5UC-30054-37211

4 vaccinations 13 coded responses 52 check-ins 12 free-text entries 1 call case

Sex: Female
Age at first dose: 51-55
ZIP prefix: 063 / CT
Registered: 2021-03-25

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

2021-03-24
Dose 1 — Moderna
2021-03-25
Registered in v-safe
2021-03-25
Survey response — days 1–6 daily, dose 1
MedDRA: Unevaluable event — Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness, Diarrhea, Rash, not including the immediate area around the injection site

Free text: My granddaughter broke out in hives after her nap. With me.. not sure why

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-03-26
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Site: Pain · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-27
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Diarrhea

Adult check-in
2021-03-28
Health check-in — days 1–6 daily, dose 1
Feeling: Good · None

Adult check-in
2021-03-29
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Fatigue or tiredness

Adult check-in
2021-03-30
Health check-in — days 1–6 daily, dose 1
Feeling: Good · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-03-31
Health check-in — day 7, dose 1
Feeling: Good · None

Adult check-in
2021-04-07
Health check-in — day 14, dose 1
Feeling: Good

Adult check-in
2021-04-14
Health check-in — day 21, dose 1
Feeling: Good

Adult check-in
2021-04-21
Dose 2 — Moderna
2021-04-21
Health check-in — day 0, dose 2
Feeling: Fair · None

Adult check-in
2021-04-22
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain, Redness, Swelling · Headache, Fatigue or tiredness

Adult check-in
2021-04-23
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Site: Pain · Headache, Fatigue or tiredness

Adult check-in
2021-04-24
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Muscle or body aches, Fatigue or tiredness

Adult check-in
2021-04-24
Pregnancy registry survey
Not pregnant at or since vaccination ·
2021-04-25
Health check-in — days 1–6 daily, dose 2
Feeling: Fair · Fatigue or tiredness

Adult check-in
2021-04-26
Survey response — days 1–6 daily, dose 2
MedDRA: Pre-existing disease — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: I think it's my normal stuff.not the shot

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-27
Survey response — days 1–6 daily, dose 2
MedDRA: Cough — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea · Be unable to do your normal daily activities

Free text: Coughing

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-04-28
Survey response — day 7, dose 2
MedDRA: Cough, Productive cough, Sinus congestion, Sneezing, Upper-airway cough syndrome — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness · Be unable to do your normal daily activities

Free text: Sinus's filled, post nasal drip, coughing and sneezing thick phlem

MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
2021-05-05
Health check-in — day 14, dose 2
Feeling: Good

Adult check-in
2021-05-12
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-05-19
Health check-in — day 28, dose 2
Feeling: Fair

Adult check-in
2021-05-26
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-06-02
Health check-in — day 42, dose 2
Feeling: Fair

Adult check-in
2021-07-23
Survey response — 3 months, dose 2
MedDRA: Dehydration, Diarrhoea, Flatulence, Nausea — Feeling: Fair · Be unable to do your normal daily activities

Free text: Diarrhea and dehydrated 4 days. Gassy. Nausea.. waiting on blood work done on tuesday

MedDRA releases: 2021-09,2024-11 · check-in free text available
2021-10-22
Health check-in — 6 months, dose 2
Feeling: Fair

Adult check-in
2022-04-23
Survey response — 12 months, dose 2
MedDRA: Office visit, Sinus disorder — Feeling: Poor · Get care from a doctor or other healthcare professional

Free text: Symptoms: Sinus issues.. dr scheduled a cat scan · Healthcare visit (other): Dr appt.

MedDRA releases: 2024-11 · check-in free text available
2022-04-23
Report sent to call center — 12 months, dose 2
Get care from a doctor or other healthcare professional

1 call case(s)
2022-04-26
Call 1 — Left Voicemail
2022-05-06
Dose 3 — Moderna
2022-05-06
Health check-in — day 0, dose 3
Feeling: Fair · Site: Pain · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-07
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-09
Survey response — days 1–6 daily, dose 3
MedDRA: Diabetic neuropathy — Feeling: Good · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Diabetes neuropathy

MedDRA releases: 2024-11 · check-in free text available
2022-05-10
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-11
Health check-in — days 1–6 daily, dose 3
Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-05-12
Survey response — days 1–6 daily, dose 3
MedDRA: Diabetes mellitus, Dizziness, Fatigue — Feeling: Fair · Headache, Joint pains, Muscle or body aches, Fatigue or tiredness

Free text: Diabetes.. very tired today...dizzy lightheaded

MedDRA releases: 2024-11 · check-in free text available
2022-05-13
Survey response — day 7, dose 3
MedDRA: Pre-existing disease — Feeling: Good

Free text: Just diabetic stuff

MedDRA releases: 2024-11 · check-in free text available
2022-05-20
Health check-in — day 14, dose 3
Feeling: Good

Adult check-in
2022-05-27
Survey response — day 21, dose 3
MedDRA: Cough, Rhinorrhoea, Sneezing — Feeling: Fair

Free text: Sneezing runny nose cough

MedDRA releases: 2024-11 · check-in free text available
2022-06-03
Health check-in — day 28, dose 3
Feeling: Fair

