
Registered: 2020-12-30

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

Adult check-in
2020-12-31
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Chills, Headache, Muscle or body aches, Fatigue or tiredness

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

Adult check-in
2021-01-02
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-03
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Diarrhea

Adult check-in
2021-01-04
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-01-06
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-01-20
Survey response — day 21, dose 1
MedDRA: Abdominal discomfort, Headache — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities

Free text: Bad headache and upset stomach. Achy

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-01-27
Dose 2 — Moderna
2021-01-30
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Diarrhea, Abdominal pain · Be unable to work

Adult check-in
2021-02-01
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-02-02
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to do your normal daily activities

Adult check-in
2021-02-03
Health check-in — day 7, dose 2
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2021-02-10
Survey response — day 14, dose 2
MedDRA: Abdominal discomfort, Fatigue, Feeling abnormal, Hypersomnia, Nasal congestion, Oropharyngeal pain — Feeling: Fair · Be unable to do your normal daily activities

Free text: Felt run down, tired, weird, little sore throat, stuffy. Stomach a little upset. Didnt feel good. Slept a lot.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-17
Survey response — day 21, dose 2
MedDRA: Fatigue, Malaise, Oropharyngeal pain, Pain, Sinus disorder — Feeling: Fair · Be unable to do your normal daily activities

Free text: Just not feeling good. Extremely tired , tiny sore throat, achy , fatigued , sinus

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-24
Survey response — day 28, dose 2
MedDRA: Eye pain, Nasal congestion, Oropharyngeal pain — Feeling: Poor · Be unable to do your normal daily activities

Free text: Sore throat little stuffy nose, eyes sting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-03
Survey response — day 35, dose 2
MedDRA: Abdominal discomfort, Chills, Cough, Headache, Nasal congestion, Office visit, Oropharyngeal pain, Pain, Pyrexia, Sinusitis — Feeling: Poor · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Sore throat, headache, low grade fever, cough, stuffy nose - sinus infection, uoset stomache /ache, achey all over, chills · Healthcare visit (other): In person visit with my Dr

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
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

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

Adult check-in
2021-04-28
Survey response — 3 months, dose 2
MedDRA: Chills, Headache, Office visit, Oropharyngeal pain, Pain, Pyrexia, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test negative — Feeling: Fair · Be unable to work, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Had exact symptoms of COVID for ocer a month. Started out as sore throat, high fever, diarreha, weak, chills, upset stomach, no appitite, headache, aches, stuffed up nose turned into a sinus infection. Tested neg. But Dr sure i had COVID anyway. · Healthcare visit (other): 2 dr visits in clinic

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Report sent to call center — 3 months, dose 2
Be unable to work · Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2022-01-22
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2020-12-30	Moderna
2	2021-01-27	Moderna

Call center

2 call center cases

2 successful

See the call center timeline

Free text

Release 2 — day 21, dose 1

2021-01-20

Symptoms: Bad headache and upset stomach. Achy

Release 4 — day 14, dose 2

2021-02-10

Symptoms: Felt run down, tired, weird, little sore throat, stuffy. Stomach a little upset. Didnt feel good. Slept a lot.

Release 4 — day 21, dose 2

2021-02-17

Symptoms: Just not feeling good. Extremely tired , tiny sore throat, achy , fatigued , sinus

Release 4 — day 28, dose 2

2021-02-24

Symptoms: Sore throat little stuffy nose, eyes sting

Release 5 — day 35, dose 2

2021-03-03

Symptoms: Sore throat, headache, low grade fever, cough, stuffy nose - sinus infection, uoset stomache /ache, achey all over, chills

Healthcare visit (other): In person visit with my Dr

Release 8 — 3 months, dose 2

2021-04-28

Symptoms: Had exact symptoms of COVID for ocer a month. Started out as sore throat, high fever, diarreha, weak, chills, upset stomach, no appitite, headache, aches, stuffed up nose turned into a sinus infection. Tested neg. But Dr sure i had COVID anyway.

Healthcare visit (other): 2 dr visits in clinic

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	Abdominal discomfort	✓	✓	✓
SD	Chills	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Eye pain	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling abnormal	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Hypersomnia	✓	✓	✓
SD	Malaise	✓	✓	✓
SD	Nasal congestion	✓	✓	✓
SD	Oropharyngeal pain	✓	✓	✓
SD	Pain	✓	✓	✓
SD	Pyrexia	✓	✓	✓
SD	Respiratory tract congestion	✓	✓	✓
SD	Rhinorrhoea	✓	✓	✓
SD	SARS-CoV-2 test negative	✓	✓	✓
SD	Sinus disorder	✓	✓	✓
SD	Sinusitis	✓	✓	✓

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