5U8-97203-18923

4 vaccinations 18 coded responses 42 check-ins 15 free-text entries 4 call cases

Sex: Female
Age at first dose: 66+
ZIP prefix: 847 / UT
Registered: 2021-02-05

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

2021-02-02
Dose 1 — Moderna
2021-02-05
Registered in v-safe
2021-02-05
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-06
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-07
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-02-08
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-02-09
Survey response — day 7, dose 1
MedDRA: Asthenopia, Vision blurred — Feeling: Good · Fatigue or tiredness

Free text: Blurry vision; eye strain

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-16
Survey response — day 14, dose 1
MedDRA: Arthralgia, Fatigue, Feeling hot, Myalgia, Rash — Feeling: Good · Be unable to do your normal daily activities

Free text: Rash, feeling hot and feverish, but Temp was 94.6. Also tired and muscle aches and joint pain.

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-02-23
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-03-02
Health check-in — day 28, dose 1
Feeling: Good

Adult check-in
2021-03-08
Dose 2 — Moderna
2021-03-09
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: 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
2021-03-10
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Pain, Swelling, Itching · Fever · Chills, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-11
Survey response — days 1–6 daily, dose 2
MedDRA: Eye irritation — Feeling: Good · Site: Redness, Swelling, Itching · Fever · Headache, Muscle or body aches

Free text: Eyes : burning

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-12
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Fever · Chills, Joint pains, Muscle or body aches

Adult check-in
2021-03-13
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-14
Health check-in — days 1–6 daily, dose 2
Feeling: Good · Site: Redness, Itching · Joint pains, Abdominal pain

Adult check-in
2021-03-15
Survey response — day 7, dose 2
MedDRA: Cough — Feeling: Good · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Free text: Cough

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-22
Survey response — day 14, dose 2
MedDRA: Erythema, Pruritus, Rash, Self-medication, Swelling — Feeling: Good

Free text: Rash remained several more days. Redness, swelling, itching. Took 1 capsule Benedryl daily for two days Showers helped. Rash is now gone

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-29
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-04-05
Survey response — day 28, dose 2
MedDRA: Arthralgia, Arthritis, Pre-existing disease — Feeling: Good · Be unable to do your normal daily activities

Free text: Joint pain right shoulder. Have had longtime arthritis in shoulder, but pain seems worse, especially as I use it for reaching and lifting

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-12
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-04-19
Survey response — day 42, dose 2
MedDRA: Diarrhoea, Sinus congestion — Feeling: Fair

Free text: Sinus congestion; diarrheaMay not be related to Covid

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-07
Survey response — 3 months, dose 2
MedDRA: Joint injury, Unevaluable event — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Symptoms: Knee injury · Healthcare visit (other): X-ray

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-07
Report sent to call center — 3 months, dose 2
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-06
Survey response — 6 months, dose 2
MedDRA: Cough, Nasal congestion — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Coughing that was hard to stop; nasal congestion.

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-09-06
Report sent to call center — 6 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-09-07
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2021-09-07
Call successful
Not applicable (accidental reporting or does not believe symptoms are related to vaccine)
2021-11-04
Dose 3 — Moderna
2021-11-11
Health check-in — day 7, dose 3
Feeling: Fair · Site: Redness, Swelling, Itching · Fever · Headache, Fatigue or tiredness, Rash, not including the immediate area around the injection site

Adult check-in
2021-11-18
Survey response — day 14, dose 3
MedDRA: Headache, Vision blurred — Feeling: Fair

Free text: Headache: blurred vision

MedDRA releases: 2024-11 · check-in free text available
2021-11-25
Survey response — day 21, dose 3
MedDRA: Fatigue, Feeling hot, Pyrexia — Feeling: Fair

Free text: Tiredness, feeling hot and feverish,

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2021-12-09
Survey response — day 35, dose 3
MedDRA: Headache, Ocular discomfort, Pyrexia — Feeling: Fair · Be unable to do your normal daily activities

Free text: Feel feverish, headache, eyes feel congested

MedDRA releases: 2024-11 · check-in free text available
2021-12-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-02-08
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-12-08
Dose 4 — Moderna
2022-12-09
Health check-in — days 1–6 daily, dose 4
Feeling: Poor · Fever · Chills, Joint pains, Muscle or body aches · Be unable to do your normal daily activities

Adult check-in
2022-12-10
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Fatigue or tiredness

Adult check-in
2022-12-11
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-12-12
Survey response — days 1–6 daily, dose 4
MedDRA: Sinus congestion — Feeling: Good · Fatigue or tiredness

Free text: Sinus congestion

MedDRA releases: 2024-11 · check-in free text available
2022-12-13
Survey response — days 1–6 daily, dose 4
MedDRA: Sinus congestion — Feeling: Good

Free text: Sinus congestion

MedDRA releases: 2024-11 · check-in free text available
2022-12-14
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Itching · Fever · Chills, Joint pains

Adult check-in
2022-12-17
Survey response — day 7, dose 4
MedDRA: Epistaxis — Feeling: Good · Fever · Joint pains, Fatigue or tiredness, Rash, not including the immediate area around the injection site · Be unable to do your normal daily activities

