5U8-75971-47840

3 vaccinations 14 coded responses 22 check-ins 14 free-text entries 1 call case

Sex: Female
Age at first dose: 56-60
ZIP prefix: 960 / CA
Registered: 2021-02-03

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

Timeline

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

2021-02-03
Registered in v-safe
2021-02-03
Dose 1 — Moderna
2021-02-03
Health check-in — day 0, dose 1
Feeling: Good · None

Adult check-in
2021-02-04
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness — Feeling: Good · Site: Pain · Fever

Free text: Slight dizziness / light headed ness when I woke up

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-10
Health check-in — day 7, dose 1
Feeling: Good · Joint pains, Muscle or body aches, Diarrhea

Adult check-in
2021-02-18
Survey response — day 14, dose 1
MedDRA: Headache, Influenza, Pain, Peripheral swelling — Feeling: Good

Free text: Headache, mild flu like symptoms, swelling of my foot & localized pain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-28
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-03
Dose 2 — Moderna
2021-03-03
Health check-in — day 0, dose 2
Feeling: Good · None

Adult check-in
2021-03-04
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Dyspnoea, Tremor — Feeling: Poor · Site: Pain, Swelling · Fever · Chills, Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work, Be unable to do your normal daily activities

Free text: Tremors, light shortness of breath, dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-05
Survey response — days 1–6 daily, dose 2
MedDRA: Dry eye, Pruritus, Pyrexia — Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work, Be unable to do your normal daily activities

Free text: Dry eyes, itchiness, consistent fever +- 102

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-06
Survey response — days 1–6 daily, dose 2
MedDRA: Abnormal dreams, Dry eye, Oral herpes — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Cold sore developing, dry eyes, strange dreams,

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-07
Survey response — days 1–6 daily, dose 2
MedDRA: Dizziness, Insomnia, Oral herpes — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to work, Be unable to do your normal daily activities

Free text: Continuation of the post injection cold sore (like the one post first injection), sleeplessness, slight dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-10
Survey response — day 7, dose 2
MedDRA: Dry eye, Photophobia — Feeling: Good · Site: Pain, Itching · 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: Dry eyes, developing sensitivity to light

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-18
Survey response — day 14, dose 2
MedDRA: Arthralgia, Chest pain, Cough, Lethargy, Myalgia — Feeling: Good · Be unable to work, Be unable to do your normal daily activities

Free text: Still lethargic, continuing pain in upper left chest with cough, joint pain and muscle soreness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-25
Survey response — day 21, dose 2
MedDRA: Chest pain, Cough, Dizziness, Fatigue, Productive cough — Feeling: Fair · Be unable to do your normal daily activities

Free text: Daily Increase of chest pain and exhaustion, serious cough and increased phlegm, some dizziness

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Survey response — day 28, dose 2
MedDRA: Chest pain, Dysgeusia, Fatigue, Loss of personal independence in daily activities, Middle insomnia, Office visit, Productive cough — 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: Same symptoms as last by week, pain in chest getting worse, waking up 2-3x a night, huge amounts of phlegm and iron tasting sputum, absolutely exhausted after 4 hours of working around house. · Healthcare visit (other): In person but MD is a quack

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-31
Report sent to call center — day 28, 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)
2021-04-17
Health check-in — day 42, dose 2
Feeling: Good

Adult check-in
2021-06-02
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-09-01
Dose 3 — Moderna
2021-09-01
Survey response — 6 months, dose 2
MedDRA: Dyspnoea — Feeling: Fair

Free text: Minor shortness of breath

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-12-01
Survey response — 3 months, dose 3
MedDRA: Arthralgia, Impaired work ability, Insomnia, Neck pain — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Extreme pain in and around my left shoulder and neck since receiving the 3rd shot, sometimes preventing me from doing work, sitting for prolonged periods, and sleeping. Strong pain meds barely put a damper on it.