Adult check-in
2022-06-10
Health check-in — day 35, dose 3
Feeling: Fair

Adult check-in
2022-06-17
Health check-in — day 42, dose 3
Feeling: Good

Adult check-in
2022-08-05
Health check-in — 3 months, dose 3
Feeling: Good

Adult check-in
2022-10-18
Dose 4 — Moderna
2022-10-18
Health check-in — day 0, dose 4
Feeling: Good · None

Adult check-in
2022-10-19
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Site: Pain, Swelling · Headache, Fatigue or tiredness

Adult check-in
2022-10-20
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Site: Pain · Muscle or body aches

Adult check-in
2022-10-21
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2022-10-22
Health check-in — days 1–6 daily, dose 4
Feeling: Good · Muscle or body aches, Fatigue or tiredness

Adult check-in
2022-10-23
Health check-in — days 1–6 daily, dose 4
Feeling: Fair · Joint pains, Muscle or body aches, Fatigue or tiredness, Diarrhea

Adult check-in
2022-10-25
Health check-in — day 7, dose 4
Feeling: Good · Muscle or body aches, Diarrhea

Adult check-in
2022-11-01
Survey response — day 14, dose 4
MedDRA: Back pain, Headache, Malaise, Pain, Unevaluable event — Feeling: Fair · Be unable to do your normal daily activities

Free text: Sinuses, . Body hurts. Back hurts. Headache. Justover all not feeling well.

MedDRA releases: 2024-11 · check-in free text available
2022-11-08
Health check-in — day 21, dose 4
Feeling: Fair

Adult check-in
2022-11-17
Health check-in — day 28, dose 4
Feeling: Good

Adult check-in
2022-11-24
Survey response — day 35, dose 4
MedDRA: Headache — Feeling: Fair · Be unable to do your normal daily activities

Free text: Really bad headaches

MedDRA releases: 2024-11 · check-in free text available
2022-11-29
Health check-in — day 42, dose 4
Feeling: Fair

Adult check-in
2023-01-19
Health check-in — 3 months, dose 4
Feeling: Fair

Adult check-in
2023-04-18
Survey response — 6 months, dose 4
MedDRA: Injection site pain, Myalgia — Feeling: Fair · Be unable to do your normal daily activities

MedDRA releases: 2024-11

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-03-24	Moderna
2	2021-04-21	Moderna
3	2022-05-06	Moderna	No
4	2022-10-18	Moderna	No

Call center

1 call center case

1 unsuccessful

See the call center timeline

Free text

Release 6 — days 1–6 daily, dose 1

2021-03-25

Systemic reaction (other): My granddaughter broke out in hives after her nap. With me.. not sure why

Release 8 — days 1–6 daily, dose 2

2021-04-26

Systemic reaction (other): I think it's my normal stuff.not the shot

2021-04-27

Systemic reaction (other): Coughing

Release 8 — day 7, dose 2

2021-04-28

Systemic reaction (other): Sinus's filled, post nasal drip, coughing and sneezing thick phlem

Release 9 — 3 months, dose 2

2021-07-23

Symptoms: Diarrhea and dehydrated 4 days. Gassy. Nausea.. waiting on blood work done on tuesday

Release 11 — 12 months, dose 2

2022-04-23

Symptoms: Sinus issues.. dr scheduled a cat scan

Healthcare visit (other): Dr appt.

Release 11 — days 1–6 daily, dose 3

2022-05-09

Systemic reaction (other): Diabetes neuropathy

2022-05-12

Systemic reaction (other): Diabetes.. very tired today...dizzy lightheaded

Release 11 — day 7, dose 3

2022-05-13

Systemic reaction (other): Just diabetic stuff

Release 11 — day 21, dose 3

2022-05-27

Symptoms: Sneezing runny nose cough

Release 12 — day 14, dose 4

2022-11-01

Symptoms: Sinuses, . Body hurts. Back hurts. Headache. Justover all not feeling well.

Release 12 — day 35, dose 4

2022-11-24

Symptoms: Really bad headaches

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	Back pain	·	·	✓
SD	Cough	·	·	✓
SD	Dehydration	✓	·	✓
SD	Diarrhoea	✓	·	✓
SD	Flatulence	✓	·	✓
SD	Headache	·	·	✓
SD	Injection site pain	·	·	✓
SD	Malaise	·	·	✓
SD	Myalgia	·	·	✓
SD	Nausea	✓	·	✓
SD	Pain	·	·	✓
SD	Rhinorrhoea	·	·	✓
SD	Sinus disorder	·	·	✓
SD	Sneezing	·	·	✓
SD	Unevaluable event	·	·	✓
SRO	Cough	✓	✓	✓
SRO	Diabetes mellitus	·	·	✓
SRO	Diabetic neuropathy	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Fatigue	·	·	✓
SRO	Pre-existing disease	✓	✓	✓
SRO	Productive cough	✓	✓	✓
SRO	Sinus congestion	✓	✓	✓
SRO	Sneezing	✓	✓	✓
SRO	Unevaluable event	✓	✓	✓
SRO	Upper-airway cough syndrome	✓	✓	✓

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