Free text: Nosebleed

MedDRA releases: 2024-11 · check-in free text available
2022-12-22
Health check-in — day 14, dose 4
Feeling: Good

Adult check-in
2022-12-29
Health check-in — day 21, dose 4
Feeling: Good

Adult check-in
2023-01-05
Survey response — day 28, dose 4
MedDRA: Arthralgia, Epistaxis — Feeling: Good

MedDRA releases: 2024-11
2023-01-14
Health check-in — day 35, dose 4
Feeling: Good

Adult check-in
2023-01-19
Survey response — day 42, dose 4
MedDRA: Emergency care, Epistaxis, Office visit — Feeling: Good · Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Emergency room or emergency department visit

MedDRA releases: 2024-11
2023-01-19
Report sent to call center — day 42, dose 4
Be unable to do your normal daily activities · Get care from a doctor or other healthcare professional

Emergency room or emergency department visit · 1 call case(s)
2023-01-20
Call 1 — Could Not Reach Participant
2023-01-25
Call successful
Not applicable – Participant does not believe symptoms are related to vaccine and does not wish to fill
2023-03-09
Survey response — 3 months, dose 4
MedDRA: Conjunctivitis — Feeling: Good · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

MedDRA releases: 2024-11
2023-03-09
Report sent to call center — 3 months, dose 4
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2023-03-10
Call 1 — Could Not Reach Participant
2023-03-15
Call 2 — Requested Callback
2023-03-17
Call 3 — Could Not Reach Participant
2023-03-17
Callback requested for
11:00AM ET

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-02-02	Moderna
2	2021-03-08	Moderna
3	2021-11-04	Moderna	No
4	2022-12-08	Moderna	No

Call center

4 call center cases

3 successful · 1 unsuccessful

See the call center timeline

Free text

Release 3 — day 7, dose 1

2021-02-09

Systemic reaction (other): Blurry vision; eye strain

Release 4 — day 14, dose 1

2021-02-16

Symptoms: Rash, feeling hot and feverish, but Temp was 94.6. Also tired and muscle aches and joint pain.

Release 5 — days 1–6 daily, dose 2

2021-03-11

Systemic reaction (other): Eyes : burning

Release 5 — day 7, dose 2

2021-03-15

Systemic reaction (other): Cough

Release 6 — day 14, dose 2

2021-03-22

Symptoms: Rash remained several more days. Redness, swelling, itching. Took 1 capsule Benedryl daily for two days Showers helped. Rash is now gone

Release 6 — day 28, dose 2

2021-04-05

Symptoms: Joint pain right shoulder. Have had longtime arthritis in shoulder, but pain seems worse, especially as I use it for reaching and lifting

Release 7 — day 42, dose 2

2021-04-19

Symptoms: Sinus congestion; diarrheaMay not be related to Covid

Release 8 — 3 months, dose 2

2021-06-07

Symptoms: Knee injury

Healthcare visit (other): X-ray

Release 9 — 6 months, dose 2

2021-09-06

Symptoms: Coughing that was hard to stop; nasal congestion.

Release 10 — day 14, dose 3

2021-11-18

Symptoms: Headache: blurred vision

Release 10 — day 21, dose 3

2021-11-25

Symptoms: Tiredness, feeling hot and feverish,

Release 10 — day 35, dose 3

2021-12-09

Symptoms: Feel feverish, headache, eyes feel congested

Release 12 — days 1–6 daily, dose 4

2022-12-12

Systemic reaction (other): Sinus congestion

2022-12-13

Systemic reaction (other): Sinus congestion

Release 12 — day 7, dose 4

2022-12-17

Systemic reaction (other): Nosebleed

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	Unevaluable event	✓	✓	✓
SD	Arthralgia	✓	✓	✓
SD	Arthritis	✓	✓	✓
SD	Conjunctivitis	·	·	✓
SD	Cough	✓	·	✓
SD	Diarrhoea	✓	✓	✓
SD	Emergency care	·	·	✓
SD	Epistaxis	·	·	✓
SD	Erythema	✓	✓	✓
SD	Fatigue	✓	✓	✓
SD	Feeling hot	✓	✓	✓
SD	Headache	·	·	✓
SD	Joint injury	✓	✓	✓
SD	Myalgia	✓	✓	✓
SD	Nasal congestion	✓	·	✓
SD	Ocular discomfort	·	·	✓
SD	Office visit	·	·	✓
SD	Pre-existing disease	✓	✓	✓
SD	Pruritus	✓	✓	✓
SD	Pyrexia	·	·	✓
SD	Rash	✓	✓	✓
SD	Self-medication	✓	✓	✓
SD	Sinus congestion	✓	✓	✓
SD	Swelling	✓	✓	✓
SD	Vision blurred	·	·	✓
SRO	Asthenopia	✓	✓	✓
SRO	Cough	✓	✓	✓
SRO	Epistaxis	·	·	✓
SRO	Eye irritation	✓	✓	✓
SRO	Sinus congestion	·	·	✓
SRO	Vision blurred	✓	✓	✓

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