5S4-64643-05753

2 vaccinations 5 coded responses 23 check-ins 5 free-text entries 0 call cases

Sex: Female
Age at first dose: 36-40
ZIP prefix: 958 / CA
Registered: 2021-04-14

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline Vaccinations Free text MedDRA terms

Timeline

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

2021-04-14
Registered in v-safe
2021-04-14
Dose 1 — Moderna
2021-04-14
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-04-15
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain, Swelling · Fever · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-16
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2021-04-17
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Site: Pain · Joint pains · Be unable to do your normal daily activities

Adult check-in
2021-04-20
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-21
Health check-in — day 7, dose 1
Feeling: Poor · Fever · Chills, Muscle or body aches, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-04-28
Survey response — day 14, dose 1
MedDRA: Abdominal discomfort, Malaise, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: My stomach hasnt been feeling well. Nausea and the feeling like my god isnt going down and digesting.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-12
Dose 2 — Moderna
2021-05-12
Health check-in — day 0, dose 2
Feeling: Good · Site: Pain · None

Adult check-in
2021-05-13
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Adult check-in
2021-05-14
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Adult check-in
2021-05-15
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Sharp pains in the chest off and on, but currently off.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-16
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Swelling · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-17
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Abdominal pain · Be unable to do your normal daily activities

Adult check-in
2021-05-18
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches

Adult check-in
2021-05-19
Health check-in — day 7, dose 2
Feeling: Good · Headache

Adult check-in
2021-05-26
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-09
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-16
Survey response — day 35, dose 2
MedDRA: Dyspnoea, Musculoskeletal chest pain, Pre-existing disease — Feeling: Poor · Be unable to do your normal daily activities

Free text: I already have COPD but for over a week now its been harder to breathe and I keep getting a sharp pain (extremely painful) in the left side of my ribs that comes and goes several times a day.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-23
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-11-10
Survey response — 6 months, dose 2
MedDRA: Decreased appetite, Dizziness — Feeling: Fair · Be unable to do your normal daily activities

Free text: Dizziness even while sitting and laying down. Lack of appetite.

MedDRA releases: 2024-11 · check-in free text available
2022-05-12
Survey response — 12 months, dose 2
MedDRA: Dyspnoea, Hypoaesthesia, Unevaluable event — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: I contacted civic at the end of January and am still experiencing extremely difficult breathing. Strange numbness of my left toe.

MedDRA releases: 2024-11 · check-in free text available

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-14	Moderna
2	2021-05-12	Moderna

Free text

Release 8 — day 14, dose 1

2021-04-28

Symptoms: My stomach hasnt been feeling well. Nausea and the feeling like my god isnt going down and digesting.

Release 8 — days 1–6 daily, dose 2

2021-05-15

Systemic reaction (other): Sharp pains in the chest off and on, but currently off.

Release 9 — day 35, dose 2

2021-06-16

Symptoms: I already have COPD but for over a week now its been harder to breathe and I keep getting a sharp pain (extremely painful) in the left side of my ribs that comes and goes several times a day.

Release 10 — 6 months, dose 2

2021-11-10

Symptoms: Dizziness even while sitting and laying down. Lack of appetite.

Release 11 — 12 months, dose 2

2022-05-12

Symptoms: I contacted civic at the end of January and am still experiencing extremely difficult breathing. Strange numbness of my left toe.

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	Decreased appetite	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Hypoaesthesia	·	·	✓
SD	Malaise	✓	✓	✓
SD	Musculoskeletal chest pain	✓	✓	✓
SD	Nausea	✓	✓	✓
SD	Pre-existing disease	✓	✓	✓
SD	Unevaluable event	·	·	✓
SRO	Chest pain	✓	✓	✓

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