MedDRA releases: 2024-11 · check-in free text available
2022-03-02
Survey response — 6 months, dose 3
MedDRA: Arthralgia, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Muscle soreness and the continuing deep tissue pain in the shoulder I received alll 3 injections in. It is deep and painful

MedDRA releases: 2024-11 · check-in free text available
2022-03-18
Call 1 — Left Voicemail
2022-09-01
Survey response — 12 months, dose 3
MedDRA: Myalgia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Extreme pain in left trapezius (shoulder) muscle & adjacent neck area

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

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-03	Moderna
2	2021-03-03	Moderna
3	2021-09-01	Moderna	No

Call center

1 call center case

1 unsuccessful

1 wait over 3 months for a first call

See the call center timeline

Free text

Release 3 — days 1–6 daily, dose 1

2021-02-04

Systemic reaction (other): Slight dizziness / light headed ness when I woke up

Release 4 — day 14, dose 1

2021-02-18

Symptoms: Headache, mild flu like symptoms, swelling of my foot & localized pain

Release 5 — days 1–6 daily, dose 2

2021-03-04

Systemic reaction (other): Tremors, light shortness of breath, dizziness

2021-03-05

Systemic reaction (other): Dry eyes, itchiness, consistent fever +- 102

2021-03-06

Systemic reaction (other): Cold sore developing, dry eyes, strange dreams,

2021-03-07

Systemic reaction (other): Continuation of the post injection cold sore (like the one post first injection), sleeplessness, slight dizziness

Release 5 — day 7, dose 2

2021-03-10

Systemic reaction (other): Dry eyes, developing sensitivity to light

Release 5 — day 14, dose 2

2021-03-18

Symptoms: Still lethargic, continuing pain in upper left chest with cough, joint pain and muscle soreness

Release 6 — day 21, dose 2

2021-03-25

Symptoms: Daily Increase of chest pain and exhaustion, serious cough and increased phlegm, some dizziness

Release 6 — day 28, dose 2

2021-03-31

Symptoms: Same symptoms as last by week, pain in chest getting worse, waking up 2-3x a night, huge amounts of phlegm and iron tasting sputum, absolutely exhausted after 4 hours of working around house.

Healthcare visit (other): In person but MD is a quack

Release 9 — 6 months, dose 2

2021-09-01

Symptoms: Minor shortness of breath

Release 10 — 3 months, dose 3

2021-12-01

Symptoms: Extreme pain in and around my left shoulder and neck since receiving the 3rd shot, sometimes preventing me from doing work, sitting for prolonged periods, and sleeping. Strong pain meds barely put a damper on it.

Release 11 — 6 months, dose 3

2022-03-02

Symptoms: Muscle soreness and the continuing deep tissue pain in the shoulder I received alll 3 injections in. It is deep and painful

Release 12 — 12 months, dose 3

2022-09-01

Symptoms: Extreme pain in left trapezius (shoulder) muscle & adjacent neck area

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	Arthralgia	✓	✓	✓
SD	Chest pain	✓	✓	✓
SD	Cough	✓	✓	✓
SD	Dizziness	✓	✓	✓
SD	Dysgeusia	✓	✓	✓
SD	Dyspnoea	✓	·	✓
SD	Fatigue	✓	✓	✓
SD	Headache	✓	✓	✓
SD	Impaired work ability	·	·	✓
SD	Influenza	✓	✓	✓
SD	Insomnia	·	·	✓
SD	Lethargy	✓	✓	✓
SD	Loss of personal independence in daily activities	✓	✓	✓
SD	Middle insomnia	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Neck pain	·	·	✓
SD	Pain	✓	✓	✓
SD	Peripheral swelling	✓	✓	✓
SD	Productive cough	✓	✓	✓
SRO	Abnormal dreams	✓	✓	✓
SRO	Dizziness	✓	✓	✓
SRO	Dry eye	✓	✓	✓
SRO	Dyspnoea	✓	✓	✓
SRO	Insomnia	✓	✓	✓
SRO	Oral herpes	✓	✓	✓
SRO	Photophobia	✓	✓	✓
SRO	Pruritus	✓	✓	✓
SRO	Pyrexia	✓	✓	✓
SRO	Tremor	✓	✓	✓

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