5UB-18816-35107

3 vaccinations 12 coded responses 36 check-ins 12 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 327 / FL
Registered: 2021-04-06

Relationship: Self
Race: White
Ethnicity: Hispanic or Latino

Timeline

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

2021-04-06
Registered in v-safe
2021-04-06
Dose 1 — Moderna
2021-04-06
Health check-in — day 0, dose 1
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Adult check-in
2021-04-07
Survey response — days 1–6 daily, dose 1
MedDRA: Feeling abnormal — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to work

Free text: Brain fog

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-09
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Poor · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I had to get a tetanus shot yesterday, not sure if it is interfering with my covid-19 vaccine

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-10
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-11
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-12
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-04-13
Survey response — day 7, dose 1
MedDRA: Axillary pain — Feeling: Fair · Muscle or body aches

Free text: Ache in the armpit of the shot arm

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-20
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-27
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-05-04
Dose 2 — Moderna
2021-05-04
Health check-in — day 0, dose 2
Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness · Be unable to work or attend school

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

Adult check-in
2021-05-06
Survey response — days 1–6 daily, dose 2
MedDRA: Menstrual disorder — Feeling: Fair · Site: Pain, Swelling · Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea, Abdominal pain · Be unable to work

Free text: My period started the evening after I received the shot, seven days early. I am on the birth control pill, my period has never come early for the 18 years I have been on the pill, so I am very certain it is has been a side effect

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-07
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain, Breast pain — Feeling: Fair · Muscle or body aches, Fatigue or tiredness, Diarrhea

Free text: Pain in left armpit near my breast

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-08
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain — Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Free text: Pain in armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-10
Survey response — days 1–6 daily, dose 2
MedDRA: Axillary pain — Feeling: Good

Free text: Still have slight pain in armpit

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-11
Health check-in — day 7, dose 2
Feeling: Good · None

Adult check-in
2021-05-18
Survey response — day 14, dose 2
MedDRA: Dyspnoea — Feeling: Fair · Be unable to work

Free text: Felt out of breath yesterday

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-27
Health check-in — day 21, dose 2
Feeling: Good

Adult check-in
2021-06-03
Health check-in — day 28, dose 2
Feeling: Good

Adult check-in
2021-06-08
Health check-in — day 35, dose 2
Feeling: Good

Adult check-in
2021-06-17
Survey response — day 42, dose 2
MedDRA: Heart rate increased, Hypertension — Feeling: Fair · Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: High heart rate, high blood pressure

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-06-17
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2021-06-24
Call 1 — Left Voicemail
2021-08-04
Health check-in — 3 months, dose 2
Feeling: Good

Adult check-in
2021-11-02
Health check-in — 6 months, dose 2
Feeling: Good

Adult check-in
2021-12-14
Dose 3 — Moderna
2021-12-14
Health check-in — day 0, dose 3
Feeling: Good · None

Adult check-in
2021-12-15
Health check-in — days 1–6 daily, dose 3
Feeling: Poor · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea, Abdominal pain · Be unable to work or attend school, Be unable to do your normal daily activities

Adult check-in
2021-12-17
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain, Back pain, Pain in extremity — Feeling: Fair · Site: Pain, Swelling · Fever · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Pain in my armpit, pain in my mud back and down my leg on the side of the injection

MedDRA releases: 2024-11 · check-in free text available
2021-12-19
Survey response — days 1–6 daily, dose 3
MedDRA: Axillary pain — Feeling: Fair · Headache, Fatigue or tiredness, Diarrhea, Abdominal pain

Free text: Some pain still in the armpit on the side of injection

MedDRA releases: 2024-11 · check-in free text available
2021-12-20
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Fatigue or tiredness

Adult check-in
2021-12-21
Health check-in — day 7, dose 3
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-12-30
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-01-04
Health check-in — day 21, dose 3
Feeling: Good

Adult check-in
2022-01-11
Health check-in — day 28, dose 3
Feeling: Good

Adult check-in
2022-01-19
Health check-in — day 35, dose 3
Feeling: Good

Adult check-in
2022-01-25
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-03-15
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-12-15
Survey response — 12 months, dose 3
MedDRA: Breast cancer, Office visit, Surgery — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional

Free text: Symptoms: Diagnosed with breast cancer April 2022 · Healthcare visit (other): Doctor visits, surgery, and cancer treatment

MedDRA releases: 2024-11 · check-in free text available
2022-12-15
Report sent to call center — 12 months, dose 3
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

1 call case(s)
2022-12-16
Call 2 — Left Voicemail
2022-12-16
Call 1 — Left Voicemail

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-04-06	Moderna
2	2021-05-04	Moderna
3	2021-12-14	Moderna	No

Call center

2 call center cases

2 unsuccessful

See the call center timeline

Free text

Release 7 — days 1–6 daily, dose 1

2021-04-07

Systemic reaction (other): Brain fog

2021-04-09

Systemic reaction (other): I had to get a tetanus shot yesterday, not sure if it is interfering with my covid-19 vaccine

Release 7 — day 7, dose 1

2021-04-13

Systemic reaction (other): Ache in the armpit of the shot arm

Release 8 — days 1–6 daily, dose 2

2021-05-06

Systemic reaction (other): My period started the evening after I received the shot, seven days early. I am on the birth control pill, my period has never come early for the 18 years I have been on the pill, so I am very certain it is has been a side effect

2021-05-07

Systemic reaction (other): Pain in left armpit near my breast

2021-05-08

Systemic reaction (other): Pain in armpit

2021-05-10

Systemic reaction (other): Still have slight pain in armpit

Release 8 — day 14, dose 2

2021-05-18

Symptoms: Felt out of breath yesterday

Release 9 — day 42, dose 2

2021-06-17

Symptoms: High heart rate, high blood pressure

Release 10 — days 1–6 daily, dose 3

2021-12-17

Systemic reaction (other): Pain in my armpit, pain in my mud back and down my leg on the side of the injection

2021-12-19

Systemic reaction (other): Some pain still in the armpit on the side of injection

Release 12 — 12 months, dose 3

2022-12-15

Symptoms: Diagnosed with breast cancer April 2022

Healthcare visit (other): Doctor visits, surgery, and cancer treatment

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	Surgery	·	·	✓
SD	Breast cancer	·	·	✓
SD	Dyspnoea	✓	✓	✓
SD	Heart rate increased	✓	✓	✓
SD	Hypertension	✓	✓	✓
SRO	Axillary pain	✓	✓	✓
SRO	Back pain	·	·	✓
SRO	Breast pain	✓	✓	✓
SRO	Feeling abnormal	✓	✓	✓
SRO	Menstrual disorder	✓	✓	✓
SRO	Pain in extremity	·	·	✓
SRO	Unevaluable event	✓	✓	✓

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